Internalized Shame Experiences and Burnout in General Surgery Residents

General surgery residents have high rates of professional burnout, characterized by depersonalization, emotional exhaustion, and reduced sense of personal accomplishment. While shame experiences in surgical residency have been sparsely studied, there are no studies evaluating internalized shame states in surgical residents. This study quantifies internalized shame in surgical residents and its association with burnout. We hypothesized that higher levels of internalized shame would be associated with higher odds of burnout.

This cross-sectional study was conducted via an anonymous survey consisting of demographic information, the Maslach Burnout Inventory (MBI), and the Experience of Shame Scale (ESS), both validated measures. Multivariable logistic regression was used to determine the association between ESS and MBI scores, controlling for age, sex, relationship and parental status, and resident seniority level.

The survey was distributed among United States general surgery residency programs via email through the Association of Program Directors in Surgery.

Categorical general surgery residents were invited to participate.

122 general surgery residents responded to the survey. Respondents were 61.48% female (n = 75), with a median age of 31 (IQR 29-32) and distributed across postgraduate years. On multivariable logistic regression, increased ESS scores were significantly associated with higher odds of burnout (OR 1.11, 95% CI 1.06-1.16, p < 0.001).

General surgery residents experience high rates of internalized shame (median ESS score 54.5, IQR 43-69), and shame states are significantly associated with increased odds of experiencing burnout. Interventions to minimize internalized shame experiences may help mitigate the high rates of burnout found in general surgery residents.