Reported Pain at Work Is a Risk Factor for Vascular Surgery Trainee Burnout

Eric Pillado, Northwestern University, Chicago, IL
Ruojia D. Li, Northwestern University, Chicago, IL
Matthew C. Chia, Northwestern University, Chicago, IL
Joshua S. Eng, Indiana University, Indianapolis, IN
Kathryn DiLosa, University of California, Davis, Sacramento, CA
Leanne Grafmuller, University of Rochester, Rochester, NY
Allan Conway, Northwell Health, New York, NY
Guillermo A. Escobar, Emory University, Atlanta, GA
Palma Shaw, Upstate Medical University, Syracuse, NY
Malachi G. Sheahan, LSU Health Sciences Center - New Orleans
Karl Y. Bilimoria, Indiana University, Indianapolis, IN
Yue-Yung Hu, Indiana University, Indianapolis, IN
Dawn M. Coleman, Duke University, Durham, NC


INTRODUCTION: Work-related pain is a known risk factor for vascular surgeon burnout. It risks early attrition from our workforce and is a recognized threat to the specialty. Our study aimed to understand whether work-related pain similarly contributed to vascular surgery trainee well-being. METHODS: A confidential, voluntary survey was administered after the 2022 VSITE to trainees in all ACGME-accredited vascular surgery programs. Burnout was measured by a modified, abbreviated Maslach Burnout Inventory; pain after a full day of work was measured using a 10-point Likert scale and then dichotomized as "no to mild pain" (0-2) vs "moderate to severe pain" (3-9). Univariable analyses and multivariable regression assessed associations of pain with well-being indicators (e.g., burnout, thoughts of attrition, and thoughts of career change). Pain management strategies were included as additional covariables in our study. RESULT: 527 trainees completed the survey (82.2% response rate). 38% reported moderate to severe pain after a full day of work of whom 73.6% reported using ergonomic adjustments and 67.0% used over-the-counter medications. Significantly more women reported moderate to severe pain than men (44.3% vs 34.5%, p<0.01). After adjusting for gender, training level, race/ethnicity, mistreatment, and dissatisfaction with operative autonomy, moderate-to-severe pain (OR 2.52, 95% CI 1.48-4.26) and using physiotherapy as pain management (OR 3.06, 95% CI 1.02-9.14) were risk factors for burnout. Moderate to severe pain was not a risk factor for thoughts of attrition or career change following adjustment. CONCLUSION: Physical pain is prevalent among vascular surgery trainees and represents a risk factor for trainee burnout. Programs should consider mitigating this occupational hazard by offering ergonomic education and adjuncts, such as posture awareness and microbreaks during surgery, early and throughout training.