VESS12 - Reported Pain at Work Is a Risk Factor for Vascular Surgery Trainee Burnout

Wednesday, June 14, 2023

3:30 PM – 3:37 PM ET

Submitting & Presenting Author(s)

Eric B. Pillado, MD, MBA

Vascular Surgery Resident
Northwestern University Feinberg School of Medicine
Chicago, Illinois

Co-Author(s)

RL

Ruojia D. Li

Northwestern University
Chicago, Illinois
MC

Matthew Chia
JE

Joshua Eng

Indiana University School of Medicine
Indianapolis, Indiana
Kathryn L. DiLosa, MD

Resident Physician
University of California Davis
Sacramento, California
Allan M. Conway, MD
Guillermo A. Escobar, MD

Associate Professor
Emory University School of Medicine
Atlanta, Georgia
Palma M. Shaw, MD, MBA

Upstate Medical University
Syracuse, New York
MS

Malachi G. Sheahan, III, MD

Professor of Surgery
Louisiana State University Health Sciences Center
New Orleans, Louisiana
KB

Karl Bilimoria

Indiana University School of Medicine
Indianapolis, Indiana
YH

Yue-Yung Hu

Assistant Professor
Ann & Robert H. Lurie Children's Hospital of Chicago
Chicago, Illinois

Senior Author(s)

Dawn M. Coleman, MD

Chief, Division of Vascular and Endovascular Surgery
Duke University Medical Center
Durham, North Carolina

Discussant(s)

CB

Channa Blakely, DO

Vascular Resident
University of Texas Medical Branch
Texas City, Texas

Objectives: Work-related pain is a known risk factor for vascular surgeon burnout. It risks early attrition from our workforce and is a recognized threat to the specialty. Our study aimed to understand whether work-related pain similarly contributed to vascular surgery trainee well-being.

Methods: A confidential, voluntary survey was administered after the 2022 VSITE. Trainees in all ACGME-accredited vascular surgery programs were asked to complete a modified, abbreviated Maslach Burnout Inventory. Pain after a full day of work was measured using a 10-point Likert scale and dichotomized into none to mild pain (0-2) vs moderate to severe pain (3-9). Univariable and multivariable regression analyses were used to assess associations of pain with well-being indicators such as burnout, thoughts of attrition, and career change. Pain management strategies were included as covariables in our study.

Results: 527 trainees completed the survey (82.2% response rate). 38% reported moderate to severe discomfort/pain after a full day of working. Among those who reported moderate to severe pain, 73.6% reported using ergonomic adjustments and 67.0% over-the-counter medications. More women tended to report moderate to severe pain than men (44.3% vs 34.5%, p< 0.01) (Table I). After adjusting for gender, training level, race/ethnicity, mistreatment, and lack of operative autonomy (a proxy for loss of meaning in work), moderate-to-severe pain (OR 2.52, 95% CI 1.48-4.26) and using physiotherapy as pain management (OR 3.06, 95% CI 1.02-9.14) were risk factors for burnout. Moderate to severe pain was not a risk factor for thoughts of attrition or career change following adjustment (Table II).

Conclusions: Physical pain is prevalent among vascular surgery trainees and represents a risk factor for trainee burnout. Programs should provide ergonomic education and adjuncts, such as posture awareness and microbreaks during surgery, early and throughout training.