Reported pain at work is a risk factor for vascular surgery trainee burnout

J Vasc Surg. 2024 May;79(5):1217-1223. doi: 10.1016/j.jvs.2024.01.003. Epub 2024 Jan 11.


Background: 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 Vascular Surgery In-Service Examination to trainees in all Accreditation Council for Graduate Medical Education-accredited vascular surgery programs. Burnout was measured by a modified, abbreviated Maslach Burnout Inventory; pain after a full day of work was measured using a 10-point Likert scale and then dichotomized as "no to mild pain" (0-2) vs "moderate to severe pain" (3-9). Univariable analyses and multivariable regression assessed associations of pain with well-being indicators (eg, burnout, thoughts of attrition, and thoughts of career change). Pain management strategies were included as additional covariables in our study.

Results: We included 527 trainees who completed the survey (82.2% response rate); 38% reported moderate to severe pain after a full day of work, of whom 73.6% reported using ergonomic adjustments and 67.0% used over-the-counter medications. Significantly more women reported moderate to severe pain than men (44.3% vs 34.5%; P < .01). After adjusting for gender, training level, race/ethnicity, mistreatment, and dissatisfaction with operative autonomy, moderate-to-severe pain (odds ratio, 2.52; 95% confidence interval, 1.48-4.26) and using physiotherapy as pain management (odds ratio, 3.06; 95% confidence interval, 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 after adjustment.

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

Keywords: Burnout; Surgical ergonomics; Wellness; Work pain.

MeSH terms

  • Burnout, Professional* / diagnosis
  • Burnout, Professional* / epidemiology
  • Female
  • Humans
  • Internship and Residency*
  • Male
  • Pain
  • Psychological Tests*
  • Risk Factors
  • Self Report*
  • Surveys and Questionnaires
  • Vascular Surgical Procedures / adverse effects
  • Vascular Surgical Procedures / education

Supplementary concepts

  • Maslach Burnout Inventory