Letter: The Prevalence of Burnout Among US Neurosurgery Residents

To the Editor: I read with great interest the article of Shakir et al1 in a recent issue of the Neurosurgery. The authors performed a cross sectional study to determine the prevalence of burnout among US neurosurgery residents and concluded that neurosurgery residents have a significantly lower prevalence of burnout than other residents/fellows and practicing physicians. The authors should be commended for addressing an important topic in medical practice.2,3 In addition, the need to identify specific medical specialties associated with high burnout rates is an important concept that needs to be further explored.4,5 Although the study of Shakir et al1 was well designed and conducted, I have a few questions that need to be clarified. Burnout in residents has been highly associated with the number of working hours per week. Since neurosurgery is particularly known for having a very demanding working load, the findings of a low rate of burnout detected by the authors is intriguing. The low response rate presented by the authors strongly suggests the possibility of response bias. It is possible that residents who were not burnout were much more willing to answer the survey than the ones who were burnout, and hence the authors’ results. It would be important to evaluate the presence of response bias to establish the generalizability of the study results. I was concerned that the study of Shakir et al1 may not reflect the reality of neurosurgery residents in the United States. I would welcome comments from the authors regarding the aforementioned issues to further strengthen the findings of this important study. Disclosure The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.