General surgery resident flourishing: assessing beyond burnout

Surgical residents have known high rates of burnout. We sought to measure flourishing, a more holistic and less well-known assessment of well-being.

General surgery residents at two institutions completed a survey including a 12-item Harvard Flourishing Index (FI), a 2-item Maslach Burnout Inventory assessing emotional exhaustion (EE) and depersonalization (DP), and questions about satisfaction, career calling, belonging, and thoughts of attrition.

Of the 125 surgical residents surveyed, 78 responded to the survey, (62% response rate). Respondents included residents at all PGY levels from 1 to 7, with 50% (n = 38) being PGY-1 or PGY-2. The median FI was 6.7 [interquartile range 5.5, 7.4]. The majority (n = 40, 52%) of residents reported EE or DP at least once a week, demonstrating high burnout. Most (n = 39, 53%) were at least somewhat dissatisfied with their surgical training. Many (n = 27, 43%) agreed or strongly agreed they had thoughts of attrition within the past year. Yet, the majority (n = 44, 60%) of residents reported a sense of belonging. Residents disclosing high burnout were more likely to report low FI (p < 0.001). Residents describing a sense of belonging were more likely to report high FI and satisfaction (p < 0.001). Residents who strongly considered leaving surgery were more likely to report lower FI, higher burnout, lower satisfaction (p < 0.001), and lower belonging (p = 0.002).

Our surgical resident cohort report lower flourishing than population means. Yet, resident flourishing is associated with lower burnout, higher satisfaction, less thoughts of attrition, and a greater sense of belonging.