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

Abstract

Objective To perform a literature review on burnout prevalence, factors that affect burnout and well-being, and solutions to address burnout in otolaryngology–head and neck surgery (OTO-HNS) residents and residents in other surgical specialties. Data Sources Ovid Medline, Embase, and article reference lists. Review Methods A literature search was performed to identify articles on resident burnout, distress, wellness, well-being, and quality of life. Articles deemed outside the scope of the current work were excluded. Search was limited to the past 5 years. Conclusions Moderate to high burnout has been reported in 35% to 86% of OTO-HNS residents. Among other surgical specialties, resident burnout ranges between 58% and 66% in plastics, 11% and 67% in neurosurgery, 38% and 68% in urology, and 31% and 56% in orthopedics. Highest burnout rates were seen in postgraduate year 2 residents. Factors significantly associated with burnout included hours worked (>80 h/wk), level of autonomy, exercise, and program support. Reported resident work hours have steadily increased: 8% of OTO-HNS residents in 2005 vs 26% in 2019 reported averaging >80 h/wk. Practical implications of resident burnout include decreased empathy, moral distress and injury, poor health, decreased quality of life, increased attrition, decreased desire to pursue fellowship, and increased likelihood of medical errors. Structured mentorship programs, wellness initiatives, and increased ancillary support have been associated with lower burnout rates and improvements in resident well-being across specialties. Implications for Practice Addressing burnout, which is prevalent in OTO-HNS residents, is critical to improving patient care and physician well-being. Surgical specialties can share strategies to effectively address resident burnout through institutional interventions, which can be essential quality improvement initiatives, to promote well-being.

Assessment of Sleep Features, Mental Health Outcomes, and Alcohol and Tobacco Consumption in Residents and Fellows in Otolaryngology Before and During the COVID-19 Pandemic

“…The proportion of depression found in European residents and fellows is higher than in most US studies. 2,3 Notably, the prevalence was higher in residents compared with fellows, which was observed in other studies. 12 It is well known that depressive symptoms may be associated with sleep disturbance, such as insomnia.…”

“…Pandemics may be associated with negative outcomes in the workload, stress, sleep and mental health status of health care workers. 2,9,10 Residents and fellows in surgical disciplines, such as otolaryngology-head and neck surgery, are particularly at risk regarding demanding, unpredictable workload, highstakes surgeries, and nights on call. 2,11 In this cohort study, we observed significant rates of depression and sleep disorders in residents and fellows, which have increased throughout the pandemic period.…”

“…munity, connectedness, and meaning. 2,18,19 More psychological follow-up and space and time to relax in hospitals are points that may improve the mental health of residents and fellows.…”

“…esidency and fellowship are stressful training periods associated with work hours, work-life balance, and the risk of burnout. 1 The impairment of the well-being of young physicians concerns 35% to 86% of young residents in US 2 and was associated with individual dysfunction, reduction of productivity, and quality of patient care. 2,3 A recent study 4 reported that the occurrence of mental health disorder and burnout in US residents in surgery may be associated with an increase of the consumption of tobacco and alcohol.…”

“…1 The impairment of the well-being of young physicians concerns 35% to 86% of young residents in US 2 and was associated with individual dysfunction, reduction of productivity, and quality of patient care. 2,3 A recent study 4 reported that the occurrence of mental health disorder and burnout in US residents in surgery may be associated with an increase of the consumption of tobacco and alcohol. During the COVID-19 pandemic, a US study 5 found that workload, stress, sleep disorders, and anxiety substantially increased in residents and fellows in otolaryngology-head and neck surgery (hereinafter, residents and fellows), especially those who worked in COVID-19 units.…”