Nurturing Resilience: Alleviating Burnout in Ophthalmology

“As the morning light fills the clinic, I’m met with a rush of patients awaiting care. Throughout the day, I juggle consultations, surgeries, and paperwork, each task demanding my full attention. The growing administrative load weighs heavily on me, leaving little room for breaks, and lunch becomes a distant luxury amidst the constant flow of patients.

In this whirlwind, a sense of disillusionment begins to creep in. While once finding immense satisfaction in restoring sight to patients, now fatigue looms large, overshadowing my efforts. Interactions feel routine, lacking the empathy and connection that once fuelled my passion for ophthalmology.

As the day progresses, I yearn for deeper connections, yet fleeting conversations offer little solace amidst the challenges of our profession. The camaraderie that once lifted our spirits has faded, replaced by a pervasive sense of isolation as we each navigate our own struggles.

By day’s end, exhaustion sets in, overshadowed by the looming threat of burnout. Despite my unwavering dedication to patient care, doubts linger, questioning whether there’s anything more I can give.” This sobering fictional reality underscores the urgent need to address burnout within ophthalmology.

In the realm of ophthalmology, where precision and empathy come together to safeguard one of humanity’s most treasured senses, burnout casts a pervasive shadow over the profession. With the escalating demands of training and practice, an increasing number of young ophthalmologists find themselves trapped in its grip, considering early departure from a field they once wholeheartedly embraced. Addressing this pervasive issue requires a multifaceted approach that integrates institutional support, self-care practices, and a cultural shift within the profession itself.

Erich Fromm’s profound insights into the essence of human existence offer guidance towards a more sustainable approach to ophthalmology.¹ He posits true values stem not from material possessions but from intrinsic qualities that define our ‘being.’ This challenges the prevailing culture of materialism, urging us to redefine success and fulfilment in terms of inner richness rather than external acquisitions.

Critical to mitigating burnout is addressing systemic stressors entrenched within training and practice environments. Institutions must proactively implement measures to alleviate burdens placed upon trainees and practitioners. Overwork, administrative pressures, and lack of support contribute to the erosion of well-being among ophthalmologists, necessitating systemic reforms.

Prioritizing self-care practises is paramount to weathering the storms of burnout. Encouraging a healthy work-life balance through flexible scheduling and time management strategies allows individuals to recharge and reconnect with their passions beyond the operating theatre. Cultivating inner richness through mindfulness, meaningful relationships, and personal growth serves as a buffer against burnout’s insidious effects.

Crucially, effecting lasting change demands a cultural shift within the ophthalmic community. Destigmatizing vulnerability and fostering open dialogue regarding mental health are paramount. By embracing vulnerability as a strength, ophthalmologists can cultivate a culture of authenticity and mutual support, bolstering resilience against burnout’s tide.

Furthermore, recent studies have shed light on specific risk factors contributing to burnout among ophthalmologists. For instance, research by Chang (et al.) examined LGBTQ identity as a potential risk factor for burnout within an international ophthalmologist cohort.² Their findings revealed that LGBTQ ophthalmologists reported higher levels of personal and work-related burnout compared to their non-LGBTQ counterparts. Additionally, discrimination or harassment based on LGBTQ status in the workplace was identified as a contributing factor to increased burnout among this demographic.

Moreover, Sedhom (et al.) conducted a survey among ophthalmologists in the United States, uncovering significant associations between burnout and demographic factors such as gender, employment setting, and practice type. Specifically, female ophthalmologists exhibited nearly twice the odds of experiencing burnout compared to their male counterparts, while physicians employed in academic and hospital settings reported higher rates of burnout than those in large private groups.³ These studies underscore the importance of addressing diverse demographic factors and workplace dynamics in mitigating burnout among ophthalmologists.

Through collaborative implementation of the recommendations below, stakeholders in the ophthalmology community can create a supportive environment fostering resilience, preventing burnout, and enhancing well-being:

Institutional Support: Implement policies promoting work-life balance, allocate resources to cope with stress, and offer tailored support programmes.

Self-Care Practises: Prioritize physical, emotional, and mental well-being through regular exercise, healthy habits, and engaging activities outside work.

Workload Restructuring: Assess workloads critically, identifying tasks incongruent with strengths or patient care contribution.

Promotion of Autonomy: Empower ophthalmologists to make decisions aligned with values, fostering collaboration and professional growth.

Peer Support and Mentorship: Establish networks enabling sharing experiences, seeking guidance, and fostering camaraderie among colleagues.

In conclusion, nurturing resilience and alleviating burnout in ophthalmology requires collective action from institutions, individuals, and the profession. By integrating Fromm’s insights and fostering a culture of openness and support, we can transcend burnout’s limitations, paving the way for a future defined by passion, purpose, and fulfilment.

Dr Mergen’s essay came second in the 2024 John Henahan Writing Prize competition answering this prompt: ‘Burnout is a chronic issue in ophthalmology, leading a growing number to abandon the field early in their careers. What should be done to reduce unnecessary stress in training and practice, allowing for a successful long-term career?’.

Burak Mergen MD, FEBO, FICO is a second year resident in Gengenbach, Germany. burakmergen@gmail.com

1. Fromm, Erich. Haben oder sein. München: Deutsche Verlags Anstalt, 1976.

2. Chang TC, A R, Candelario C, Berrocal AM, Briceño CA, Chen J, Shoham-Hazon N, Berco E, Valle DS, Vanner EA. “LGBTQ+ Identity and Ophthalmologist Burnout,” Am J Ophthalmol, 2023 Feb; 246: 66–85. doi: 10.1016/j. ajo.2022.10.002. Epub 2022 Oct 14. PMID: 36252675.

3. Sedhom JA, Patnaik JL, McCourt EA, Liao S, Subramanian PS, Davidson RS, Palestine AG, Kahook MY, Seibold LK. “Physician burnout in ophthalmology: U.S. survey,” J Cataract Refract Surg, 2022 Jun 1; 48(6): 723–729. doi: 10.1097/j. jcrs.0000000000000837. PMID: 34596630.