Burnout in Surgical Trainees: a Narrative Review of Trends, Contributors, Consequences and Possible Interventions

Abstract

Surgical disciplines are popular and training places are competitive to obtain, but trainees report higher levels of burnout than either their non-surgical peers or attending or consultant surgeons. In this review, we critically summarise evidence on trends and changes in burnout over the past decade, contributors to surgical trainee burnout, the personal and professional consequences of burnout and consider the evidence for interventions. There is no evidence for a linear increase in burnout levels in surgeons over the past decade but the impact of the COVID-19 pandemic has yet to be established and is likely to be significant. Working long hours and experiencing stressful interpersonal interactions at work are associated with higher burnout in trainees but feeling more supported by training programmes and receiving workplace supervision are associated with reduced burnout. Burnout is associated with poorer overall mental and physical well-being in surgical trainees and has also been linked with the delivery of less safe patient care in this group. Useful interventions could include mentorship and improving work conditions, but there is a need for more and higher quality studies.

Surgeon burnout, impact on patient safety and professionalism: A systematic review and meta-analysis

“…The present review extends these findings by reporting on these associations in surgeons specifically, which are a group known to report higher levels of burnout than other medical specialties 48 .…”

“…To date, the great majority of studies have been in high-income countries [54][55][56] , but these may not translate to other nations. Finally, a recent review has shown that surgical trainees are more burned out than their non-surgical counterparts 48 , therefore, healthcare providers ought to also explore how training programmes can be modified to help support trainees earlier in their careers.…”

How UK surgeons experience burnout and the link between burnout and patient care: A qualitative investigation

“…The mentality and mindset of pragmatic surgery professionals may be more compatible with an intervention approach that focuses on “what can be done” to deal with stress and burnout at work. 24 The findings from our study suggest interventions should be designed to be low-stigma as we found that surgeons were reluctant to talk about current burnout. Resilience-building training may therefore be less stigmatising than interventions promoted as “burnout support” interventions and more acceptable to surgeons.…”

“…23 Therefore, there is clearly a need for more and higherquality studies investigating burnout treatments in surgeons and surgical trainees. 24 The second question this study attempted to answer was: how does burnout affect the care that surgeons provide? These findings support studies that have found that burnout has a negative impact on patient satisfaction and surgical professionalism.…”

“… 23 Therefore, there is clearly a need for more and higher-quality studies investigating burnout treatments in surgeons and surgical trainees. 24 …”