C. R. Coverley1, J. Tieman1, M. Chang1, D. Cole1, O. Osuchukwu1, T. S. Riall1 1Banner University Medical Center – Tucson – Banner Health,Surgery,Tucson, AZ, USA
Introduction: Burnout poses a significant threat to the surgical workforce and has been shown to affect surgeons-in-training. In studies assessing burnout in residents, surgeons, and physicians, physicians are classified as “burned out” if they meet criteria on any one subscale of the Maslach Burnout Inventory (MBI) – Emotional Exhaustion (EE), Depersonalization (DP), or Personal Accomplishment (PA). These criteria have been criticized as potentially over representing true burnout. Our goal was to evaluate resident burnout based on these criteria and to correlate these with other measures of life satisfaction and wellbeing.
Methods: In 2016 we instituted the Energy Leadership Resiliency and Wellbeing Program as part of the formal training experience for our general surgery residents. We compared residents who met the criteria for burnout in one or more of three subscales of the MBI with resident-reported satisfaction in 14 different areas of life as measured by the validated Energy Leadership Index (ELI). These areas were: Financial Success, Leadership, Work Relationships, Family Relationships, Intimate Relationships, Engagement at Work, Personal Freedom, Communication, Productivity, Time Management, Work-Life Balance, Health and Wellness, Energy Level, and Spiritual Satisfaction. We then compared satisfaction in the 14 areas in residents who did or did not meet criteria on one, two, or all three subscales.
Results: Forty-three surgical residents, 30.2% female and 69.8% male, completed the MBI and ELI. 53.5% of our residents met criteria for burnout on at least one subscale of the MBI; 41.9% met criteria on 2 subscales, and 7.0% met criteria on all 3 subscales. Our analysis demonstrated that residents who met the definition of burnout in one subscale had decreased satisfaction in almost all surveyed areas. They also had higher perceived stress levels, higher depression rates, and lower wellbeing overall as measured by the Physician Well Being Index (PWBI) (Table). The percent of residents Very Satisfied or Completely Satisfied in each area uniformly decreased as the number of burnout subscales that were positive increased.
Conclusion: Our hypothesis explored the possibility that traditional MBI measures may not take into account the multifaceted nature of a rigorous surgical training experience and may overestimate true burnout. The results of our analysis highlight the validity of the MBI as a measure for identifying residents who already are displaying symptoms of burnout and dissatisfaction in multiple areas of their lives. Identifying surgical residents at risk and reaching out through implementation of formal wellbeing programs will play a critical role in training a resilient, productive, and professionally satisfied surgical workforce.
