Wong K P, Kaliya-Perumal A K, Oh Jyl
Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.
Malays Orthop J. 2019 Jul;13(2):15-19. doi: 10.5704/MOJ.1907.003.
Orthopaedic surgery is physically demanding. Surgeons may have to work long unpredictable hours especially during residency training. This arduous task comes with the risk of burnout leading to negative repercussions to the surgeon and the patient. In view of strategising peer support, we intend to review the literature and analyse whether orthopaedic resident burnout is a global issue. We also intend to derive common strategies to tackle burnout at individual and organisational levels. A literature search was carried out in the databases including PubMed, Scopus, SciELO, and Google Scholar to shortlist studies dealing with orthopaedic residency and related burnout. Those studies that used the Maslach Burnout Inventory (MBI) for quantifying burnout were collectively interpreted. Other studies were reviewed to analyse the vulnerability, risk factors, consequences and management strategies related to burnout. Among a total of 72 titles shortlisted, eight studies independently reported burnout among orthopaedic surgery residents/trainees and used MBI as a tool for assessing burnout. Based on the three subscales of MBI, 37.2% had high degree of emotional exhaustion (EE), 48% had high degree of depersonalisation (DP) and 33.1% perceived low personal accomplishment. This signifies the high prevalence of burnout among orthopaedic residents/trainees. Burnout among orthopaedic surgery residents seems to be a universal problem. Risk factors could be multifactorial, influenced by clinical competency and work-home environment. This can be tackled at the individual level by being aware of burnout syndrome, involving in adequate physical activity and spending quality social time; and at the organisational level by duty hour limitation, professional appreciation and mentorship programme.
骨科手术对体力要求很高。外科医生可能不得不长时间工作，而且工作时间难以预测，尤其是在住院医师培训期间。这项艰巨的任务伴随着职业倦怠的风险，会给外科医生和患者带来负面影响。为了制定同伴支持策略，我们打算回顾文献，分析骨科住院医师职业倦怠是否是一个全球性问题。我们还打算得出在个人和组织层面应对职业倦怠的共同策略。在包括PubMed、Scopus、SciELO和谷歌学术在内的数据库中进行了文献检索，以筛选出涉及骨科住院医师培训及相关职业倦怠的研究。对那些使用马氏职业倦怠量表（MBI）来量化职业倦怠的研究进行了综合解读。对其他研究进行了综述，以分析与职业倦怠相关的易感性、风险因素、后果及管理策略。在总共筛选出的72篇文献中，有8项研究独立报告了骨科手术住院医师/实习生存在职业倦怠，并使用MBI作为评估职业倦怠的工具。根据MBI的三个子量表，37.2%的人有高度的情感耗竭（EE），48%的人有高度的去个性化（DP），33.1%的人自我成就感较低。这表明骨科住院医师/实习生中职业倦怠的发生率很高。骨科手术住院医师的职业倦怠似乎是一个普遍问题。风险因素可能是多方面的，受临床能力和工作家庭环境的影响。在个人层面，可以通过了解职业倦怠综合征、进行适当的体育活动和享受高质量的社交时光来解决；在组织层面，可以通过限制工作时间、给予职业认可和开展导师指导计划来解决。
