SURVEY

https://doi.org/10.5005/jp-journals-10049-2056
Research and Innovation in Anesthesia
Volume 9 | Issue 2 | Year 2024

Burnout among Anesthesiologists: A Survey on Prevalence, Contributing Factors and Coping Strategies

Tejaswini Rao Jujjavarapu1, Sri Archana Rapaka2, Sree Ramya Konda3

1,2Department of Anesthesia, Mallareddy Medical College for Women, Hyderabad, Telangana, India

3Department of Psychology, Birkbeck, University of London, UK

Corresponding Author: Tejaswini Rao Jujjavarapu, Department of Anesthesia, Mallareddy Medical College for Women, Hyderabad, Telangana, India, Phone: +91 9347370079, e-mail: tejaswini0196@gmail.com

Received: 09 August 2024; Accepted: 31 October 2024; Published on: 18 December 2024

ABSTRACT

Background: Burnout among healthcare professionals, particularly anesthesiologists, is a critical concern due to its impact on job performance, patient safety, and overall well-being. Anesthesiologists are uniquely vulnerable due to the high-stress nature of their work, long hours, and the critical decisions they must make.

Objective: This study aims to examine the prevalence of burnout among anesthesiologists, identify key factors contributing to their burnout, and explore the coping strategies employed to mitigate these effects.

Methods: A comprehensive survey was conducted among 130 anesthesiologists across various settings, including academic hospitals, private practices, and surgical centers. The survey included validated burnout assessment tools—Maslach burnout inventory (MBI), questions on work-related stressors, and inquiries about personal and institutional coping strategies.

Results: Preliminary findings indicate a significant prevalence of burnout, with high levels of emotional exhaustion, depersonalization, and reduced personal accomplishment. Key contributing factors include excessive workload, work-life imbalance, and lack of support. Coping strategies varied widely, with some anesthesiologists relying on personal resilience and others benefiting from institutional support programs.

Conclusion: The study highlights the pressing issue of burnout among anesthesiologists and underscores the need for targeted interventions. Strategies to reduce burnout should focus on addressing the identified contributing factors and enhancing support systems both at the personal and institutional levels.

Keywords: Anesthesiologists, Burnout, Coping strategies, Maslach burnout inventory, Stressors

How to cite this article: Jujjavarapu TR, Rapaka SA, Konda SR. Burnout among Anesthesiologists: A Survey on Prevalence, Contributing Factors and Coping Strategies. Res and Innov Anesth 2024;9(2):69–91.

Source of support: Nil

Conflict of interest: None

INTRODUCTION

Burnout is a psychological syndrome resulting from prolonged or excessive stress, characterized by three key dimensions: emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment.1,2 It has become an increasingly prevalent issue within the medical field, affecting various specialties and threatening both the well-being of healthcare professionals and the quality of patient care (Table 1). Among these specialties, anesthesiology stands out as particularly vulnerable to burnout due to the unique and demanding nature of the role.3

Table 1: Demography
Count Column N%
Age 30–39 56 43.1%
40–49 10 7.7%
50–59 6 4.6%
60 and above 4 3.1%
Under 30 54 41.5%
Gender Female 84 64.6%
Male 45 34.6%
Prefer not to say 1 0.8%
Years of experience in anesthesiology 0–5 years 96 73.8%
11–15 years 6 4.6%
16–20 years 6 4.6%
6–10 years 12 9.2%
Over 20 years 10 7.7%
Work setting Academic hospital 93 71.5%
Community hospital 9 6.9%
Other (please specify) 5 3.8%
Private practice 23 17.7%

ANESTHESIOLOGY AS A HIGH-RISK SPECIALTY

Anesthesiologists are pivotal in the surgical environment, tasked with ensuring patient safety through the management of anesthesia and monitoring of vital functions during procedures (Table 2). The nature of anesthesiologists’ work involves high-stakes decision-making, responsibility for critical patient outcomes, and exposure to long and irregular working hours (Table 3). This high-pressure environment, coupled with the emotional and cognitive demands of the role, contributes to a heightened risk of burnout.3

Table 2: Job-related stressors
1 2 3 4 5
Count Row N% Count Row N% Count Row N% Count Row N% Count Row N%
High workload 2 1.5% 4 3.1% 49 37.7% 47 36.2% 28 21.5%
Long working hours 0 0.0% 8 6.2% 29 22.3% 43 33.1% 50 38.5%
Administrative tasks 11 8.5% 18 13.8% 49 37.7% 32 24.6% 20 15.4%
Work-life imbalance 5 3.8% 77 16.9% 31 23.8% 35 26.9% 37 28.5%
Lack of support system from colleagues 17 13.1% 30 23.1% 40 30.8% 22 16.9% 21 16.2%
Difficult patient cases 1 0.8% 11 8.5% 55 42.6% 44 34.1% 18 14.0%
Inadequate staffing 1 0.8% 13 10.0% 31 23.8% 34 26.2% 51 39.2%
Pressure to perform 6 4.6% 11 8.5% 32 24.6% 38 29.2% 43 33.1%
Table 3: Average weekly working hours
Count Column N%
Average weekly working hours 40–50 hours 36 27.7%
51–60 hours 34 26.2%
<40 hours 9 6.9%
>60 hours 51 39.2%

CURRENT UNDERSTANDING OF BURNOUT IN HEALTH CARE

The existing literature has established that burnout is prevalent among healthcare professionals, with varying degrees of impact across different specialties (Table 4). Studies have highlighted that burnout can lead to reduced job satisfaction, increased absenteeism, and even premature career exits (Fig. 1). For anesthesiologists, burnout can be particularly detrimental, potentially leading to compromised patient safety and increased rates of medical errors (Table 5). Understanding the specific factors contributing to burnout in this field is essential for developing effective interventions.2,4

