Factors associated with burnout among US neurosurgery residents: a nationwide survey

Restricted access


Excessive dissatisfaction and stress among physicians can precipitate burnout, which results in diminished productivity, quality of care, and patient satisfaction and treatment adherence. Given the multiplicity of its harms and detriments to workforce retention and in light of the growing physician shortage, burnout has garnered much attention in recent years. Using a national survey, the authors formally evaluated burnout among neurosurgery trainees.


An 86-item questionnaire was disseminated to residents in the American Association of Neurological Surgeons database between June and November 2015. Questions evaluated personal and workplace stressors, mentorship, career satisfaction, and burnout. Burnout was assessed using the previously validated Maslach Burnout Inventory. Factors associated with burnout were determined using univariate and multivariate logistic regression.


The response rate with completed surveys was 21% (346/1643). The majority of residents were male (78%), 26–35 years old (92%), in a stable relationship (70%), and without children (73%). Respondents were equally distributed across all residency years. Eighty-one percent of residents were satisfied with their career choice, although 41% had at some point given serious thought to quitting. The overall burnout rate was 67%. In the multivariate analysis, notable factors associated with burnout included inadequate operating room exposure (OR 7.57, p = 0.011), hostile faculty (OR 4.07, p = 0.008), and social stressors outside of work (OR 4.52, p = 0.008). Meaningful mentorship was protective against burnout in the multivariate regression models (OR 0.338, p = 0.031).


Rates of burnout and career satisfaction are paradoxically high among neurosurgery trainees. While several factors were predictive of burnout, including inadequate operative exposure and social stressors, meaningful mentorship proved to be protective against burnout. The documented negative effects of burnout on patient care and health care economics necessitate further studies for potential solutions to curb its rise.

ABBREVIATIONS AANS = American Association of Neurological Surgeons; CSNS = Council of State Neurosurgical Societies; MBI = Maslach Burnout Inventory.

Downloadable materials

  • Appendix Table (PDF 444 KB)

Article Information

Correspondence Frank J. Attenello: Keck School of Medicine, University of Southern California, Los Angeles, CA. attenell@usc.edu.

INCLUDE WHEN CITING Published online February 9, 2018; DOI: 10.3171/2017.9.JNS17996.

Disclosures Dr. Schirmer has received support from the NIH/NINDS for non–study-related clinical or research effort, has ownership of NTI, and has received an honorarium from the AANS.

© AANS, except where prohibited by US copyright law.



  • View in gallery

    Neurosurgery resident career and personal satisfaction. Figure is available in color online only.

  • View in gallery

    Professional and personal stressors encountered by neurosurgery resident trainees. Figure is available in color online only.

  • View in gallery

    Breakdown of perceptions among neurosurgery residents regarding the trajectory of their careers. Figure is available in color online only.

  • View in gallery

    Professional burnout indices among neurosurgery residents according to the MBI subscales. Figure is available in color online only.

  • View in gallery

    Maslach Burnout Inventory and career satisfaction trends by postgraduate year. Figure is available in color online only.

Cited By



All Time Past Year Past 30 Days
Abstract Views 1418 1417 529
Full Text Views 754 754 16
PDF Downloads 353 353 6
EPUB Downloads 0 0 0


Google Scholar