Burnout Among Surgeons in the UK During the COVID-19 Pandemic: A Cohort Study

Jonathan Houdmont,Matt Stanislas,Kevin Sargen,Jenna Morgan,Sita Kotecha,Sandip Nandhra,Murali Shyamsundar,Hannah Byrne,Kit Lam,Frank Mcdermot,Rachel Hargest,Imeshi Wijetunga,Victor Babu,Charles Maxwell-Armstrong,Farah Roslan,Jim Tiernan,Michael Wilson,Joseph Shalhoub,Naveed Kara,Kizzie Peters,Theophilus Joachim,Lucinda Cruddas,Ian Chetter,Nilanjana Tewari,Adam Brooks,Daryll Baker,Jamil Ahmed,Marina Pitsika,Tony Thomas,Emmanouil Psaltis,Karl Trimble,Roshan Lal,Josh Burke,Lynda Wyld,Patrick O’Brien,Panchali Sarmah,Irwin Lasrado,Laura Parry,Dimitrios Karavias,George Mannu,Rebecca Winterborn,Hannah Cook,Gurminder Mann,Rachel Lee,Anisa Kushairi,Peter Vauhan,Imran Bhatti,Annie Joseph,Katherine Grant,James Coulston,Luke Wheldon,James Mccaslin,Mukul Dube,Prita Daliya,Elena Theophilidou,Katie E Rollins ,I J Beckingham ,Patricia A Thomas ,T O White ,Sarah E Miller ,Benjamin Kye Jyn Tan ,Andrew G Miller ,David L Bartlett ,Frank J M F Dor ,Chakradhar Reddy ,Sangara Narayanan Narayanasamy ,Richard Siqueira Dias ,Steven A White ,John S Hammond ,Giles J Toogood ,Steven S Brown ,Alfred Adiamah,Juliet Hassard,Dileep N Lobo,L W Young

doi:10.1007/s00268-021-06351-6

Abstract

BackgroundSurgeon burnout has implications for patient safety and workforce sustainability. The aim of this study was to establish the prevalence of burnout among surgeons in the UK during the COVID-19 pandemic.MethodsThis cross-sectional online survey was set in the UK National Health Service and involved 601 surgeons across the UK of all specialities and grades. Participants completed the Maslach Burnout Inventory and a bespoke questionnaire. Outcome measures included emotional exhaustion, depersonalisation and low personal accomplishment, as measured by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS).ResultsA total of 142 surgeons reported having contracted COVID-19. Burnout prevalence was particularly high in the emotional exhaustion (57%) and depersonalisation (50%) domains, while lower on the low personal accomplishment domain (15%). Burnout prevalence was unrelated to COVID-19 status; however, the greater the perceived impact of COVID-19 on work, the higher the prevalence of emotional exhaustion and depersonalisation. Degree of worry about contracting COVID-19 oneself and degree of worry about family and friends contacting COVID-19 was positively associated with prevalence on all three burnout domains. Across all three domains, burnout prevalence was exceptionally high in the Core Trainee 1–2 and Specialty Trainee 1–2 grades.ConclusionsThese findings highlight potential undesirable implications for patient safety arising from surgeon burnout. Moreover, there is a need for ongoing monitoring in addition to an enhanced focus on mental health self-care in surgeon training and the provision of accessible and confidential support for practising surgeons.

Highlights

The eleventh revision of the International Classification of Diseases (ICD-11) conceptualises burnout as an ‘occupational condition’ arising from chronic work-related stress, characterised by being emotionally over-extended and exhausted by one’s work, feelings of cynicism and loss of empathy, and a sense of low personal accomplishment with respect to one’s work.Physician burnout has been described as an ‘epidemic’ that affects patient safety, quality of care and patient satisfaction [1]
Degree of worry about contracting COVID-19 oneself and degree of worry about family and friends contacting COVID-19 was positively associated with prevalence on all three burnout domains
These findings highlight potential undesirable implications for patient safety arising from surgeon burnout

Summary

Introduction

The eleventh revision of the International Classification of Diseases (ICD-11) conceptualises burnout as an ‘occupational condition’ arising from chronic work-related stress, characterised by being emotionally over-extended and exhausted by one’s work (emotional exhaustion), feelings of cynicism and loss of empathy (depersonalisation), and a sense of low personal accomplishment with respect to one’s work.Physician burnout has been described as an ‘epidemic’ that affects patient safety, quality of care and patient satisfaction [1]. 8.9% reported concern that they had made a major medical error in the last 3 months, which had an adverse relationship with mental Quality of Life, all three domains of burnout and symptoms of depression. The aim of this study was to establish the prevalence of burnout among surgeons in the UK during the COVID-19 pandemic Methods This cross-sectional online survey was set in the UK National Health Service and involved 601 surgeons across the UK of all specialities and grades. Outcome measures included emotional exhaustion, depersonalisation and low personal accomplishment, as measured by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Burnout prevalence was high in the emotional exhaustion (57%) and depersonalisation (50%) domains, while lower on the low personal accomplishment domain (15%). Burnout prevalence was exceptionally high in the Core Trainee 1–2 and Specialty Trainee 1–2 grades

Objectives

Methods

Results

Conclusion