Table 4: Section 3 Maslach Burnout Inventory (MBI)
Count %
Burnout <17 (low level burnout) 22 16.9%
18–29 (moderate burnout) 67 51.5%
>30 (high level burnout) 41 31.5%
Depersonalization <5 (low burnout) 1 0.8%
6–11 (moderate burnout) 16 12.3%
>12 (high level burnout) 113 86.9%
Personal achievement <33 (high level) 102 78.5%
34–39 (moderate) 21 16.2%
>40 (low level) 7 5.4%
Table 5: Section 4 (copying mechanisms and support)
1 2 3 4 5
Count Row N% Count Row N% Count Row N% Count Row N% Count Row N%
Exercise 34 26.2% 33 25.4% 39 30.0% 11 8.5% 13 10.0%
Hobbies 38 29.2% 41 31.5% 28 21.5% 12 9.2% 11 8.5%
Meditation or mindfulness 60 46.2% 43 33.1% 12 9.2% 8 6.2% 7 5.4%
Socializing with friend’s family 16 12.3% 35 26.9% 37 28.5% 24 18.5% 18 13.8%
Professional counseling 82 63.1% 22 16.9% 17 13.1% 5 3.8% 4 3.1%
Peer support groups 58 44.6% 26 20.0% 23 17.7% 15 11.5% 8 6.2%
Substance use alcohol drugs 94 72.3% 17 13.1% 14 10.8% 3 2.3% 2 1.5%

Fig. 1: Bar diagram showing demographic profile

OBJECTIVES OF THE STUDY

This study aims to provide a comprehensive evaluation of burnout among anesthesiologists by addressing several key areas:

Table 6: Section 5 (support systems at workplace)
1 2 3 4 5
Count Row N% Count Row N% Count Row N% Count Row N% Count Row N%
Peer support 23 17.7% 26 20.0% 45 34.6% 26 20.0% 10 7.7%
Access to mental health resources 60 46.2% 23 17.7% 27 20.8% 14 10.8% 6 4.6%
Administrative support 58 44.6% 32 24.6% 27 20.8% 11 8.5% 2 1.5%
Professional development opportunities 40 30.8% 24 18.5% 37 28.5% 21 16.2% 8 6.2%
Work-life balance initiatives 47 36.2% 30 23.1% 34 26.2% 9 6.9% 10 7.7%
Table 7: Section 6 (personal rating)
Count Column N%
Rate your overall job satisfaction 1 10 7.7%
2 22 16.9%
3 56 43.1%
4 33 25.4%
5 9 6.9%
Rate your overall life satisfaction 1 11 8.5%
2 28 21.5%
3 59 45.4%
4 17 13.1%
5 15 11.5%
Do you plan to leave the field of anesthesiology within the next 5 years Maybe 41 31.5%
No 73 56.2%
Yes 16 12.3%

SIGNIFICANCE AND IMPACT

Understanding burnout among anesthesiologists is crucial for several reasons.5,10

Table 8: Associations between demographic factors and burnout
Burnout p-value
<17 (low level burnout) 18–29 (moderate burnout) >30 (high level burnout)
Count Row N% Count Row N% Count Row N%
Age 30–39 6 10.7% 28 50.0% 22 39.3% 0.126
40–49 2 20.0% 6 60.0% 2 20.0%
50–59 3 50.0% 3 50.0% 0 0.0%
60 and above 2 50.0% 2 50.0% 0 0.0%
Under 30 9 16.7% 28 51.9% 17 31.5%
Gender Female 14 16.7% 43 51.2% 27 32.1% 0.913
Male 8 17.8% 23 51.1% 14 31.1%
Prefer not to say 0 0.0% 1 100.0% 0 0.0%
Years of experience in anesthesiology 0–5 years 14 14.6% 49 51.0% 33 34.4% 0.084
11–15 years 0 0.0% 0 0.0% 1 100.0%
11–15 years I 20.0% 3 60.0% 1 20.0%
16–20 years 2 33.3% 3 50.0% 1 16.7%
6–10 years 0 0.0% 7 58.3% 5 41.7%
Over 20 years 5 50.0% 5 50.0% 0 0.0%
Work setting Academic hospital 16 17.2% 50 53.8% 27 29.0% 0.507
Community hospital 1 11.1% 3 33.3% 5 55.6%
Other (please specify) 1 20.0% 1 20.0% 3 60.0%
Private practice 4 17.4% 13 56.5% 6 26.1%

Pearson Chi-squared tests

Table 9: Associations between demographic factors and depersonalization
Depersonalization p-value
<5 (low burnout) 6–11 (moderate burnout) >12 (high level burnout)
Count Row N% Count Row N% Count Row N%
Age 30–39 0 0.0% 4 7.1% 52 92.9% <0.001*
40–49 1 10.0% 1 10.0% 8 80.0%
50–59 0 0.0% 3 50.0% 3 50.0%
60 and above 0 0.0% 3 75.0% 1 25.0%
Under 30 0 0.0% 5 9.3% 49 90.7%
Gender Female 1 1.2% 10 11.9% 73 86.9% 0.946
Male 0 0.0% 6 13.3% 39 86.7%
Prefer not to say 0 0.0% 0 0.0% 1 100.0%
Years of experience in anesthesiology 0–5 years 0 0.0% 8 8.3% 88 91.7% <0.001*
11–15 years 0 0.0% 0 0.0% 1 100.0%
11–15 years 0 0.0% 1 20.0% 4 80.0%
16–20 years I 16.7% 1 16.7% 4 66.7%
6–10 years 0 0.0% 0 0.0% 12 100.0%
Over 20 years 0 0.0% 6 60.0% 4 40.0%
Work setting Academic hospital 1 1.1% 12 12.9% 80 86.0% 0.978
Community hospital 0 0.0% 1 11.1% 8 88.9%
Other (please specify) 0 0.0% 0 0.0% 5 100.0%
Private practice 0 0.0% 3 13.0% 20 87.0%

Pearson Chi-squared tests; *Indicates p value is Significant

METHODOLOGY

Participants

A total of 130 anesthesiologists participated in this survey. Demographic details such as age, gender, years of experience, and work setting were collected (Table 10).

