Factors associated with burnout among US neurosurgery residents

A nationwide survey

Frank J. Attenello, Ian A. Buchanan, Timothy Wen, Daniel A. Donoho, Shirley McCartney, Steven Y. Cen, Alexander A. Khalessi, Aaron A. Cohen-Gadol, Joseph S. Cheng, William J. Mack, Clemens M. Schirmer, Karin R. Swartz, J. Adair Prall, Ann R. Stroink, Steven L. Giannotta, Paul Klimo

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: Excessive dissatisfaction and stress among physicians can precipitate burnout, which results in diminished productivity, quality of care, and patient satisfaction and treatment adherence. Given the multiplicity of its harms and detriments to workforce retention and in light of the growing physician shortage, burnout has garnered much attention in recent years. Using a national survey, the authors formally evaluated burnout among neurosurgery trainees. Methods: An 86-item questionnaire was disseminated to residents in the American Association of Neurological Surgeons database between June and November 2015. Questions evaluated personal and workplace stressors, mentorship, career satisfaction, and burnout. Burnout was assessed using the previously validated Maslach Burnout Inventory. Factors associated with burnout were determined using univariate and multivariate logistic regression. Results: The response rate with completed surveys was 21% (346/1643). The majority of residents were male (78%), 26-35 years old (92%), in a stable relationship (70%), and without children (73%). Respondents were equally distributed across all residency years. Eighty-one percent of residents were satisfied with their career choice, although 41% had at some point given serious thought to quitting. The overall burnout rate was 67%. In the multivariate analysis, notable factors associated with burnout included inadequate operating room exposure (OR 7.57, p = 0.011), hostile faculty (OR 4.07, p = 0.008), and social stressors outside of work (OR 4.52, p = 0.008). Meaningful mentorship was protective against burnout in the multivariate regression models (OR 0.338, p = 0.031). Conclusions: Rates of burnout and career satisfaction are paradoxically high among neurosurgery trainees. While several factors were predictive of burnout, including inadequate operative exposure and social stressors, meaningful mentorship proved to be protective against burnout. The documented negative effects of burnout on patient care and health care economics necessitate further studies for potential solutions to curb its rise.

Original languageEnglish (US)
Pages (from-to)1349-1363
Number of pages15
JournalJournal of neurosurgery
Volume129
Issue number5
DOIs
StatePublished - Nov 1 2018

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Neurosurgery
Mentors
Career Choice
Physicians
Quality of Health Care
Operating Rooms
Internship and Residency
Patient Satisfaction
Workplace
Patient Care
Multivariate Analysis
Logistic Models
Economics
Databases
Delivery of Health Care
Equipment and Supplies
Surveys and Questionnaires
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Attenello, F. J., Buchanan, I. A., Wen, T., Donoho, D. A., McCartney, S., Cen, S. Y., ... Klimo, P. (2018). Factors associated with burnout among US neurosurgery residents: A nationwide survey. Journal of neurosurgery, 129(5), 1349-1363. https://doi.org/10.3171/2017.9.JNS17996

Factors associated with burnout among US neurosurgery residents : A nationwide survey. / Attenello, Frank J.; Buchanan, Ian A.; Wen, Timothy; Donoho, Daniel A.; McCartney, Shirley; Cen, Steven Y.; Khalessi, Alexander A.; Cohen-Gadol, Aaron A.; Cheng, Joseph S.; Mack, William J.; Schirmer, Clemens M.; Swartz, Karin R.; Prall, J. Adair; Stroink, Ann R.; Giannotta, Steven L.; Klimo, Paul.

In: Journal of neurosurgery, Vol. 129, No. 5, 01.11.2018, p. 1349-1363.

Research output: Contribution to journalArticle

Attenello, FJ, Buchanan, IA, Wen, T, Donoho, DA, McCartney, S, Cen, SY, Khalessi, AA, Cohen-Gadol, AA, Cheng, JS, Mack, WJ, Schirmer, CM, Swartz, KR, Prall, JA, Stroink, AR, Giannotta, SL & Klimo, P 2018, 'Factors associated with burnout among US neurosurgery residents: A nationwide survey', Journal of neurosurgery, vol. 129, no. 5, pp. 1349-1363. https://doi.org/10.3171/2017.9.JNS17996
Attenello FJ, Buchanan IA, Wen T, Donoho DA, McCartney S, Cen SY et al. Factors associated with burnout among US neurosurgery residents: A nationwide survey. Journal of neurosurgery. 2018 Nov 1;129(5):1349-1363. https://doi.org/10.3171/2017.9.JNS17996
Attenello, Frank J. ; Buchanan, Ian A. ; Wen, Timothy ; Donoho, Daniel A. ; McCartney, Shirley ; Cen, Steven Y. ; Khalessi, Alexander A. ; Cohen-Gadol, Aaron A. ; Cheng, Joseph S. ; Mack, William J. ; Schirmer, Clemens M. ; Swartz, Karin R. ; Prall, J. Adair ; Stroink, Ann R. ; Giannotta, Steven L. ; Klimo, Paul. / Factors associated with burnout among US neurosurgery residents : A nationwide survey. In: Journal of neurosurgery. 2018 ; Vol. 129, No. 5. pp. 1349-1363.
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T2 - A nationwide survey

AU - Attenello, Frank J.

AU - Buchanan, Ian A.

AU - Wen, Timothy

AU - Donoho, Daniel A.

AU - McCartney, Shirley

AU - Cen, Steven Y.

AU - Khalessi, Alexander A.

AU - Cohen-Gadol, Aaron A.

AU - Cheng, Joseph S.

AU - Mack, William J.

AU - Schirmer, Clemens M.

AU - Swartz, Karin R.

AU - Prall, J. Adair

AU - Stroink, Ann R.

AU - Giannotta, Steven L.

AU - Klimo, Paul

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N2 - Objective: Excessive dissatisfaction and stress among physicians can precipitate burnout, which results in diminished productivity, quality of care, and patient satisfaction and treatment adherence. Given the multiplicity of its harms and detriments to workforce retention and in light of the growing physician shortage, burnout has garnered much attention in recent years. Using a national survey, the authors formally evaluated burnout among neurosurgery trainees. Methods: An 86-item questionnaire was disseminated to residents in the American Association of Neurological Surgeons database between June and November 2015. Questions evaluated personal and workplace stressors, mentorship, career satisfaction, and burnout. Burnout was assessed using the previously validated Maslach Burnout Inventory. Factors associated with burnout were determined using univariate and multivariate logistic regression. Results: The response rate with completed surveys was 21% (346/1643). The majority of residents were male (78%), 26-35 years old (92%), in a stable relationship (70%), and without children (73%). Respondents were equally distributed across all residency years. Eighty-one percent of residents were satisfied with their career choice, although 41% had at some point given serious thought to quitting. The overall burnout rate was 67%. In the multivariate analysis, notable factors associated with burnout included inadequate operating room exposure (OR 7.57, p = 0.011), hostile faculty (OR 4.07, p = 0.008), and social stressors outside of work (OR 4.52, p = 0.008). Meaningful mentorship was protective against burnout in the multivariate regression models (OR 0.338, p = 0.031). Conclusions: Rates of burnout and career satisfaction are paradoxically high among neurosurgery trainees. While several factors were predictive of burnout, including inadequate operative exposure and social stressors, meaningful mentorship proved to be protective against burnout. The documented negative effects of burnout on patient care and health care economics necessitate further studies for potential solutions to curb its rise.

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