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Huo B, Dow T, Wallace AM, French DG. Grit and Thoracic Surgery Interest Among Medical Students. JOURNAL OF SURGICAL EDUCATION 2024:S1931-7204(24)00236-8. [PMID: 38806309 DOI: 10.1016/j.jsurg.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 04/11/2024] [Accepted: 05/10/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVE This study evaluated the relationship between medical student Grit and thoracic surgery career interest. DESIGN An online questionnaire was designed to measure self-reported ratings of Grit among medical student using the Short-Grit scale, as well as thoracic surgery career interest. SETTING Faculty of Medicine, Dalhousie University, Halifax, NS, Canada. PARTICIPANTS From 2019 to 2021, 192/367 (52.3%) participants in their first or second year of medical school. The cohort was comprised of 109 (56.8%) females while 115 (59.9%) were <24 years of age. RESULTS Mean Grit was high (M = 4.159 +/- 0.450) among medical students. There were 80 (41.2%) students interested in thoracic surgery. There was a significant difference in Grit between students with a career interest in thoracic surgery (4.256 +/- 0.442) and those uninterested in thoracic surgery (4.089 +/- 0.444); t(190) = 2.572, p = 0.011; Cohen's D = 0.442. Career interest in thoracic surgery was not influenced by career factor interest. CONCLUSIONS Grittier students have a career interest in thoracic surgery. Recruitment teams in thoracic surgery residency programs with high rates of burnout and poor psychological wellbeing among trainees may take interest in these findings.
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Affiliation(s)
- Bright Huo
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario.
| | - Todd Dow
- Division of Plastic Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia
| | - Alison M Wallace
- Division of Thoracic Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia; Department of Pathology, Dalhousie University, Halifax, Nova Scotia
| | - Daniel G French
- Division of Thoracic Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia
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Sun R, Pitsika M, Momin S, Sher Z, Macarthur D. Evaluating neurosurgical training: a national survey examining the British trainee experience. Br J Neurosurg 2024:1-13. [PMID: 38533926 DOI: 10.1080/02688697.2024.2332178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/12/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE Neurosurgery training in the UK has undergone significant changes over the past few years, including the new competency-based curriculum and a reduction of elective operating due to the pandemic. We conducted a comprehensive survey to assess UK neurosurgical trainees' experiences and perceptions to develop targeted action plans. METHODS An online anonymised survey was developed and distributed amongst the BNTA mailing list. Question types included 10-point Likert scales and free text options. Descriptive statistics, non-parametric testing of Likert scores, and Spearman's rank correlation were used to analyse responses. Pearson's chi-squared test was used for subgroup analysis of categorical data. RESULTS A total of 75 trainees with a National Training Number (NTN) responded. Overall trainees feel they are well trained, well supported, and have caught up with training emerging out of COVID. Funding for training varied between deaneries. There is significant concern amongst trainees regarding the workforce crisis. This, as well as financial concerns are leading to more than a quarter of trainees considering quitting. Half of the trainees are considering going OOP. More than one third of the trainees and more than half of the female trainees are considering working Less Than Full Time (LTFT). Most important supportive mechanisms towards completion of training were social support, along with personal satisfaction from work. An independent mentoring scheme is a preferred additional support mechanism. CONCLUSIONS Overall training experience for neurosurgery trainees in UK and Ireland was positive. There are significant concerns regarding the workforce crisis and costs of training, with a large proportion of neurosurgery trainees considering resigning. OOP and LTFT are popular means of becoming more competitive for consultant posts and to spend time with their families. Deanery experience, senior and peer support does, and will improve trainee experience and protect against attrition.
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Affiliation(s)
- Rosa Sun
- Department of Neurosurgery, University Hospitals North Midlands, Newcastle-under-Lyme, UK
| | - Marina Pitsika
- Department of Neurosurgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Clinical Fellow, General Medical Council, London, UK
| | - Sheikh Momin
- Department of Neurosurgery, University Hospitals North Midlands, Newcastle-under-Lyme, UK
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Zenab Sher
- Department of Neurosurgery, University Hospitals Coventry Warwickshire, Coventry, UK
| | - Donald Macarthur
- Department of Neurosurgery, Nottingham University Hospitals NHS Trust, Nottingham, UK
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de Vries AJ, Hoeve YT, Jaarsma DADC, Pols J, van Raay JJAM. Developing a model describing voluntary residency attrition: a qualitative study. BMC MEDICAL EDUCATION 2024; 24:221. [PMID: 38429755 PMCID: PMC10908006 DOI: 10.1186/s12909-024-05223-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 02/23/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Many factors influencing residency attrition are identified in the literature, but what role these factors play and how they influence each other remains unclear. Understanding more about the interaction between these factors can provide background to put the available evidence into perspective and provide tools to reduce attrition. The aim of this study was therefore to develop a model that describes voluntary residency attrition. METHODS Semi-structured interviews were held with a convenient sample of orthopaedic surgery residents in the Netherlands who dropped out of training between 2000 and 2018. Transcripts were analysed using a constructivist grounded theory approach. Concepts and themes were identified by iterative constant comparison. RESULTS Seventeen interviews with former residents were analysed and showed that reasons for voluntary attrition were different for each individual and often a result of a cumulative effect. Individual expectations and needs determine residents' experiences with the content of the profession, the professional culture and the learning climate. Personal factors like previous clinical experiences, personal circumstances and personal characteristics influence expectations and needs. Specific aspects of the residency programme contributing to attrition were type of patient care, required skills for the profession, work-life balance and interpersonal interaction. CONCLUSIONS This study provides a model for voluntary resident attrition showing the factors involved and how they interact. This model places previous research into perspective, gives implications for practice on the (im)possibilities of preventing attrition and opens possibilities for further research into resident attrition.