Instruments

  • Maslach burnout inventory (MBI): Used to measure burnout levels across three dimensions—emotional exhaustion, depersonalization, and personal achievement.

  • Survey on job-related stressors: Evaluated factors such as workload, working hours, administrative tasks, work-life balance, support from colleagues, and difficult patient cases (Table 11).

  • Coping mechanisms and support systems: Assessed the use of exercise, hobbies, meditation, socializing, professional counseling, and peer support.

RESULTS

Demographic Profile

  • Age distribution: The majority were aged 30–39 (43.1%) and under 30 (41.5%).

  • Gender: Predominantly female (64.6%) (Table 12).

  • Years of experience: Most had 0–5 years of experience (73.8%).

  • Work setting: Mainly academic hospitals (71.5%) (Table 13).

Job-related Stressors

  • High workload: 37.7% reported it as a major stressor (Table 14).

  • Long working hours: 38.5% indicated significant stress from long hours.

  • Administrative tasks: 37.7% found these tasks stressful (Table 15).

  • Work-life imbalance: 28.5% experienced considerable imbalance.

  • Inadequate staffing: 39.2% felt this was a major issue (Table 16).

Burnout Levels (Maslach Burnout Inventory Scores)

  • Emotional exhaustion: 31.5% had high levels (Table 17).

  • Depersonalization: 86.9% experienced high depersonalization.

  • Personal achievement: 78.5% reported high levels, indicating lower feelings of accomplishment (Table 18).

Coping Mechanisms

  • Exercise: 30% used it frequently (Table 19).

  • Hobbies: 31.5% engaged in hobbies regularly.

  • Meditation or mindfulness: 46.2% practiced it often.

  • Professional counseling: 63.1% sought counseling (Table 20).

Support Systems at Workplace

  • Peer support: 34.6% found it moderately supportive.

  • Access to mental health resources: 46.2% had adequate access (Table 21).

  • Administrative support: 44.6% felt supported.

Job Satisfaction and Future Intentions

  • Job satisfaction: 43.1% rated it as moderate, while 16.9% were dissatisfied.

  • Life satisfaction: 45.4% have reported moderate satisfaction with their lives.

  • Leaving the field: 31.5% considered leaving anesthesiology within the next 5 years (Table 22).

Associations between Demographic Factors and Burnout

  • Age and burnout: Younger anesthesiologists (<40 years) showed higher burnout levels.

  • Gender and burnout: No significant difference in burnout levels between genders.

  • Years of experience and burnout: Those with 0–5 years of experience exhibited higher burnout (Fig. 2).

  • Work setting and burnout: Anesthesiologists in community hospitals reported higher burnout.

  • Associations between demographic factors and depersonalization

Fig. 2: Bar diagram showing MBI findings

Associations between Demographic Factors with Personal Achievement

Table 10: Association between demographic factors with personal achievement
Personal achievement p-value
<33 (high level) 34–39 (moderate) >40 (low level)
Count Row N% Count Row N% Count Row N%
Age 30–39 43 76.8% 9 16.1% 4 7.1% 0.310
40–49 7 70.0% 3 30.0% 0 0.0%
50–59 5 83.3% 0 0.0% 1 16.7%
60 and above 3 75.0% 0 0.0% 1 25.0%
Under 30 44 81.5% 9 16.7% 1 1.9%
Gender Female 67 79.8% 14 16.7% 3 3.6% 0.753
Male 34 75.6% 7 15.6% 4 8.9%
Prefer not to say 1 100.0% 0 0.0% 0 0.0%
Years of experience in anesthesiology 0–5 years 79 82.3% 14 14.6% 3 3.1% 0.001
11–15 years 0 0.0% 0 0.0% 1 100.0%
11–15 years 3 60.0% 2 40.0% 0 0.0%
16–20 years 4 66.7% 2 33.3% 0 0.0%
6–10 years 8 66.7% 3 25.0% 1 8.3%
Over 20 years 8 80.0% 0 0.0% 2 20.0%
Work setting Academic hospital 74 79.6% 14 15.1% 5 5.4% 0.950
Community hospital 7 77.8% 2 22.2% 0 0.0%
Other (please specify) 4 80.0% 1 20.0% 0 0.0%
Private practice 17 73.9% 4 17.4% 2 8.7%

