Abstract
INTRODUCTION: Burnout among surgeons is increasingly recognized as a crisis. However, little is known about changes in burnout prevalence over time. We evaluated temporal trends in burnout among surgeons and surgical trainees of all specialties in the US and Canada. METHODS: We systematically reviewed MEDLINE, Embase, and PsycINFO for studies assessing surgeon burnout from January 1981 to September 2021. Changes in dichotomized Maslach Burnout Inventory score and mean subscale score were assessed using multivariable random-effects meta-regression. RESULTS: Of 3,575 studies screened, 104 studies representing 67,003 individuals met inclusion criteria. Publication dates ranged from 1996 to 2021. Overall, 42% of surgeons met criteria for burnout (95% CI 38% to 45%). Trainees were more affected than attending surgeons (46% vs 36%, p = 0.011). Prevalence remained stable over the study period (odds ratio [OR] 0.93 per decade, 95% CI 0.85 to 1.01). Mean scores for emotional exhaustion (−5.4 per decade, 95% CI −8.1 to −1.9) and depersonalization (−1.5 per decade, 95% CI −3.0 to −0.2) improved over time. Personal accomplishment scores remained unchanged. A high degree of heterogeneity was noted in all analyses, despite adjustment for training status, specialty, practice setting, and study quality (Figure).FigureCONCLUSION: Contrary to popular perception, we found no evidence of rising surgeon burnout. Rather, emotional exhaustion and depersonalization are decreasing. Given the degree of heterogeneity, additional small, low-quality studies will not provide further clarity. Future research should be deliberately designed to support longitudinal integration through prospective meta-regression. Meaningful intervention to reduce surgeon burnout is needed across all training levels and specialties.
Published Version
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