Neurosurgery Resident Wellness and Recovery from Burnout: A 39-Year Single-Institution Experience

Abstract

Physician burnout in neurosurgery is highly prevalent and occurs most severely during residency. Although earlier assessments have identified stressors contributing to neurosurgery resident burnout, recovery interventions have not been studied extensively. We aimed to characterize burnout patterns and factors contributing to recovery through a single-institution assessment of neurosurgery residents across 4 decades. We administered a 59-item questionnaire to all living current and former residents of a large neurosurgical training institution (n= 96). Respondents indicated the timeline of burnout or hardship during residency and evaluated burnout stressors and recovery factors through a 5-point Likert scale and free-text response. The survey response rate was 67% (64 of 96). The overall self-reported burnout rate was 30% (19 of 64). Recent trainees were significantly more likely to report burnout (P < 0.05). Postgraduate year 2 was cited by 66% of respondents as the onset of burnout or hardship. The most common stressors included work-life imbalance (55%) and imbalance of resident duties (33%). The highest-impact recovery factors were end of a rotation or postgraduate year (80%), increased sleep (48%), and meaningful relationships with colleagues (42%). Institution-specific factors, such as outdoor activities (52%) and intraprogram social events (34%), were also influential in recovery. In free-text responses, respondents identified a strong sense of mission in neurosurgical training as a central driver of recovery to wellness. Institutional support structures promoting mentorship and camaraderie are actionable methods to encourage resident burnout recovery. This study serves as a model for other programs to identify their "critical periods" of burnout and effective wellness interventions.