Surgeons as Educators A Guide for Academic Development and Teaching Excellence

(Ben Green) #1

© Springer International Publishing AG 2018 489
T.S. Köhler, B. Schwartz (eds.), Surgeons as Educators,
https://doi.org/10.1007/978-3-319-64728-9_25


Resident Physician Burnout: Improving


the Wellness of Surgical Trainees


Laura M. Douglass and Amanda C. North


What Is Burnout?


Burnout is a syndrome characterized by emotional exhaustion, depersonalization,
and a sense of decreased personal accomplishment specific to the workplace [ 1 ].
Considered the gold standard measure of burnout and the most commonly referenced
measure of burnout in the medical literature, The Maslach Burnout Inventory (MBI)
is a reproducible and validated 22-item survey evaluating the three components of
burnout [ 2 ]. Emotional exhaustion is the extent to which a person feels emotionally
overextended (nine items). Depersonalization is the degree to which a person feels
detached toward or cynical about patients (five items). Personal accomplishment is
the level of pride or satisfaction with one’s achievements (eight items). Each item is
scored on a 7-point Likert scale. Physicians with an emotional exhaustion score of
27 or higher or depersonalization score of 10 or higher are considered to have at
least one manifestation of burnout [ 1 , 2 ].


Who Is Burned Out?


Physicians as a whole are burned out at higher rates than population-matched
controls in the United States [ 3 ]. While attending surgeons report a 40% burnout
rate in a survey of 7905 members of the American College of Surgeons [ 4 ], Pulcrano
et al. found that surgical residents are particularly vulnerable and are more likely to
be burned out and report poor quality of life (QOL) than attending surgeons [ 5 ].
Throughout the entire medical training process, residency training appears to have
the highest risk for burnout. Dyrbye et  al. found that burnout, high


L.M. Douglass • A.C. North, MD (*)
Montefiore Medical Center, Bronx, NY, USA
e-mail: [email protected]


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