Academic versus non-academic neurosurgeons in China: a national cross-sectional study on workload, burnout and engagement

Abstract

ObjectivesChinese neurosurgery has made great progress during the past decades; yet, little is known about the working status of neurosurgeons. This study aimed to evaluate the difference between academic and non-academic neurosurgeons, focusing on their professional burnout, job satisfaction and work engagement.DesignCross-sectional nationwide survey.Study settingThe survey was conducted in China between 2017 and 2018.ParticipantsA total number of 823 academic neurosurgeons and 379 non-academic neurosurgeons participated in this study.Outcome measuresProfessional burnout, job satisfaction and work engagement were assessed using the Maslach Burnout Inventory, the Job Descriptive Index and the Utrecht Work Engagement Scale, respectively.ResultsThe majority of respondents were male (92.93%), less than 45 years old (85.27%) and married (79.53%). Chinese neurosurgeons worked 63.91±11.04 hours per week, and approximately 45% experienced burnout. Compared with non-academic respondents, academic neurosurgeons had longer working hours (p<0.01), higher income (p<0.01) and were less willing to get married (p<0.01). In addition, they showed a lower degree of burnout (p<0.01), a higher level of job satisfaction (p<0.01) and were more enthusiastic at work (p=0.015). Multivariate regression analyses indicated that divorced (OR 7.02, 95% CI 2.37 to 15.08) and workplace violence (OR 1.52, 95% CI 1.18 to 2.24) were associated with burnout for both academic and non-academic respondents. Long working hours (≥71 hours per week) and low annual income (<1 00 000 RMB) were risk factors for burnout among academic neurosurgeons. For non-academic neurosurgical surgeons (age 36–45 years), working as attending doctors, serving in public hospitals and having the first house-living child were all closely related to the incidence of burnout.ConclusionChinese neurosurgeons are under significant stress particularly for the non-academic neurosurgeons. Offering better opportunities for training, promotion, higher income and safer working environments could be solutions to relieve burnout and improve career satisfaction and engagement.Trial registration numberChiCTR1800014762. This article is not linked to a clinical trial.

Burnout Among Neurosurgeons and Residents in Neurosurgery: A Systematic Review and Meta-Analysis of the Literature

“… 12 2019 US Residents 31% 427 141 (33) 324 99 NA Yu et al. 13 2019 China Neurosurgeons and residents 16% 1202 535 (44.5) 1117 85 34.32 …”

“…Five of the studies included obtained 6 stars, 5 , 9 , 10 , 11 , 12 whereas 1 study gathered 5 stars. 13 …”

“…In contrast, certain characteristics of neurosurgical practice correlate with the development of BS, especially work-life imbalance, residents' duties, provision of emergency services, and weekly workload. 13 , 22 Interestingly enough, a recent Chinese study published by Yu et al. 13 found that academic neurosurgeons have a significantly low ( P < 0.01) rate of burnout even if they have to work a long hours; this could be explained by the high sense of personal accomplishment, and possibly by the high salaries ( P < 0.01).…”

“… 13 , 22 Interestingly enough, a recent Chinese study published by Yu et al. 13 found that academic neurosurgeons have a significantly low ( P < 0.01) rate of burnout even if they have to work a long hours; this could be explained by the high sense of personal accomplishment, and possibly by the high salaries ( P < 0.01). 13 …”

“… 22 Personal characteristics do not appear to have as much influence on burnout as the characteristics of employment, in both neurosurgeons and neurosurgical residents. 13 …”