Pearson Chi-squared tests

Associations between Job-related Stressors and Burnout

Table 11: Association between job-related stressors and burnout
Burnout p-value
<17 (low level burnout) 18–29 (moderate burnout) >30 (high level burnout)
Count Row N% Count Row N% Count Row N%
Average weekly working hours 40–50 hours 13 36.1% 14 38.9% 9 25.0% 0.023*
51–60 hours 3 8.8% 17 50.0% 14 41.2%
<40 hours 1 11.1% 6 66.7% 2 22.2%
>60 hours 5 9.8% 30 58.8% 16 31.4%
High workload 1 1 50.0% 1 50.0% 0 0.0% 0.035*
2 1 25.0% 2 50.0% 1 25.0%
3 14 28.6% 27 55.1% 8 16.3%
4 3 6.4% 24 51.1% 20 42.6%
5 3 10.7% 13 46.4% 12 42.9%
Long working hours 2 4 50.0% 3 37.5% 1 12.5% <0.001*
3 9 31.0% 19 65.5% 1 3.4%
4 5 11.6% 25 58.1% 13 30.2%
5 4 8.0% 20 40.0% 26 52.0%
Administrative tasks 1 3 27.3% 7 63.6% 1 9.1% 0.226
2 4 22.2% 10 55.6% 4 22.2%
3 10 20.4% 27 55.1% 12 24.5%
4 3 9.4% 14 43.8% 15 46.9%
5 2 10.0% 9 45.0% 9 45.0%
Work-life imbalance 1 0 0.0% 3 60.0% 2 40.0% 0.003*
2 8 36.4% 10 45.5% 4 18.2%
3 7 22.6% 18 58.1% 6 19.4%
4 5 14.3% 22 62.9% 8 22.9%
5 2 5.4% 14 37.8% 21 56.8%
Lack of support system from colleagues 1 7 41.2% 9 52.9% 1 5.9% <0.001*
2 6 20.0% 18 60.0% 6 20.0%
3 5 12.5% 26 65.0% 9 22.5%
4 3 13.6% 10 45.5% 9 40.9%
5 1 4.8% 4 19.0% 16 76.2%
Difficult patient cases 1 0 0.0% 1 100.0% 0 0.0% 0.137
2 3 27.3% 6 54.5% 2 18.2%
3 9 16.4% 34 61.8% 12 21.8%
4 6 13.6% 22 50.0% 16 36.4%
5 4 22.2% 4 22.2% 10 55.6%
Inadequate staffing 1 0 0.0% 1 100.0% 0 0.0% 0.007*
2 5 38.5% 6 46.2% 2 15.4%
3 8 25.8% 16 51.6% 7 22.6%
4 9 26.5% 15 44.1% 10 29.4%
5 0 0.0% 29 56.9% 22 43.1%
Pressure to perform 1 5 83.3% 1 16.7% 0 0.0% <0.001*
2 5 45.5% 6 54.5% 0 0.0%
3 9 28.1% 17 53.1% 6 18.8%
4 1 2.6% 23 60.5% 14 36.8%
5 2 4.7% 20 46.5% 21 48.8%

*Indicates p value is Significant

Associations between Job-related Stressors and Depersonalisation

Table 12: Association between job-related stressors and depersonalization
Depersonalization p-value
<5 (low burnout) 6–11 (moderate burnout) >12 (high level burnout)
Count Row N% Count Row N% Count Row N%
Average weekly working hours 40–50 hours 1 2.8% 7 19.4% 28 77.8% 0.328
51–60 hours 0 0.0% 2 5.9% 32 94.1%
<40 hours 0 0.0% 2 22.2% 7 77.8%
>60 hours 0 0.0% 5 9.8% 46 90.2%
High workload 1 0 0.0% 0 0.0% 2 100.0% 0.757
2 0 0.0% 1 25.0% 3 75.0%
3 1 2.0% 8 16.3% 40 81.6%
4 0 0.0% 3 6.4% 44 93.6%
5 0 0.0% 4 14.3% 24 85.7%
Long working hours 2 1 12.5% 2 25.0% 5 62.5% 0.006
3 0 0.0% 5 17.2% 24 82.8%
4 0 0.0% 4 9.3% 39 90.7%
5 0 0.0% 5 10.0% 45 90.0%
Administrative tasks 1 0 0.0% 4 36.4% 7 63.6% 0.099
2 1 5.6% 1 5.6% 16 88.9%
3 0 0.0% 5 10.2% 44 89.8%
4 0 0.0% 3 9.4% 29 90.6%
5 0 0.0% 3 15.0% 17 85.0%
Work-life imbalance 1 0 0.0% 0 0.0% 5 100.0% 0.077
2 1 4.5% 6 27.3% 15 68.2%
3 0 0.0% 5 16.1% 26 83.9%
4 0 0.0% 4 11.4% 31 88.6%
5 0 0.0% 1 2.7% 36 97.3%
Lack of support system from colleagues 1 0 0.0% 5 29.4% 12 70.6% 0.198
2 1 3.3% 3 10.0% 26 86.7%
3 0 0.0% 5 12.5% 35 87.5%
4 0 0.0% 3 13.6% 19 86.4%
5 0 0.0% 0 0.0% 21 100.0%
Difficult patient cases 1 0 0.0% 1 100.0% 0 0.0% 0.179
2 0 0.0% 1 9.1% 10 90.9%
3 1 1.8% 4 7.3% 50 90.9%
4 0 0.0% 6 13.6% 38 86.4%
5 0 0.0% 4 22.2% 14 77.8%
Inadequate staffing 1 0 0.0% 0 0.0% 1 100.0% 0.567
2 0 0.0% 2 15.4% 11 84.6%
3 0 0.0% 6 19.4% 25 80.6%
4 1 2.9% 5 14.7% 28 82.4%
5 0 0.0% 3 5.9% 48 94.1%
Pressure to perform 1 1 16.7% 3 50.0% 2 33.3% <0.001*
2 0 0.0% 3 27.3% 8 72.7%
3 0 0.0% 4 12.5% 28 87.5%
4 0 0.0% 3 7.9% 35 92.1%
5 0 0.0% 3 7.0% 40 93.0%

