Prevalence and risk factors for burnout in U.S. vascular surgery trainees

Document Type


Publication Date


Publication Title

Journal of vascular surgery


Objective: Burnout and suicidality are known risks for vascular surgeons above other surgical subspecialties, with surgical trainees at risk for exposure to factors that increase burnout. This study aimed to inform initiatives to improve wellness by assessing the prevalence of hazards in vascular training (mistreatment, duty hour violations) and the rates of wellness outcomes (burnout, thoughts of attrition/specialty change/suicide). We hypothesized that mistreatment and duty hour violations would predispose trainees to increased burnout. Methods: We performed a cross-sectional study of residents and fellows enrolled in accredited U.S. vascular surgery training programs using a voluntary, confidential survey administered during the 2020 Vascular Surgery In-Training Examination. The primary outcome assessed was burnout symptoms reported on a weekly basis or more frequently. The rates of wellness outcomes were measured. The association of mistreatment and duty hours with the primary outcome was modeled with multivariable logistic regression. Results: A total of 475 residents and fellows who were enrolled in one of 120 vascular surgery training programs completed the survey (84.2% response rate). Of 408 trainees completing burnout survey items, 182 (44.6%) reported symptoms of burnout. Fewer trainees reported thoughts of attrition (n = 42 [10.0%], specialty change (n = 35 [8.4%]), or suicide (n = 22 [4.9%]). Mistreatment was reported by 191 (47.3%) vascular trainees and was more common in female trainees (n = 63 [48.5%] reporting monthly or more frequently) compared to male trainees (n = 51 [18.6%], p < .001). Duty-hour violations were also more commonly reported by female trainees (n = 31 [21.4%] reporting 3+ months in violation) compared to male trainees (n = 50 [16.2%], p = .002). After controlling for race/ethnicity, post-graduate year, program type, and geography, female trainees were less likely to report burnout (odds ratio [OR] 0.49, 95% CI 0.28 – 0.86). Trainees experiencing mistreatment monthly or more were three times more likely to report burnout (OR 3.09, 95% CI 1.78 – 5.39). Frequency of duty hour violations also increased the odds of reporting burnout (1-2 months in violation OR 2.09, 95% CI 1.17 – 3.73; 3+ months in violation OR 3.95, 95% CI 2.24 – 6.97). Conclusions: Nearly half of vascular surgery trainees reported symptoms of burnout, which was associated with frequency of mistreatment and duty hour violations. Interventions to improve well-being in vascular surgery must be tailored to the local training environment to address trainee experiences that contribute to burnout.

PubMed ID