Burnout amongst neurosurgical trainees in the UK and Ireland

Abstract

Introduction Burnout is becoming an increasingly recognised phenomenon within the medical profession. This study aims to investigate the presence of burnout amongst neurosurgical trainees in the UK and Ireland as well as investigating potential exacerbating and protective factors. Method An online survey was sent to all neurosurgical trainees in the UK and Ireland via the British Neurosurgical Trainees’ Association (BNTA) mailing list. Responding participants anonymously completed the Copenhagen Burnout Inventory (CBI) and answered questions about known risk factors for burnout including workplace environment, workplace bullying, time spent on leisure activities and sleep and reported likelihood of leaving neurosurgery. We also collated data on responders’ demographics. We compared CBI scores for participants with and without risk factors to determine correlation with CBI. Results There were 75 respondents (response rate 42%) from a range of ages and all training grades, 72% of whom were male. The median CBI score was 38.85 (IQR 17.76). Participants showed a higher degree of personal and workplace burnout (median CBIs of 47.02, IQR 25.00; and 49.14, IQR 19.64, respectively) compared with patient-related burnout (median CBI 18.67, IQR 25.00). Participants with the following self-reported risk factors were significantly more likely to have higher CBIs: workplace bullying (p = 0.01), getting on less well with colleagues (p < 0.05), working longer hours (p < 0.05) and insufficient sleep, exercise and leisure time (all p < 0.01). Those with higher CBI scores were more likely to consider leaving neurosurgical training (p = 0.01). Conclusion We identified a high burnout incidence in a cohort representative of UK neurosurgical trainees, although our results may have been skewed somewhat by selection bias. We determined potential risk factors for burnout related to specific workplace stressors and time for non-work activities. In the future, changes to training curricula should address these issues, aiming to improve training, enhance patient care and reduce attrition rates.

Resident Burnout and Well‐being in Otolaryngology and Other Surgical Specialties: Strategies for Change

“…Hours worked 49,80,83 High workload (United States and Canada) 37,49 Frequency of being on-call 49 PGY-2 10,52 Inadequate operating time 10,[36][37][38] Lack of independence 37 Workplace violence/bullying 51,80,83 Stressful work relationships 83 Feeling underappreciated 37 Coresident attrition 37 Unstable work routine 37,52 Lack of work-life balance 36,52 Lack of sleep 80,83 Lack of leisure time 37,83 Insufficient exercise 83 Divorced 80 Stressful social relationships 10,38,84,85 Mentorship 10,36,38 Operative caseload 49 End of rotation/year 52 Wellness education, exercise program 68 Program-led social events, outdoor activities 52 Meaningful relationships with colleagues 52 Adequate sleep 52 Marriage and/or children 84 Grit 84 Strong sense of purpose 52 Urology Hours worked 39,<...…”

A Scoping Review of Professionalism in Neurosurgery

“…There were 51 total articles dedicated to burnout and wellness. 67-117 The concept of burnout and wellness arguably first appears in the neurosurgical literature in a study by Cusimano et al 67 in 1999 that examined attrition rates within Canadian neurosurgery residency programs. The first use of the term “burnout” appears in the neurosurgical literature in a survey study by Klimo et al in 2013.…”

“…68 There were a total of 23 burnout-related surveys identified and 4 systematic reviews. 67,68,70,74,75,77,79,82,[86][87][88][89][90]92,93,[96][97][98][99][100]102,103,107,[109][110][111][112][113] Five articles published since 2020 specifically studied burnout related to work during the COVID-19 era. 97,98,100,112,113 Four articles were preintervention and postintervention studies that examined wellness programs, exercise, and mindfulness in residency training.…”

Reliability and validity support for an abbreviated Copenhagen burnout inventory using exploratory and confirmatory factor analysis

“… 13 , 14 , 15 , 16 The CBI has been applied extensively to physicians. 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 Despite widespread international use in measuring burnout among physicians, the CBI has been used infrequently to measure burnout among emergency physicians in the United States. 37 , 38 …”

“…The CBI has been used to assess varied types of health care personnel in several countries, amassing substantial validity evidence 13–16 . The CBI has been applied extensively to physicians 17–36 . Despite widespread international use in measuring burnout among physicians, the CBI has been used infrequently to measure burnout among emergency physicians in the United States 37–38 …”