*Indicates p value is Significant

Associations between Job-related Stressors and Personal Achievement

Table 13: Association between job-related stressors and personal achievement
Personal achievement
<33 (high level) 34–39 (moderate) >40 (low level)
Count Row N% Count Row N% Count Row N% p-value
Average weekly working hours 40–50 hours 30 83.3% 6 16.7% 0 0.0% 0.721
51–60 hours 26 76.5% 5 14.7% 3 8.8%
<40 hours 7 77.8% 1 11.1% 1 11.1%
>60 hours 39 76.5% 9 17.6% 3 5.9%
High workload 1 2 100.0% 0 0.0% 0 0.0% 0.397
2 2 50.0% 2 50.0% 0 0.0%
3 42 85.7% 4 8.2% 3 6.1%
4 37 78.7% 8 17.0% 2 4.3%
5 19 67.9% 7 25.0% 2 7.1%
Long working hours 2 6 75.0% 2 25.0% 0 0.0% 0.514
3 26 89.7% 1 3.4% 2 6.9%
4 32 74.4% 9 20.9% 2 4.7%
5 38 76.0% 9 18.0% 3 6.0%
Administrative tasks I 9 81.8% 2 18.2% 0 0.0% 0.426
2 15 83.3% 1 5.6% 2 11.1%
3 41 83.7% 5 10.2% 3 6.1%
4 22 68.8% 9 28.1% 1 3.1%
5 15 75.0% 4 20.0% 1 5.0%
Work-life imbalance 1 3 60.0% 2 40.0% 0 0.0% 0.525
2 18 81.8% 3 13.6% 1 4.5%
3 26 83.9% 3 9.7% 2 6.5%
4 30 85.7% 4 11.4% 1 2.9%
5 25 67.6% 9 24.3% 3 8.1%
Lack of support system from colleagues 1 12 70.6% 4 23.5% 1 5.9% 0.197
2 27 90.0% 3 10.0% 0 0.0%
3 34 85.0% 5 12.5% 1 2.5%
4 16 72.7% 3 13.6% 3 13.6%
5 13 61.9% 6 28.6% 2 9.5%
Difficult patient cases 1 1 100.0% 0 0.0% 0 0.0% 0.122
2 11 100.0% 0 0.0% 0 0.0%
3 47 85.5% 6 10.9% 2 3.6%
4 31 70.5% 11 25.0% 2 4.5%
5 11 61.1% 4 22.2% 3 16.7%
Inadequate staffing 1 1 100.0% 0 0.0% 0 0.0% 0.360
2 12 92.3% 1 7.7% 0 0.0
3 22 71.0% 6 19.4% 3 9.7%
4 31 91.2% 2 5.9% 1 2.9%
5 36 70.6% 12 23.5% 3 5.9%
Pressure to perform 1 6 100.0% 0 0.0% 0 0.0% 0.527
2 10 90.9% 1 9.1% 0 0.0%
3 27 84.4% 4 12.5% 1 3.1%
4 28 73.7% 6 15.8% 4 10.5%
5 31 72.1% 10 23.3% 2 4.7%
Table 14: Association between coping mechanisms and support and burnout
Burnout p-value
<17 (low level burnout) 18–29 (moderate burnout) >30 (high level burnout)
Count Row N% Count Row N% Count Row N%
Exercise 1 4 11.8% 21 61.8% 9 26.5% 0.662
2 7 21.2% 14 42.4% 12 36.4%
3 7 17.9% 21 53.8% 11 28.2%
4 1 9.1% 7 63.6% 3 27.3%
5 3 23.1% 4 30.8% 6 46.2%
Hobbies 1 1 2.6% 18 47.4% 19 50.0% 0.003*
2 9 22.0% 26 63.4% 6 14.6%
3 5 17.9% 12 42.9% 11 39.3%
4 2 16.7% 8 66.7% 2 16.7%
5 5 45.5% 3 27.3% 3 27.3%
Meditation or mindfulness 1 9 15.0% 29 48.3% 22 36.7% 0.205
2 8 18.6% 23 53.5% 12 27.9%
3 2 16.7% 9 75.0% 1 8.3%
4 0 0.0% 5 62.5% 3 37.5%
5 3 42.9% 1 14.3% 3 42.9%
Socializing with friend’s family 1 1 6.2% 8 50.0% 7 43.8% 0.655
2 6 17.1% 18 51.4% 11 31.4%
3 6 16.2% 19 51.4% 12 32.4%
4 3 12.5% 14 58.3% 7 29.2%
5 6 33.3% 8 44.4% 4 22.2%
Professional counseling 1 12 14.6% 46 56.1% 24 29.3% 0.015*
2 9 40.9% 8 36.4% 5 22.7%
3 0 0.0% 10 58.8% 7 41.2%
4 0 0.0% 3 60.0% 2 40.0%
5 1 25.0% 0 0.0% 3 75.0%
Peer support groups 1 7 12.1% 33 56.9% 18 31.0% 0.198
2 4 15.4% 14 53.8% 8 30.8%
3 5 21.7% 11 47.8% 7 30.4%
4 3 20.0% 9 60.0% 3 20.0%
5 3 37.5% 0 0.0% 5 62.5%
Substance use alcohol drugs 1 16 17.0% 51 54.3% 27 28.7% 0.015*
2 4 23.5% 12 70.6% 1 5.9%
3 2 14.3% 3 21.4% 9 64.3%
4 0 0.0% 1 33.3% 2 66.7%
5 0 0.0% 0 0.0% 2 100.0%

