Dear Friends and Colleagues,

This open letter to the BOA membership is to update you all on the progress of the BOA Burnout Survey and to add a little personal perspective as to why this survey is being conducted.

Firstly, the response so far has been good with over 1,000 people completing the survey; however, this is still only around 20-25% of the total BOA membership and it would be increasingly valuable as a piece of research if we could get this number closer to 50%. We have noticed a poorer uptake in Scotland, Wales and Northern Ireland, and would not wish the results to be reflective of the English experience only. As a proud Scot, I know how much we dislike being told things by London!

Secondly, the free text comments have been both heart-warming in their support for this work, and also heart-breaking to hear the difficulties many of you are facing during this difficult time. I would like to reassure you that we will painstakingly work through the qualitative data we receive and use it to guide the work that is being started in conjunction with this survey around wellbeing with the BOA.

Thirdly, I would like to tell you that I have personally experienced burnout and seen it in my colleagues. On reflection, I believe I have had three points in my career so far where I have been burned out. These have spanned over a decade from the end of my training to just a couple of years ago, but each time I have learned something new about myself, my career and my place of work. It has become increasingly evident and the literature supports this, that whilst there may be things we can do to make ourselves more resilient to the stresses of the workplace, in general we are a reasonably resilient profession as from our school days, through medical school, into training and onto substantive posts, we have had to be. It is however the environment in which we work that is the predominant driver of burnout. The current pandemic is unmasking many of the problems we have faced for some time and burnout is not a new phenomenon within medicine, but wellbeing has never been discussed for doctors as it is now. When I presented a paper on burnout at the BOA Congress in 2019, I was not asked a single question by the audience, which puzzled me. I spoke with a friend at Congress who also works in this area about this, and his response stuck with me “...We, as orthopaedic surgeons, do not have the vocabulary to speak about these issues…” I would like this survey and the current BOA Wellbeing Initiative to be the start of that conversation. Let us find the words and not be afraid to speak out, because from the responses I have seen so far, we could all do with a little more care and compassion for ourselves and each other.

Stay safe, look after yourselves and each other.



Lt Col B Caesar RAMC
Consultant Trauma and Orthopaedic Surgeon

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