Occupational stress and burnout among young surgeons: a review

Authors

  • Dhivakar S. Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  • Ankit Rai Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  • Harindra Sandhu Department of General Surgery, LLRM Meerut, Uttar Pradesh, India
  • Asish Das Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  • Ram Prasad Subedi Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  • Kamireddy Madana Raghava Reddy Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20230342

Keywords:

COVID-19, Burnout, Surgical residency, Pandemic, Surgeon

Abstract

A surgeon's lifestyle is a multifaceted commitment that revolves around their workplace, physical, personal, emotional, and communal domains. Surgical training programs are competitive and challenging to match and provide a sense of gratification among medical school trainees. But they also report a much higher level of burnout when compared to their peers from other specialities. Workplace burnout has been a scorching issue since the COVID pandemic broke out in 2019. We did this review to understand the factors leading to workplace burnout, identify any East-West differences, and find possible solutions. We also tried to find the role of COVID-19 in worsening occupational stress among surgeons. We searched the PubMed and SCOPUS databases for studies between January 2000 to January 2022 on burnout, well-being, wellness, and practice improvement among surgeons. The search included studies on COVID-19 that were available either as full-text papers or abstracts. Burnout has affected younger surgeons owing to loss of professional control, inefficient work-life balance, administrative burdens, medico-legal problems, and the competitive nature of the job and tiresome training programs. Burnout is more common in South-Asian countries. Workplace stressors, including long hours and difficult interactions with co-workers, are linked to greater levels of burnout. The COVID-19 pandemic has only made matters worse.

References

McCray LW, Cronholm PF, Bogner HR, Gallo JJ, Neill RA. Resident physician burnout: is there hope? Fam Med. 2008;40(9):626-32.

Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136(5):358-67.

Gifford E, Galante J, Kaji AH, Nguyen V, Nelson MT. Factors associated with general surgery residents' desire to leave residency programs: a multi-institutional study. JAMA Surg. 2014;149(9):948-53.

Guest RS, Baser R, Li Y, Scardino PT, Brown AE. Cancer surgeons' distress and well-being, I: the tension between a culture of productivity and the need for self-care. Ann Surg Oncol. 2011;18(5):1229-35.

Shanafelt TD, Balch CM, Bechamps GJ, Russell T, Dyrbye L. Burnout and career satisfaction among American surgeons. Ann Surg. 2009;250(3):463-71.

Dyrbye LN, Shanafelt TD, Balch CM, Satele D, Sloan J. Relationship between work-home conflicts and burnout among American surgeons: a comparison by sex. Arch Surg. 2011;146(2):211-7.

Shanafelt TD, Balch CM, Dyrbye L, Bechamps G, Russell T et al. Special report: suicidal ideation among American surgeons. Arch Surg. 2011;146(1):54-62.

Shanafelt TD, Balch CM, Bechamps G, Russell T, Dyrbye L, et al. Burnout and medical errors among American surgeons. Ann Surg. 2010;251(6):995-1000.

Prentice S, Dorstyn D, Benson J, Elliott T. Burnout Levels and Patterns in Postgraduate Medical Trainees: A Systematic Review and Meta-Analysis. Acad Med. 2020;95(9):1444-54.

Gandhi K, Sahni N, Padhy SK, Mathew PJ. Comparison of stress and burnout among anesthesia and surgical residents in a tertiary care teaching hospital in North India. J Postgrad Med. 2018;64(3):145-9.

Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, et al. National Sleep Foundation's sleep time duration recommendations: methodology and results summary. Sleep Health. 2015;1(1):40-43.

Tomasko JM, Pauli EM, Kunselman AR, Haluck RS. Sleep deprivation increases cognitive workload during simulated surgical tasks. Am J Surg. 2012;203(1):37-43.

Elmore LC, Jeffe DB, Jin L, Awad MM, Turnbull IR. National Survey of Burnout among US General Surgery Residents. J Am Coll Surg. 2016;223(3):440-51.

Balch CM, Shanafelt TD, Sloan JA, Satele DV, Freischlag JA. Distress and career satisfaction among 14 surgical specialties, comparing academic and private practice settings. Ann Surg. 2011;254(4):558-68.

Smeds MR, Janko MR, Allen S, Amankwah K, Arnell T, et al. Burnout and its relationship with perceived stress, self-efficacy, depression, social support, and programmatic factors in general surgery residents. Am J Surg. 2020;219(6):907-12.

Dyrbye LN, Burke SE, Hardeman RR. Association of Clinical Specialty with Symptoms of Burnout and Career Choice Regret Among US Resident Physicians. JAMA. 2018;320(11):1114-30.

Milam LA, Cohen GL, Mueller C, Salles A. The Relationship Between Self-Efficacy and Well-Being Among Surgical Residents. J Surg Educ. 2019;76(2):321-8.

Chaput B, Bertheuil N, Jacques J, Smilevitch D, Bekara F et al. Professional Burnout Among Plastic Surgery Residents: Can it be Prevented? Outcomes of a National Survey. Ann Plast Surg. 2015;75(1):2-8.

Chati R, Huet E, Grimberg L, Schwarz L, Tuech JJ, et al. Factors associated with burnout among French digestive surgeons in training: results of a national survey on 328 residents and fellows. Am J Surg. 2017;213(4):754-62.

Asante JO, Li MJ, Liao J, Huang YX, Hao YT. The relationship between psychosocial risk factors, burnout and quality of life among primary healthcare workers in rural Guangdong province: a cross-sectional study. BMC Health Serv Res. 2019;19(1):447.

Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D. Changes in Burnout and Satisfaction with Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. Mayo Clin Proc. 2015;90(12):1600-13.

Thommasen HV, Lavanchy M, Connelly I, Berkowitz J, Grzybowski S. Mental health, job satisfaction, and intention to relocate. Opinions of physicians in rural British Columbia. Can Fam Physician. 2001;47:737-44.

Galam E, Komly V, Le Tourneur A, Jund J. Burnout among French GPs in training: a cross-sectional study. Br J Gen Pract. 2013;63(608):e217-24.

Xiao Y, Wang J, Chen S, Wu Z, Cai J. Psychological distress, burnout level and job satisfaction in emergency medicine: A cross-sectional study of physicians in China. Emerg Med Australas. 2014;26(6):538-42.

Kumar S. Burnout and Doctors: Prevalence, Prevention and Intervention. Healthcare (Basel). 2016;4(3):37.

Olsen OK, Pallesen S, Torsheim T, Espevik R. The effect of sleep deprivation on leadership behaviour in military officers: an experimental study. J Sleep Res. 2016;25(6):683-9.

Buysse DJ. Sleep health: can we define it? Does it matter? Sleep. 2014;37(1):9-17.

Guest RS, Baser R, Li Y, Scardino PT, Brown AE et al. Cancer surgeons' distress and well-being, I: the tension between a culture of productivity and the need for self-care. Ann Surg Oncol. 2011;18(5):1229-35.

Sanches I, Teixeira F, dos Santos JM, Ferreira AJ. Effects of Acute Sleep Deprivation Resulting from Night Shift Work on Young Doctors. Acta Med Port. 2015;28(4):457-62.

Goldstein AN, Walker MP. The role of sleep-in emotional brain function. Annu Rev Clin Psychol 2014;10:679-708.

St-Onge MP, Mikic A, Pietrolungo CE. Effects of Diet on Sleep Quality. Adv Nutr. 2016;7(5):938-49.

McCue JD. The effects of stress on physicians and their medical practice. N Engl J Med. 1982;306(8):458-63.

Resident Services Committee, Association of Program Directors in Internal Medicine. Stress and impairment during residency training: strategies for reduction, identification, and management. Ann Intern Med. 1988;109:154-61.

Tokarz JP, Bremer W, Peters K, Pfifferling JH, Viner J. Beyond Survival. Chicago: Am Med Asso. 1979.

Angres DH, Busch KA. The chemically dependent physician: clinical and legal considerations. New Dir Ment Health Serv. 1989;(41):21-32.

Morse RM, Martin MA, Swenson WM, Niven RG. Prognosis of physicians treated for alcoholism and drug dependence. JAMA. 1984;251(6):743-6.

Thomas NK. Resident burnout. JAMA. 2004;292(23):2880-9.

Tawfik DS, Profit J, Morgenthaler TI, Satele DV, Sinsky CA. Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical Errors. Mayo Clin Proc. 2018;93(11):1571-80.

O'Donnell EP, Humeniuk KM, West CP, Tilburt JC. The effects of fatigue and dissatisfaction on how physicians perceive their social responsibilities. Mayo Clin Proc. 2015;90(2):194-201.

Center C, Davis M, Detre T, Ford DE, Hansbrough W. Confronting depression and suicide in physicians: a consensus statement. JAMA. 2003;289(23):3161-6.

Maslach C, Jackson S. The measurement of experienced burnout. J Occup Behav. 1981;2:99-113.

Medscape National Physician Burnout and Suicide Report 2020. Available at: https://www.medscape.com/slideshow/2020-lifestyle-burnout-6012460. Accessed on December 25, 2022.

Peckham C. Medscape Survey Lifestyle Report 2016: Bias and Burnout. Available at: http://www.medscape.com/features/slideshow/lifestyle/2016/general-surgery. Accessed on December 25, 2022.

Khasne RW, Dhakulkar BS, Mahajan HC, Kulkarni AP. Burnout among Healthcare Workers during COVID-19 Pandemic in India: Results of a Questionnaire-based Survey. Indian J Crit Care Med. 2020;24(8):664-71.

Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, et al. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun. 2020;88:901-7.

Al-Ghunaim TA, Johnson J, Biyani CS, O'Connor D. Psychological and occupational impact of the COVID-19 pandemic on UK surgeons: a qualitative investigation. BMJ Open. 2021;11(4):e045699.

Jessop ZM, Dobbs TD, Ali SR, Combellack E, Clancy R. Personal protective equipment for surgeons during COVID-19 pandemic: a systematic review of availability, usage, and rationing. Br J Surg. 2020;107(10):1262-80.

Coleman JR, Abdelsattar JM, Glocker RJ; RAS-ACS COVID-19 Task Force. COVID-19 Pandemic and the Lived Experience of Surgical Residents, Fellows, and Early-Career Surgeons in the American College of Surgeons. J Am Coll Surg. 2021;232(2):119-35.

Aziz H, James T, Remulla D, Sher L, Genyk Y. Effect of COVID-19 on Surgical Training Across the United States: A National Survey of General Surgery Residents. J Surg Educ. 2021;78(2):431-9.

Downloads

Published

2023-02-14

How to Cite

Dhivakar S., Rai, A., Sandhu, H., Das, A., Subedi, R. P., & Reddy, K. M. R. (2023). Occupational stress and burnout among young surgeons: a review. International Journal of Research in Medical Sciences, 11(3), 1050–1055. https://doi.org/10.18203/2320-6012.ijrms20230342

Issue

Section

Review Articles