*Indicates p value is Significant

Table 15: Association between coping mechanisms and support and depersonalization
Depersonalization p-value
<5 (low burnout) 6–11 (moderate burnout) >12 (high level burnout)
Count Row N% Count Row N% Count Row N%
Exercise 1 0 0.0% 3 8.8% 31 91.2% 0.048*
2 0 0.0% 2 6.1% 31 93.9%
3 0 0.0% 6 15.4% 33 84.6%
4 0 0.0% 1 9.1% 10 90.9%
5 1 7.7% 4 30.8% 8 61.5%
Hobbies 1 0 0.0% 1 2.6% 37 97.4% 0.001*
2 0 0.0% 2 4.9% 39 95.1%
3 0 0.0% 6 21.4% 22 78.6%
4 0 0.0% 3 25.0% 9 75.0%
5 1 9.1% 4 36.4% 6 54.5%
Meditation or mindfulness 1 0 0.0% 5 8.3% 55 91.7% 0.004*
2 0 0.0% 5 11.6% 38 88.4%
3 0 0.0% 3 25.0% 9 75.0%
4 0 0.0% 1 12.5% 7 87.5%
5 1 14.3% 2 28.6% 4 57.1%
Socializing with friend’s family 1 0 0.0% 1 6.2% 15 93.8% 0.033*
2 1 2.9% 2 5.7% 32 91.4%
3 0 0.0% 4 10.8% 33 89.2%
4 0 0.0% 2 8.3% 22 91.7%
5 0 0.0% 7 38.9% 11 61.1%
Professional counseling 1 1 1.2% 11 13.4% 70 85.4% 0.857
2 0 0.0% 3 13.6% 19 86.4%
3 0 0.0% 0 0.0% 17 100.0%
4 0 0.0% 1 20.0% 4 80.0%
5 0 0.0% 1 25.0% 3 75.0%
Peer support groups 1 0 0.0% 8 13.8% 50 86.2% 0.566
2 0 0.0% 2 7.7% 24 92.3%
3 1 4.3% 2 8.7% 20 87.0%
4 0 0.0% 2 13.3% 13 86.7%
5 0 0.0% 2 25.0% 6 75.0%
Substance use alcohol drugs 1 1 1.1% 10 10.6% 83 88.3% 0.619
2 0 0.0% 5 29.4% 12 70.6%
3 0 0.0% 1 7.1% 13 92.9%
4 0 0.0% 0 0.0% 3 100.0%
5 0 0.0% 0 0.0% 2 100.0%

*Indicates p value is Significant

Table 16: Association between coping mechanisms and support and personal achievement
Personal achievement
<33 (high level) 34–39 (moderate) >40 (low level)
Count Row N% Count Row N% Count Row N% p-value
Exercise 1 26 76.5% 6 17.6% 2 5.9% 0.623
2 29 87.9% 4 12.1% 0 0.0%
3 31 79.5% 6 15.4% 2 5.1%
4 8 72.7% 2 18.2% 1 9.1%
5 8 61.5% 3 23.1% 2 15.4%
Hobbies 1 26 68.4% 11 28.9% 1 2.6% 0.003*
2 37 90.2% 4 9.8% 0 0.0%
3 24 85.7% 3 10.7% 1 3.6%
4 8 66.7% 2 16.7% 2 16.7%
5 7 63.6% 1 9.1% 3 27.3%
Meditation or mindfulness 1 47 78.3% 12 20.0% 1 1.7% 0.002*
2 36 83.7% 6 14.0% 1 2.3%
3 9 75.0% 2 16.7% 1 8.3%
4 6 75.0% 1 12.5% 1 12.5%
5 4 57.1% 0 0.0% 3 42.9%
Socializing with friend’s family 1 13 81.2% 2 12.5% 1 6.2% 0.336
2 25 71.4% 8 22.9% 2 5.7%
3 32 86.5% 4 10.8% 1 2.7%
4 19 79.2% 5 20.8% 0 0.0%
5 13 72.2% 2 11.1% 3 16.7%
Professional counseling 1 65 79.3% 13 15.9% 4 4.9% 0.168
2 21 95.5% 1 4.5% 0 0.0%
3 10 58.8% 5 29.4% 2 11.8%
4 4 80.0% 1 20.0% 0 0.0%
5 2 50.0% 1 25.0% 1 25.0%
Peer support groups 1 46 79.3% 10 17.2% 2 3.4% 0.438
2 20 76.9% 4 15.4% 2 7.7%
3 19 82.6% 3 13.0% 1 4.3%
4 12 80.0% 3 20.0% 0 0.0%
5 5 62.5% 1 12.5% 2 25.0%
Substance use alcohol drugs 1 74 78.7% 15 16.0% 5 5.3% 0.114
2 15 88.2% 2 11.8% 0 0.0%
3 10 71.4% 3 21.4% 1 7.1%
4 3 100.0% 0 0.0% 0 0.0%
5 0 0.0% 1 50.0% 1 50.0%

*Indicates p value is Significant

Table 17: Association between support system at workplace and burnout
Burnout p-value
<17 (low level burnout) 18–29 (moderate burnout) >30 (high level burnout)
Count Row N% Count Row N% Count Row N%
Peer support I 0 0.0% 11 47.8% 12 52.2% 0.035*
2 7 26.9% 10 38.5% 9 34.6%
3 8 17.8% 27 60.0% 10 22.2%
4 3 11.5% 16 61.5% 7 26.9%
5 4 40.0% 3 30.0% 3 30.0%
Access to mental health resources I 7 11.7% 31 51.7% 22 36.7% 0.328
2 4 17.4% 13 56.5% 6 26.1%
3 5 18.5% 13 48.1% 9 33.3%
4 3 21.4% 9 64.3% 2 14.3%
5 3 50.0% I 16.7% 2 33.3%
Administrative support 1 5 8.6% 29 50.0% 24 41.4% 0.043
2 7 21.9% 16 50.0% 9 28.1%
3 4 14.8% 17 63.0% 6 22.2%
4 5 45.5% 5 45.5% 1 9.1%
5 1 50.0% 0 0.0% 1 50.0%
Professional development opportunities 1 5 12.5% 17 42.5% 18 45.0% 0.077
2 3 12.5% 12 50.0% 9 37.5%
3 6 16.2% 26 70.3% 5 13.5%
4 5 23.8% 10 47.6% 6 28.6%
5 3 37.5% 2 25.0% 3 37.5%
Work-life balance initiatives I 2 4.3% 28 59.6% 17 36.2% 0.014*
2 5 16.7% 13 43.3% 12 40.0%
3 9 26.5% 19 55.9% 6 17.6%
4 1 11.1% 5 55.6% 3 33.3%
5 5 50.0% 2 20.0% 3 30.0%

