Prevalence of Burnout Among Neurosurgery Residents in the United States: A Meta-analysis

Introduction: Burnout is highly prevalent among neurosurgery residents and can negatively impact well-being and patient care. Understanding factors associated with burnout is critical to improve neurosurgery training. We conducted a systematic review examining burnout rates among US neurosurgery residents.

Methods: We systematically searched PubMed, Embase, Google Scholar, and the Cochrane Library for studies evaluating burnout among US neurosurgery residents. Burnout rates, measurement scales, and associated factors were extracted. The primary focus was the overall burnout rate. Secondary areas of focus included emotional exhaustion, depersonalization, and personal accomplishment per the Maslach Burnout Inventory (MBI). Random-effects models pooled burnout incidence across studies, which were analyzed using restricted maximum likelihood (REML) methods with no transformation. Pooled proportions with 95% confidence intervals (CI) were reported.

Results: Seven studies including 1239 residents were analyzed; 4 were nationwide surveys and 3 were single-center studies, with a 21.6% response rate. Overall, 362 (31.8%) residents were female, and 713 (75.2%) were married. Regarding year of training, 347 (30.5%) were junior residents, 533 (46.8%) were middle residents, and 258 (22.7%) were senior residents. Five studies used the MBI and 2 used institutional questionnaires. The pooled burnout rate was 44% (531/1232 residents; 95% CI 27-60%). Severe emotional exhaustion was reported in 32% (95% CI 25-39%) and severe depersonalization in 37% (95% CI 9-65%). Low personal accomplishment was reported in 28% (95% CI 0-60%). There were no differences in burnout by gender or residency year.

Conclusion : This systematic review found a high prevalence of burnout among US neurosurgery residents, affecting nearly half of trainees. Emotional exhaustion and depersonalization were also common. These findings highlight the substantial risk of burnout in neurosurgery training. Focused efforts to promote wellness and improve the residency experience are needed to address this critical issue. Further research should identify drivers of burnout and effective interventions.