The Prevalence of Burnout in Limb Lengthening and Reconstruction Surgeons

Aim:To evaluate the level of burnout among international limb reconstruction surgeons.Background: Burnout describes chronic workplace stress that has not been successfully managed.Limb reconstruction surgeons may be particularly at risk for burnout.The development of necessary skills and expertise has a steep learning curve and the patients are among the most complex in orthopaedics, with multiple failed surgeries and high complication rates.Methods: An internet-based REDCap survey consisted of demographic questions, four open-ended questions, and two valid, reliable measures:(1) Patient Health Questionnaire 4 (PHQ-4)-a screening tool for anxiety and depression, and (2) The Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS-MP) which measures levels of depersonalization, emotional exhaustion, and low personal achievement.The surveys were distributed to international limb reconstruction surgeons.Statistical analysis consisted of descriptive and non-parametric analysis: Chi-square and Kruskal-Wallis tests.Results: There were 103 surgeon responses from at least one country of each of the six populated continents.Eighty-three percent of the respondents were male.The career level distribution was early (1-10 years' experience) = 51%, mid (11-20 years' experience) = 30%, and late (>20 years' experience) = 20%.Twenty-four percent stated they were currently being treated or had been treated in the past for mood or anxiety or both with medication or counselling.Based on the MBI-HSS-MP scores, 38% of limb reconstruction surgeons displayed burnout symptoms, and 16% exhibited severe burnout.The mid-career had the highest levels of overall burnout; there was no statistical significance between the groups.The PHQ-4 scores were within normal limits.Discussion: In this study sample, 38% displayed burnout symptoms and 16% exhibited severe burnout.The mid-career group had the highest level of burnout.Clinical significance: Unmanaged burnout can lead to major depression or suicidal ideation, or both.Support systems for limb reconstruction surgeons need to be developed and maintained.