Pearson Chi-squared tests; *Indicates p value is Significant

Table 18: Association between support system at workplace and depersonalization
Depersonalization p-value
<5 (low burnout) 6–11 (moderate burnout) >12 (high level burnout)
Count Row N% Count Row N% Count Row N%
Peer support 1 0 0.0% 0 0.0% 23 100.0% 0.161
2 0 0.0% 5 19.2% 21 80.8%
3 0 0.0% 6 13.3% 39 86.7%
4 1 3.8% 2 7.7% 23 88.5%
5 0 0.0% 3 30.0% 7 70.0%
Access to mental health resources 1 0 0.0% 6 10.0% 54 90.0% 0.273
2 0 0.0% 4 17.4% 19 82.6%
3 1 3.7% 1 3.7% 25 92.6%
4 0 0.0% 3 21.4% 11 78.6%
5 0 0.0% 2 33.3% 4 66.7%
Administrative support 1 0 0.0% 7 12.1% 51 87.9% 0.006*
2 0 0.0% 2 6.2% 30 93.8%
3 0 0.0% 2 7.4% 25 92.6%
4 1 9.1% 4 36.4% 6 54.5%
5 0 0.0% 1 50.0% 1 50.0%
Professional development opportunities 1 0 0.0% 4 10.0% 36 90.0% 0.276
2 0 0.0% 1 4.2% 23 95.8%
3 1 2.7% 4 10.8% 32 86.5%
4 0 0.0% 4 19.0% 17 81.0%
5 0 0.0% 3 37.5% 5 62.5%
Work-life balance initiatives 1 0 0.0% 3 6.4% 44 93.6% <0.001*
2 0 0.0% 1 3.3% 29 96.7%
3 0 0.0% 6 17.6% 28 82.4%
4 1 11.1% 1 11.1% 7 77.8%
5 0 0.0% 5 50.0% 5 50.0%

Pearson Chi-squared tests; *Indicates p value is Significant

Table 19: Association between support system at workplace and personal achievement
Personal achievement p-value
<33 (high level) 34–39 (moderate) >40 (low level)
Count Row N% Count Row N% Count Row N%
Peer support 1 14 60.9% 8 34.8% 1 4.3% 0.041*
2 19 73.1% 6 23.1% 1 3.8%
3 41 91.1% 2 4.4% 2 4.4%
4 21 80.8% 4 15.4% 1 3.8%
5 7 70.0% 1 10.0% 2 20.0%
Access to mental health resources 1 46 76.7% 11 18.3% 3 5.0% 0.15
2 19 82.6% 3 13.0% 1 4.3%
3 21 77.8% 5 18.5% 1 3.7%
4 13 92.9% 1 7.1% 0 0.0%
5 3 50.0% 1 16.7% 2 33.3%
Administrative support 1 45 77.6% 10 17.2% 3 5.2% 0.106
2 27 84.4% 5 15.6% 0 0.0%
3 19 70.4% 6 22.2% 7 7.4%
4 10 90.9% 0 0.0% 1 9.1%
5 1 50.0% 0 0.0% 1 50.0%
Professional development opportunities 1 31 77.5% 7 17.5% 2 5.0% 0.355
2 20 83.3% 3 12.5% 1 4.2%
3 30 81.1% 6 16.2% 1 2.7%
4 15 71.4% 5 23.8% 1 4.8%
5 6 75.0% 0 0.0% 2 25.0%
Work-life balance initiatives 1 37 78.7% 9 19.1% 1 2.1% 0.060
2 25 83.3% 4 13.3% 1 3.3%
3 28 82.4% 5 14.7% 1 2.9%
4 6 66.7% 2 22.2% 1 11.1%
5 6 60.0% 1 10.0% 3 30.0%

Pearson Chi-squared tests; *Indicates p value is Significant

Table 20: Association between personal rating and burnout
Burnout p-value
<17 (low level burnout) 18–29 (moderate burnout) >30 (high level burnout)
Count Row N% Count Row N% Count Row N%
Rate your overall job satisfaction 1 1 10.0% 3 30.0% 6 60.0% 0.009*
2 1 4.5% 13 59.1% 8 36.4%
3 8 14.3% 28 50.0% 20 35.7%
4 7 21.2% 21 63.6% 5 15.2%
5 5 55.6% 2 22.2% 2 22.2%
Rate your overall life satisfaction 1 0 0.0% 4 36.4% 7 63.6% 0.008*
2 4 14.3% 15 53.6% 9 32.1%
3 9 15.3% 29 49.2% 21 35.6%
4 2 11.8% 13 76.5% 2 11.8%
5 7 46.7% 6 40.0% 2 13.3%
Do you plan to leave the field of anesthesiology within the next 5 years Maybe 4 9.8% 17 41.5% 20 48.8% 0.003*
No 17 23.3% 43 58.9% 13 17.8%
Yes 1 6.2% 7 43.8% 8 50.0%

