Correlation Between the "Big Five" Personality Traits and Burnout in Orthopaedic Surgery Residents

Burnout is prevalent among orthopaedic surgeons, but the intrinsic factors that predispose surgeons to it are unknown. Recent studies have demonstrated that personality traits correlate with the risk of burnout, but orthopaedic-specific data are lacking. This study examined the relationship between the "Big Five" personality traits and burnout among orthopaedic residents. We hypothesized that high neuroticism and low agreeableness scores would be associated with significantly higher rates of stress and burnout.

The Profiling of Orthopaedic Surgery Trainees (POST) study is a prospective cohort study that collected cross-sectional cognitive assessments of orthopaedic residents at 12 institutions from 2020 to 2022. Participants completed a demographic survey, "Big Five" personality assessment, Perceived Stress Scale (PSS), and Abbreviated Maslach Burnout Inventory (aMBI) at study enrollment and 6 or 12 months later. Linear regressions assessed correlations between each "Big Five" personality trait and PSS and aMBI scores.

Overall, 83 of 129 (64%) eligible orthopaedic residents participated (mean age: 29 years, 12% women). Stress and burnout affected 63% to 66% and 48% to 49% of residents over the study period, respectively. Collectively, mean percentiles on the "Big Five" were highest for conscientiousness (69%), followed by extraversion (63%), openness (62%), agreeableness (58%), and neuroticism (36%). Neuroticism was positively correlated with stress (r = 0.26; p = 0.01), emotional exhaustion (r = 0.43; p < 0.01), and depersonalization (r = 0.26; p = 0.01) but negatively correlated with personal accomplishment (r = -0.30; p = 0.01). Conversely, agreeableness was negatively correlated with depersonalization (r = -0.23; p = 0.01) and positively correlated with personal accomplishment (r = 0.29; p = 0.01).

Personality traits, particularly high neuroticism and low agreeableness, were associated with stress and burnout among orthopaedic residents. These findings suggest that personality assessments may identify residents at highest risk of burnout and provide an opportunity for proactive interventions to mitigate intrinsic drivers of burnout.

Level III. See Instructions for Authors for a complete description of levels of evidence.