Orthopaedic Resident Burnout: A Literature Review on Vulnerability, Risk Factors, Consequences and Management Strategies

Abstract

Introduction: Orthopaedic surgery is physically demanding. Surgeons may have to work long unpredictable hours especially during residency training. This arduous task comes with the risk of burnout leading to negative repercussions to the surgeon and the patient. In view of strategising peer support, we intend to review the literature and analyse whether orthopaedic resident burnout is a global issue. We also intend to derive common strategies to tackle burnout at individual and organisational levels. Materials and Methods: A literature search was carried out in the databases including PubMed, Scopus, SciELO, and Google Scholar to shortlist studies dealing with orthopaedic residency and related burnout. Those studies that used the Maslach Burnout Inventory (MBI) for quantifying burnout were collectively interpreted. Other studies were reviewed to analyse the vulnerability, risk factors, consequences and management strategies related to burnout. Results: Among a total of 72 titles shortlisted, eight studies independently reported burnout among orthopaedic surgery residents/trainees and used MBI as a tool for assessing burnout. Based on the three subscales of MBI, 37.2% had high degree of emotional exhaustion (EE), 48% had high degree of depersonalisation (DP) and 33.1% perceived low personal accomplishment. This signifies the high prevalence of burnout among orthopaedic residents/trainees. Conclusion: Burnout among orthopaedic surgery residents seems to be a universal problem. Risk factors could be multifactorial, influenced by clinical competency and work-home environment. This can be tackled at the individual level by being aware of burnout syndrome, involving in adequate physical activity and spending quality social time; and at the organisational level by duty hour limitation, professional appreciation and mentorship programme.

An assessment of burnout in New Zealand orthopaedic resident medical officers

“…Personal strategies to combat burnout include spending time with partners, children and extended family and friends, as well as maintaining a social life outside work and maintaining physical fitness. 8,9,12,21 A strong and positive maintenance of relationships with colleagues was deemed particularly important. 12 On an institutional level, limiting work hours to fewer than 80, providing senior support when required and providing mentorship programmes have been shown to decrease levels of burnout in registrar populations.…”

“…[1][2][3][4][5] Recently, there has been a growing concern for the wellbeing of the junior workforce, due to a number of changes in the working environment. [6][7][8][9][10][11][12] These changes include an increased need for service provision, less teaching time, a diminished opportunity to progress through a chosen career pathway and a general increase in the number of patients (with increasing amounts of significant comorbidities), all potentially leading to a greater manifestation of occupational burnout. [6][7][8][9][10][11][12] The consequences of burnout are far reaching, affecting all levels of healthcare.…”

“…[6][7][8][9][10][11][12] These changes include an increased need for service provision, less teaching time, a diminished opportunity to progress through a chosen career pathway and a general increase in the number of patients (with increasing amounts of significant comorbidities), all potentially leading to a greater manifestation of occupational burnout. [6][7][8][9][10][11][12] The consequences of burnout are far reaching, affecting all levels of healthcare. Adverse effects to doctors include increased rates of suicidal ideation and drug abuse, as well as health concerns such as hypertension, anxiety, depression, headaches and other cardiovascular disease.…”

“…This is detrimental to their personal health and overall job satisfaction, and compromises patient care and safety. 6,7,[9][10][11][12] The phenomenon of burnout among orthopaedic scheme trainees has been extensively studied and documented in other first world countries that share a similar demand of excellence from their doctors. [6][7][8][10][11][12]17,18 To our knowledge, there is currently no published study analysing the rates of burnout among New Zealand orthopaedic registrars.…”

“…6,7,[9][10][11][12] The phenomenon of burnout among orthopaedic scheme trainees has been extensively studied and documented in other first world countries that share a similar demand of excellence from their doctors. [6][7][8][10][11][12]17,18 To our knowledge, there is currently no published study analysing the rates of burnout among New Zealand orthopaedic registrars. The aim of this study was to assess the rates of New Zealand orthopaedic registrar burnout, both at a trainee and non-trainee level.…”