Trainee perspective of the causes of stress and burnout in surgical training: a qualitative study from Wales

Abstract

ObjectivesStress and burn-out among surgical trainees has been reported most prevalent in core surgical trainees (CST) and female trainees in particular. This study aimed to identify factors perceived by CSTs to be associated with stress and burnout in those at risk.DesignAn open-ended questionnaire was distributed to 79 CSTs and two researchers categorised responses independently, according to Michie’s model of workplace stress.SettingA UK regional postgraduate medical region (Wales).ParticipantsSixty-three responses were received; 42 males, 21 females. The response rate was 79.7%.ResultsInter-rater reliability was good (k=0.792 (79.2%), p<0.001). The most common theme of Michie’s model related to CST stress and burnout was career development, with most statements associated with curriculum, examination and academic demands required to attain a CST certificate of completion of training, and higher surgical national training number appointment. This was closely followed by those intrinsic to the job with recurrent discussion around the difficulties balancing work perceived to be service provision (ward work and on-calls), outpatient clinic and operative experience. Conversely, the most common themes relevant to stress and burnout among female trainees were associated with relationships at work (primarily the male-dominated nature of surgery), extraorganisational factors (family–work life balance) and individual characteristics (personality and physiological differences).ConclusionCSTs’ perceptions regarding the causes of National Health Service related stress and burnout are numerous, and these findings provide a basis for the development of targeted stressor counter-measures to improve training and well-being.

Use of the Maslach Burnout Inventory Among Public Health Care Professionals: Protocol for a Scoping Review

“…The main characteristics of burnout syndrome are emotional exhaustion, resulting in fatigue; depersonalization, associated with negative behaviors and cynicism in work relationships; and low scores in personal accomplishment, with feelings of incompetence and low productivity [12][13][14]. Individuals with burnout syndrome see work as a source of misery and unpleasurable [3], leading to high employee turnover, work absenteeism, decreased quantity and quality of work, and increased occupational accidents, thereby representing institutional consequences [15,16].…”

Recommendations for improving the working conditions and cultures of distressed junior doctors, based on a qualitative study and stakeholder perspectives

“…5 Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK. 6 Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK. 7 University of Exeter, Exeter EX4 4PY, UK.…”

“…Doctors are vulnerable to burnout [1][2][3][4][5][6], anxiety and depression [7][8][9], and, in several countries, increased suicide rates [10][11][12][13][14]. Junior doctors face additional stressors as they move from being students to qualified doctors, including the transition from study to work [13], role uncertainty [5,6,13,15], low pay relative to their years of training [15], poor leadership or lack of support [5,16,17], contract concerns [5], assessment and training requirements [6], a potentially toxic working environment [17], frequent rotations and -in recent times -COVID-19-related redeployment [18]. It is, therefore, perhaps unsurprising that junior doctors are vulnerable to mental ill-health and burnout [19].…”

Are there differences in cardiothoracic surgery performed by trainees versus fully trained surgeons?

“…There is an increasing demand to decrease the training time in the operating room. This includes a reduction of overall training years, adherence to working hour restrictions, a maintainance of a work‐life balance, 5 an increasing percentage of trainees who may wish to take time out of training to start a family, 6,7 and recently the impact of the COVID‐19 pandemic on training programs 8…”

“…There is an increasing demand to decrease the training time in the operating room. This includes a reduction of overall training years, adherence to working hour restrictions, a maintainance of a work-life balance, 5 an increasing percentage of trainees who may wish to take time out of training to start a family, 6,7 and recently the impact of the COVID-19 pandemic on training programs. 8 Training programs differ as to their goals in different centers across The purpose of this review is to evaluate all published literature on all adult cardiothoracic and congenital cardiac surgery cases performed by trainee surgeons (TS) and the patient outcomes (differences in morbidity and mortality) when compared to cases undertaken by fully trained surgeons (FTS).…”