Burnout syndrome among southern region orthopedic surgeons, Saudi Arabia

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

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.

Perceptions of Neurosurgery among Medical Students and Interns: A National Cross-Sectional Study

Background: Neurosurgery is considered one of the most admired surgical specializations. Still, as evidenced by observations over the years, it is not amongst the top choices of medical students in Saudi Arabia. This study will help in understanding the perception and attitudes of medical students and interns toward the neurosurgery specialization, which will aid in developing strategies to increase the interest of undergraduates in neurosurgery specialization and bridge the human resource gap in this vital specialty. Objectives: This study aimed to assess perceptions, attitudes, and gender differences of medical students and interns toward neurosurgery. The influence of demographic factors on perceptions of neurosurgery of interns and senior medical students in Saudi Arabia was also investigated. Methodology: We conducted a cross-sectional study on a convenience sample of medical students (clinical years) and interns studying in different colleges of medicine in Saudi Arabia. A total of 1014 responses were included in this study (518 males and 496 females). The questionnaire comprised of two parts: the first part carried general descriptive questions, while the second part had 24-item Likert scale-based questions. Results: Around 40% of medical students and 26% of interns agreed or strongly agreed to the statement ‘I would consider a career in neurosurgery. Around 70% of both interns and students agreed or strongly agreed with the statement ‘Huge prestige is attached to neurosurgery’. The responses to the statement ‘Neurosurgery is a male specialty’ was significantly different between genders, as 36.5% of the male respondents agreed or strongly agreed with the statement while just 12.5% of the females responded likewise (p = 0.000). Only 23% of participants reported having completed a rotation in neurosurgery. About 44.7% of respondents were interested in taking an elective rotation in neurosurgery, while the remaining respondents (55.3%) responded with a negative answer. Only 23% of participants had completed an undergraduate rotation in neurosurgery. More males (65.3%) agreed or strongly agreed with the statement ‘Work as a neurosurgery specialist can impede family life as compared to females (57.5%), which was highly significant (p = 0.000). More medical students (45.1%) responded in the agreement or strong agreement in response to the statement’ Neurosurgery should be a compulsory rotation during internship’ as compared to interns (25.8%). Around 65% of the respondents agreed or strongly agreed that teachers/seniors have a great influence on students’ specialization choices. Around 67% of the respondents foresaw a purely clinical role for themselves after graduation, while 17% were interested in a clinical–academician role. Conclusions: The study reflected a generally positive attitude towards neurosurgery amongst medical students and interns. Interest in neurosurgery as a specialization can be strengthened by enhancing the exposure of students and interns to the specialty. Teachers and seniors can be useful influencers to motivate students to consider neurosurgery specialization.

The Prevalence of Burnout and Its Associated Factors Among Surgical Specialists in Kuwait Ministry of Health Hospitals

Background

Workplace burnout is a state of emotional exhaustion (EE), depersonalization of others (DP), and low personal accomplishment (PA) owing to workplace stressors. This study aimed to assess the prevalence of burnout and its associated factors among surgical specialists in Kuwait.

Methods

This cross-sectional study assessed the prevalence of burnout among 489 surgeons in practice at Kuwait Ministry of Health (MOH). Data were collected using a self-administered questionnaire. Burnout was assessed using the Maslach Burnout Inventory, which defines burnout as having a high score of EE or DP, or a low score of PA; with severe burnout involving all. The associations between burnout or severe burnout with sociodemographic and occupational characteristics were assessed using multivariate binary logistic regression to adjust for potential confounders.

Results

Prevalence estimates for burnout and severe burnout were 76.9% (95% Confidence Interval = 72.9–80.7%) and 14.0% (11.0–17.5%), respectively. The prevalence estimates for high EE, high DP, and low PA scores were 44.7, 43.1, and 47.2%, respectively. The prevalence of burnout and severe burnout was highest among neurosurgeons. Burnout was lowest among otolaryngology surgeons and severe burnout was lowest among cardiothoracic surgeons. After adjustment, burnout was associated with younger age, lower income, and more on-calls per month. The four most common sources of stress included less family time, verbal assault, case overload, and highly complicated cases.

Conclusion

The prevalence of burnout among surgeons in Kuwait MOH hospitals is high. Occupational health programs should use these findings to design and implement interventions that can treat and prevent burnout in this population.