Team Sport Participation Protects Against Burnout During Neurosurgery Training: Cross-Sectional Survey Study

Abstract

Burnout is experienced by up to two thirds of neurosurgery residents. Team sport participation as an adolescent protects against adverse mental health outcomes in adulthood. The objective of this study was to determine whether high school or collegiate team sport participation is associated with improved psychological well-being during neurosurgery residency. A cross-sectional survey study of U.S. neurosurgery residents was conducted between June 2020 and February 2021. Outcomes included self-ratings of sadness, anxiety, stress, burnout, optimism, and fulfillment, on 100-point scales, which were averaged into a "Burnout Composite Score" (BCS). Respondents were grouped and compared according to their prior self-reported participation in team sports (participants vs. nonparticipants). A 3-way analysis of variance tested the effects of resident level, exercise days, and team sport participation on BCS. Of 229 submitted responses, 228 (99.5%) provided complete data and 185 (81.1%) residents participated in team sports. Days/week of exercise was similar across groups (2.5 ± 1.8 vs. 2.1 ± 1.8, P= 0.20). The team sport group reported lower mean BCS (37.1 vs. 43.6 P= 0.030, Cohen d=0.369). There was a significant interaction between prior team sport participation and exercise regimen on BCS (F [3, 211]= 3.39, P= 0.019, n2= 0.046), such that more exercise days per week was associated with decreased BCS for prior team sport athletes (F [3, 211]= 11.10, P < 0.0005), but not for nonparticipants (F [3, 211]= 0.476, P= 0.699). The positive impact of prior team sport participation was more pronounced for senior residents (-11.5 points, P= 0.016) than junior residents (-4.3 points, P= 0.29). Prior team sport participation was associated with lower BCS among neurosurgery residents, an effect more pronounced during senior residency. Lessons imparted during early team sport experience may have profound impacts on reducing burnout throughout a 7-year neurosurgery residency.