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Purpose <p>Surgical burnout is a well-known factor in dissatisfaction and early departure from clinical practice. However, few studies view burnout as a staged process that directly leads to attrition. This narrative review presents burnout as a progressive, modifiable trajectory contributing to dropout among surgeons and trainees, supported by evidence from various career stages and cultural contexts.</p> Methods <p>We conducted a synthesis of international literature published between 2000 and 2025, sourced from PubMed. Both quantitative and qualitative studies were included. Thematic synthesis focused on burnout stages, professional identity, culture, and career phase modifiers. Keywords used in the search included “surgical burnout,” “attrition,” “disengagement,” “professional identity,” “workforce sustainability,” and “cultural resistance.” Studies were selected based on relevance to empirical and conceptual works addressing burnout in surgeons or related specialists.</p> Results <p>We identified three phases in the burnout-to-burnout dropout continuum: erosion of engagement, identity disruption, and withdrawal. These phases are influenced by factors such as workload, gender, institutional support, and cultural norms. We proposed a visual framework for this process and recommended targeted interventions for each phase.</p> Conclusions <p>Burnout is not merely an endpoint but a driver of disengagement. Educators and institutional leaders must implement stage-specific strategies to combat burnout as an evolving threat to the sustainability of the surgical workforce.</p>

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Burnout as a process driver of surgical attrition: a narrative review of the path to dropout

  • 期刊论文

  • 发表日期：

    2025年12月4日

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  • Keita Ishido,
  • Kaito Sano,
  • Saseem Poudel,
  • Zen Naito,
  • Akitaka Motoyoshi,
  • Satoshi Hirano

摘要

Purpose

Surgical burnout is a well-known factor in dissatisfaction and early departure from clinical practice. However, few studies view burnout as a staged process that directly leads to attrition. This narrative review presents burnout as a progressive, modifiable trajectory contributing to dropout among surgeons and trainees, supported by evidence from various career stages and cultural contexts.

Methods

We conducted a synthesis of international literature published between 2000 and 2025, sourced from PubMed. Both quantitative and qualitative studies were included. Thematic synthesis focused on burnout stages, professional identity, culture, and career phase modifiers. Keywords used in the search included “surgical burnout,” “attrition,” “disengagement,” “professional identity,” “workforce sustainability,” and “cultural resistance.” Studies were selected based on relevance to empirical and conceptual works addressing burnout in surgeons or related specialists.

Results

We identified three phases in the burnout-to-burnout dropout continuum: erosion of engagement, identity disruption, and withdrawal. These phases are influenced by factors such as workload, gender, institutional support, and cultural norms. We proposed a visual framework for this process and recommended targeted interventions for each phase.

Conclusions

Burnout is not merely an endpoint but a driver of disengagement. Educators and institutional leaders must implement stage-specific strategies to combat burnout as an evolving threat to the sustainability of the surgical workforce.