Pearson Chi-squared tests; *Indicates p value is Significant

Table 21: Association between personal rating and depersonalization
Depersonalization p-value
<5 (low burnout) 6–11 (moderate burnout) >12 (high level burnout)
Count Row N% Count Row N% Count Row N%
Rate your overall job satisfaction 1 0 0.0% 1 10.0% 9 90.0% <0.001*
2 0 0.0% 1 4.5% 21 95.5%
3 0 0.0% 5 8.9% 51 91.1%
4 1 3.0% 3 9.1% 29 87.9%
5 0 0.0% 6 66.7% 3 33.3%
Rate your overall life satisfaction 1 0 0.0% 0 0.0% 11 100.0% <0.001*
2 0 0.0% 3 10.7% 25 89.3%
3 1 1.7% 4 6.8% 54 91.5%
4 0 0.0% 1 5.9% 16 94.1%
5 0 0.0% 8 53.3% 7 46.7%
Do you plan to leave the field of anesthesiology within the next 5 years Maybe 0 0.0% 2 4.9% 39 95.1% 0.338
No I 1.4% 12 16.4% 60 82.2%
Yes 0 0.0% 2 12.5% 14 87.5%

Pearson Chi-squared tests; *Indicates p value is Significant

Table 22: Association between personal rating and personal achievement
Personal achievement p-value
<33 (high level) 34–39 (moderate) >40 (low level)
Count Row N% Count Row N% Count Row N%
Rate your overall job satisfaction 1 6 60.0% 3 30.0% I 10.0% 0.012*
2 18 81.8% 3 13.6% 1 4.5%
3 47 83.9% 7 12.5% 2 3.6%
4 27 81.8% 6 18.2% 0 0.0%
5 4 44.4% 2 22.2% 3 33.3%
Rate your overall life satisfaction 1 8 72.7% 2 18.2% 1 9.1% 0.330
2 24 85.7% 3 10.7% 1 3.6%
3 46 78.0% 11 18.6% 2 3.4%
4 14 82.4% 3 17.6% 0 0.0%
5 10 66.7% 2 13.3% 3 20.0%
Do you plan to leave the field of anesthesiology within the next 5 years Maybe 30 73.2% 9 22.0% 2 4.9% 0.419
No 61 83.6% 9 12.3% 3 4.1%
Yes 11 68.8% 3 18.8% 2 12.5%

Pearson Chi-squared tests; *Indicates p value is Significant

DISCUSSION

The study’s demographic analysis reveals that the majority of anesthesiologists are aged between 30 and 39 (43.1%), followed closely by those under 30 (41.5%). A significant proportion of participants are female (64.6%), with most having 0–5 years of experience in anesthesiology (73.8%) and predominantly working in academic hospitals (71.5%) (Fig. 3).

Fig. 3: Bar diagram showing associations between coping mechanisms, support, and burnout

Job-related stressors are a critical concern, with high workload (37.7%) and long working hours (38.5%) identified as the major stressors (Fig. 4). Additional stressors include administrative tasks, work-life imbalance, and inadequate staffing, all contributing to the overall stress levels of anesthesiologists.

Fig. 4: Bar diagram showing association between coping mechanisms, support, and depersonalization

Regarding average weekly working hours, a substantial 39.2% of respondents work >60 hours per week, while 27.7% work 40–50 hours, and 26.2% work 51–60 hours per week (Fig. 5). The MBI indicates that 51.5% of anesthesiologists experience moderate burnout, with a high prevalence of depersonalization (86.9%). Despite these challenges, most participants reported high levels of personal achievement (78.5%) (Fig. 6).

Fig. 5: Bar diagram showing association between coping mechanisms, support, and personal achievement

Fig. 6: Bar diagram showing association between support system at workplace and burnout

Coping mechanisms and support systems play a crucial role in managing stress. Professional counseling (63.1%) and substance use (72.3%) are common coping strategies, along with exercise and hobbies. However, the availability of peer support and access to mental health resources at the workplace is only moderate. Administrative support and opportunities for professional development are even less frequent (Fig. 7).

Fig. 7: Bar diagram showing association between support system at workplace and depersonalization

Personal ratings of job and life satisfaction are moderate, with 43.1% rating their job satisfaction as 3 and 45.4% rating their life satisfaction similarly. Importantly, 56.2% of respondents do not plan to leave the field of anesthesiology within the next 5 years.

Associations between various factors reveal that high burnout is linked to working >60 hours per week, high workload, long working hours, work-life imbalance, and a lack of support systems. Lower job and life satisfaction are also associated with higher burnout, and there is a significant correlation between planning to leave the field and experiencing high burnout (Fig. 8).

Fig. 8: Bar diagram showing association between support system at workplace and personal achievement

Depersonalization is strongly correlated with longer working hours, administrative tasks, lack of peer support, and inadequate staffing. Lower job satisfaction and poor work-life balance initiatives further exacerbate depersonalization. On the positive side, higher personal achievement is associated with higher job satisfaction and effective coping mechanisms, such as exercise, hobbies, and mindfulness.

CONCLUSION

Burnout among anesthesiologists is a pervasive and serious issue that has significant implications for both personal well-being and patient care. This survey highlights the high prevalence of burnout and identifies key factors contributing to it, including workload, work-life imbalance, and inadequate support. Addressing these issues requires a multifaceted approach involving organizational changes, increased support, and targeted interventions for high-risk groups.

Efforts to reduce burnout should focus on creating a more supportive and sustainable work environment. By implementing strategies such as flexible scheduling, increasing staffing levels, and providing mental health resources, healthcare organizations can help mitigate burnout and improve the overall well-being of anesthesiologists. This, in turn, will enhance the quality of care provided to patients and contribute to a more resilient and effective healthcare system.

The study underscores significant burnout and depersonalization among anesthesiologists, primarily driven by high workload, long working hours, inadequate support systems, and poor work-life balance. Implementing effective coping mechanisms and fostering supportive workplace environments are essential strategies to mitigate these issues. Addressing these factors is crucial to enhancing job satisfaction and reducing the intention to leave the field.

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