General Surgery Resident Burnout Prevalence at 69% !

Posted by Dike Drummond MD

resident-physician-burnout-prevalence-study-OPT-150.jpgGeneral Surgery Resident Burnout Survey shows prevalence of 69%

A just released study in the Journal of the American College of Surgeons surveyed all 258 US General Surgery Residency Programs  - and all 1224 residents - for the presence of burnout symptoms. 

  • 665 residents actively engaged in clinical training had data for analysis
  • 69% of those met the criterion for burnout on at least one subscale of the Maslach Burnout Inventory.

Is anyone actually surprised at this number?

The threat of burnout is part of the fabric of the resident experience - especially for surgeons.

Here we have the best and brightest, in the midst of the conditioning of our medical education -- before their careers have even officially launched -- and nearly 70% are already suffering from burnout. And this is AFTER WORK HOUR RESTRICTIONS have been put into place!

People ask me all the time if work hour restrictions have made a difference. My answer is they have actually increased physician burnout, especially for newly graduated residents as they enter a workplace without those same hourly restrictions. It may make things slightly easier for the resident while they are in training, but that same resident is not prepared for the time commitment of private practice when they graduate.

What work hour restrictions cannot do is remove the conditioning of our medical education. Only the faculty can recognize and mitigate for the four horsemen

I guess there is some perverse logic to the "trial by fire" nature of the program. Giving them a taste scoop of physician burnout now ... is work hardening for when they are out in their practice after all.

I am not surprised by the numbers. Every surgeon I have ever spoken to knows this story by heart ... because they all lived it ... each and every one.

Does this sound familiar?

Your chief resident is getting ready to leave the hospital. You are staying behind, in houts and on call overnight. Your chief turns to you as they push through the exit door to head to their care and says,

"Give me a call if you need any backup, but just remember A CALL TO ME IS A SIGN OF _______________"

You know exactly what fills in that blank every time and it is NOT A JOKE !

That message is just a fraction of the dysfunctional conditioning surgeons receive in their training.

  • It is a subtle form of hazing
  • I am certain it has caused avoidable patient deaths in teaching hospitals for decades
  • It has traumatized generations of surgeons in ways that set them up for burnout when they are out in practice
  • It drives home a blind spot in all surgeons around their own stress levels and prevents them from asking for help and support even when they desperately need it.

If we are going to keep studying prevalence, the next study needs to look at the faculty of the same General Surgery Residencies. 

My suspicion is that the rates will be very similar. 

Whenever I do burnout prevention trainings or retreats at medical schools and residency programs, the people who are most reliably absent are the faculty. They conveniently excuse themselves from the program because it is actually "just for the residents. Unfortunately, when I am with the residents they always have specific faculty members in mind when they plead, "Just give me the tools so I don't end up like [insert burned out faculty member's name here]."

I am convinced the resident's burnout rates will mirror those of the faculty. I have yet to see a surgery residency that has a functioning burnout prevention training. And in most cases the residents are actively working strategies to get around work hour restrictions so they can do more cases.

Here are the top three physician burnout preventing resources we recommend:

  1. Build life balance and maintain your interests outside medicine with the Schedule HACK
  2. Hard wire an Off Switch on your role of "doctor" with the Boundary Ritual
  3. Learn to be the Eye of the Storm with One Minute Mindfulness training


Here is the study online:

National Survey of Burnout among US General Surgery Residents

Leisha C. Elmore, Donna B. Jeffe, Linda Jin, Michael M. Awad, Isaiah R. Turnbull
Publication stage: In Press Accepted Manuscript
 Published online: May 27 2016


Are you surprised at this finding?
What do you think can be done to prevent physician burnout in today's surgical residents?