M. L. Williford1, S. Scarlet1, M. Meyers1, S. Meltzer-Brody2, C. Goettler3, J. Green4, A. Hildreth5, T. Clancy6, D. Luckett7, T. M. Farrell1 7University Of North Carolina At Chapel Hill,Public Health,Chapel Hill, NC, USA 1University Of North Carolina At Chapel Hill,Surgery,Chapel Hill, NC, USA 2University Of North Carolina At Chapel Hill,Psychiatry,Chapel Hill, NC, USA 3East Carolina University Brody School Of Medicine,Surgery,Greenville, NC, USA 4Carolinas Medical Center,Surgery,Charlotte, NC, USA 5Wake Forest University School Of Medicine,Surgery,Winston-Salem, NC, USA 6New Hanover Regional Medical Center,Surgery,Wilmington, NC, USA
Introduction:
The delivery of high value health care requires that health care providers be healthy themselves. Despite robust prevalence data for burnout and depression among physicians as a whole, relatively little is known about how these conditions are perceived within the surgical community. The aims of this study were twofold. First, this study aimed to establish the prevalence of burnout and depression among surgery trainees using validated methods. Second, this study aimed to characterize how resident and attending surgeons perceived burnout and depression, and to identify potential causative factors and barriers to seeking care that were amenable to change.
Methods:
All resident and attending surgeons practicing at the 6 General Surgery training programs in North Carolina were identified as potential subjects. Anonymous electronic surveys were created for each cohort, and were collected from November 2016 to March 2017. The resident survey utilized validated tools to characterize the risk of burnout (Maslach Burnout Inventory or MBI) and depression (Patient Health Questionnaire or PHQ-9). The attending survey focused on the attending perception of resident burnout. Both surveys included questions regarding potential causative factors of burnout and depression.
Results:
The response rate for the resident survey was 58% (n=92). According to the MBI, 75% of residents were at high risk of burnout. According to the PHQ-9, 40% of residents were at moderate to severe risk of depression. Burnout was significantly associated with an increase in PHQ-9 score (p<0.001). Nine residents (12%) acknowledged suicidal ideation in the past 2 weeks, compared to a national average of 3%. All residents acknowledging suicidal ideation scored at high risk for burnout and depression.
The majority of residents (53%) correctly estimated that greater than half of residents were experiencing burnout, but only 18% estimated the true prevalence quartile. The majority of attendings (61%) believed that less than half of residents were experiencing burnout, and only one attending estimated the true prevalence quartile. The majority of attendings (75%) and residents (51%) underestimated the percentage of residents at moderate to severe risk of depression.
Ninety percent of residents and attendings identified the same top 3 factors contributing to burnout: inability to take time off to seek treatment, avoidance or denial of the problem, and negative stigma toward those seeking care.
Conclusion:
The prevalence of burnout, depression, and suicidality among surgery residents is markedly elevated which is consistent with previous studies. Both residents and attendings identify the same causative factors of burnout. However, both cohorts underestimate the true prevalence of resident burnout and depression which may hinder wellness interventions. A greater understanding of these perceptions offers an opportunity for education and the development of concrete solutions.