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Burnout and Career Satisfaction Among American Surgeons

Shanafelt, Tait D. MD*; Balch, Charles M. MD; Bechamps, Gerald J. MD§; Russell, Thomas MD; Dyrbye, Lotte MD*; Satele, Daniel BA*; Collicott, Paul MD; Novotny, Paul J. MS*; Sloan, Jeff PhD*; Freischlag, Julie A. MD

doi: 10.1097/SLA.0b013e3181ac4dfd
Original Articles

Objective: To determine the incidence of burnout among American surgeons and evaluate personal and professional characteristics associated with surgeon burnout.

Background: Burnout is a syndrome of emotional exhaustion and depersonalization that leads to decreased effectiveness at work. A limited amount of information exists about the relationship between specific demographic and practice characteristics with burnout among American surgeons.

Methods: Members of the American College of Surgeons (ACS) were sent an anonymous, cross-sectional survey in June 2008. The survey evaluated demographic variables, practice characteristics, career satisfaction, burnout, and quality of life (QOL). Burnout and QOL were measured using validated instruments.

Results: Of the approximately 24,922 surgeons sampled, 7905 (32%) returned surveys. Responders had been in practice 18 years, worked 60 hours per week, and were on call 2 nights/wk (median values). Overall, 40% of responding surgeons were burned out, 30% screened positive for symptoms of depression, and 28% had a mental QOL score >1/2 standard deviation below the population norm. Factors independently associated with burnout included younger age, having children, area of specialization, number of nights on call per week, hours worked per week, and having compensation determined entirely based on billing. Only 36% of surgeons felt their work schedule left enough time for personal/family life and only 51% would recommend their children pursue a career as a physician/surgeon.

Conclusion: Burnout is common among American surgeons and is the single greatest predictor of surgeons’ satisfaction with career and specialty choice. Additional research is needed to identify individual, organizational, and societal interventions that preserve and promote the mental health of American surgeons.

This study of physician burnout, the largest conducted to date, demonstrated that burnout is common among surgeons. A variety of personal and professional characteristics were related to burnout, which was the single greatest predictor of surgeons’ satisfaction with their career and specialty choice.

From the *Mayo Clinic; †American College of Surgeons; ‡Department of Surgery, Johns Hopkins Medical Institutions, Johns Hopkins University, Baltimore, Maryland; and §Winchester Surgical Clinic.

Corresponding Author: Charles M. Balch, MD, Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD 21287. Phone: 410-614-6686. Fax: 410-502-0403. E-mail:

Financial Disclosure and Commercial Sponsorship. Both my co-authors and I have nothing to disclose.

© 2009 Lippincott Williams & Wilkins, Inc.