title: The experience of burnout across different surgical specialties in the United Kingdom: a cross-sectional survey.
abstract: BACKGROUND
  We used a cross-sectional e-mail survey to assess the prevalence of psychological morbidity across different surgical specialties and identify predictor variables of burnout in surgeons.
  
  
  METHODS
  The survey was sent to 1971 surgeons from 127 National Health Service (NHS) hospital trusts across the United Kingdom. Burnout prevalence and mood were assessed using the Maslach Burnout Inventory-General Survey and Profile of Mood States (POMS), respectively. Demographic and POMS factors were investigated as predictors of burnout using linear and stepwise regression analyses.
  
  
  RESULTS
  Responses to the survey were received from 342 surgeons (17% response rate). One-third of 313 respondents showed high mean levels of burnout on exhaustion (2.32; standard deviation [SD], 1.62) and cynicism (2.34; SD, 1.44) subscales. Some specialties worked significantly more hours per week (F[8, 252] = 2.89; P = .004), but burnout prevalence did not differ significantly between specialty, grade, age, gender, hours worked per week, or years spent in post. The number of years in specialty (β = -0.17; P = .003) independently predicted surgeons' scores on exhaustion. POMS factors significantly predicted burnout, where fatigue (β = 0.58; P < .001) was the best predictor of exhaustion scores, depression (β = 0.28; P < .001) the best predictor of cynicism, and vigor (β = 0.29; P < .001) the best predictor of professional efficacy. Management issues were cited as contributing to psychological morbidity.
  
  
  CONCLUSIONS
  UK surgeons show high levels of cynicism and exhaustion burnout irrespective of their specialty, grade, or hours worked per week. Surgeons' mood profiles significantly predicted burnout, indicating the POMS could be used as part of an assessment for preventive interventions. NHS management and infrastructure are highlighted as influences on surgeons' psychological health.
authors.affiliation: Department of Psychological Sciences, University of Worcester, Worcester, UK. d.upton@worc.ac.uk
authors.forename: Dominic
authors.initials: D
authors.lastname: Upton
authors.forename: Victoria
authors.initials: V
authors.lastname: Mason
authors.forename: Bethany
authors.initials: B
authors.lastname: Doran
authors.forename: Kazia
authors.initials: K
authors.lastname: Solowiej
authors.forename: Uttam
authors.initials: U
authors.lastname: Shiralkar
authors.forename: Sandy
authors.initials: S
authors.lastname: Shiralkar
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D002055:Burnout, Professional / Q000453:epidemiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013043:Specialties, Surgical / Q000706:statistics & numerical data*; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult