Stress and burnout in colorectal and vascular surgical consultants working in the UK National Health Service A. Sharma 1 , D. M. Sharp 2 , L. G. Walker 2 * and J. R. T. Monson 1 1 Academic Surgical Unit, University of Hull, Cottingham, Hull, UK 2 Institute of Rehabilitation, University of Hull, Hull, UK * Correspondence to: Institute of Rehabilitation, University of Hull, 215 Anlaby Road, Kingston upon Hull, HU3 2PG, UK. E-mail: L.G.Walker@ hull.ac.uk Abstract Background: It has been suggested that dealing with cancer is associated with increased stress and burnout in health-care professionals. The aim of this study is to examine the prevalence of psychiatric morbidity and burnout in surgeons working in the National Health Service (NHS), and the putative relationship between psychiatric morbidity, burnout and the amount of cancer- related work. Methods: All consultant colorectal and vascular surgeons identified from their professional societies were sent a booklet consisting of questions about cancer-related and specialty-specific work load, job satisfaction and socio-demographics. It also included the General Health Questionnaire (GHQ-12), the Maslach Burnout Inventory (MBI) and the Coping Questionnaire. Logistic regression analysis was used to identify independent predictors of psychiatric morbidity (GHQ), burnout (MBI) and retirement intentions. Results: Five hundred and one questionnaire booklets were completed and returned (response rate 58.7%). The mean age of respondents was 47 years (range 31–65). The majority of the surgeons were male (460, 92%). One hundred and sixty-three (33%) surgeons scored in the positive range of the GHQ, and 154 (32%) had high burnout on at least one subscale of the MBI. Three hundred and eighty- three (77%) surgeons stated that they intended to retire before the statutory retirement age. Level of work satisfaction and perceived adequacy of training in communication and management skills were significantly negatively correlated with GHQ and MBI scores. Surgeons who planned to take early retirement or wished to retire as soon as they could afford to were more likely to have psychiatric morbidity and/or burnout. Surgeons who were married or cohabiting were less likely to have psychiatric morbidity, and younger surgeons were more likely to have higher levels of depersonalization (DP). Work satisfaction was negatively correlated with psychiatric morbidity and all three burnout scales. Colorectal surgeons had a greater cancer-related workload than vascular surgeons (48.6 vs 7.5%, respectively, U ¼ 2667; p50:005). However, there were no significant differences between the two groups in psychiatric morbidity, personal accomplishment and emotional exhaustion. Vascular surgeons, however, had significantly higher levels of DP ðp ¼ 0:04Þ: Conclusion: Levels of psychiatric morbidity, burnout and work dissatisfaction are worryingly high in colorectal and vascular surgeons and are likely to impact adversely on patient satisfaction and service quality. The number of surgeons intending to retire early is also a cause for concern both in terms of the overall number of trained surgeons in the NHS and in the balance between senior and junior surgeons. Apart from DP, these indicators of stress, however, were unrelated to cancer workload. Copyright # 2007 John Wiley & Sons, Ltd. Keywords: surgeons; stress; burnout; coping; oncology; cancer Introduction There is evidence to suggest that job-related stress and professional ‘burnout’ is increasing, and it has been suggested that this may be due to changes in the National Health Service (NHS) [1–3]. In a survey of 882 UK consultants in 1996, Ramirez et al. [2] found that 27% were likely to have significant psychiatric morbidity. At approximately the same time, Wall et al. [4] studied a sample of 11 000 NHS employees and found a 27% pre- valence of minor psychiatric disorders in compar- ison with a prevalence of 18% in general population. The most important sources of stress were work overload, feeling badly managed and resourced, managerial responsibilities and dealing Received: 5 February 2007 Revised: 17 July 2007 Accepted: 28 July 2007 Copyright # 2007 John Wiley & Sons, Ltd. Psycho-Oncology Psycho-Oncology 17: 570–576 (2008) Published online 12 October 2007 in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/pon.1269