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Affiliation(s)
- Astrid J de Vries
- Department of Orthopaedic Surgery, Martini Hospital Groningen, Groningen, The Netherlands.
| | - Yvonne Ten Hoeve
- Health Sciences - Nursing Research, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | | | - Jan Pols
- Center for Education Development and Research in Health Professions (CEDAR), Lifelong Learning, Education and Assessment Research Network (LEARN), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jos J A M van Raay
- Department of Orthopaedic Surgery, Martini Hospital Groningen, Groningen, The Netherlands
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Huo B, Dow T, Helyer L. The Relation of Grit and Surgical Specialty Interest Among Medical Students. JOURNAL OF SURGICAL EDUCATION 2022; 79:1159-1165. [PMID: 35660308 DOI: 10.1016/j.jsurg.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/14/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The assessment of Grit among medical students applying to surgical residency programs may be useful, but the relationship between student Grit and surgical specialty interest is not clear. This study investigated whether medical student Grit differs based on interest in direct-entry surgical specialties. DESIGN A literature search informed the development of a cross-sectional study assessing medical student ratings of the validated 6-item Short-Grit scale. Medical students also indicated their career preferences. SETTING Faculty of Medicine, Dalhousie University, Halifax, NS, Canada; a tertiary medical center. PARTICIPANTS Surgical specialty interest and Grittiness were assessed among 297 (50.4%) pre-clerkship medical students in their first or second year of training. Data was collected from program applicants over 4 years. RESULTS Medical students had high levels of Grit (M = 4.029, SD = 0.517). There was a significant difference in Grit level between medical students interested in cardiac surgery ([M = 4.197, SD = 0.471 vs M = 3.919, 0.518]; t(295) = 4.674, p < 0.001; Cohen's D = 0.556), general surgery ([M = 4.178, SD = 0.466 vs M = 3.916, 0.527]; t(295) = 4.434, p < 0.001; Cohen's D = 0.520), neurosurgery ([M = 4.238, SD = 0.457 vs M = 3.950, 0.518]; t(295) = 4.412, p < 0.001; Cohen's D = 0.575), plastic surgery ([M = 4.138, SD = 0.497 vs M = 3.967, 0.520]; t(295) = 2.747, p = 0.006; Cohen's D = 0.333), and vascular surgery (M = 4.248, SD = 0.368 vs M = 3.948, 0.541); t(295) = 4.570, p < 0.001; Cohen's D = 0.501). CONCLUSIONS Medical students with a career interest in "poor lifestyle" surgical specialties have higher Grit than their peers. These findings may be noteworthy for surgical residency programs with high rates of attrition and burnout.
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Affiliation(s)
- Bright Huo
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Todd Dow
- Division of Plastic Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lucy Helyer
- Division of General Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
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Sun X, Zhang M, Lu Z, Zhang Z, Zheng JC, Cheng L, Zeng L, Qian Y, Huang L. Turnover intention and related factors among resident physicians in China under the standardised residency training programme: a cross-sectional survey. BMJ Open 2022; 12:e061922. [PMID: 35410941 PMCID: PMC9003615 DOI: 10.1136/bmjopen-2022-061922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES This study aimed at examining the extent of turnover intention among the Chinese resident physicians who entered the newly established national standardised residency training programme (SRTP), and exploring factors associated with their turnover intention. DESIGN Cross-sectional survey. SETTING Ten institutions from five geographical areas in China. METHODS 1414 residents were surveyed using paper-based questionnaires and scales regarding their demographics, work situation, attitudes towards SRTP, job satisfaction, psychological resilience, burnout and turnover intention in 2017. The turnover intention was described and compared between categorical groups. Linear regressions were used to select the factors associated with turnover intention. The structural equation model was used to capture the potential mediating effects. RESULTS The mean turnover intention score was 12.45 (SD=4.47). Nearly half (47.87%) of the residents had a high and very high level of turnover intention. Psychological resilience (β=0.066), burnout (β=0.141) and job satisfaction (β=0.022) were positively associated with turnover intention, while specialty (β=-0.135), year of training (β=-0.687), career in medicine (β=-2.191), necessity of training (β=-0.695) and satisfaction with income (β=-1.215) had negative associations with turnover intention. Working hours and nightshift interval indirectly were associated with turnover intention through the mediating effects of burnout. Career in medicine, necessity of training, satisfaction with income, and psychological resilience showed direct effects and indirect effects on turnover intention through burnout and job satisfaction as mediators. CONCLUSIONS The turnover intention among Chinese residents was prevalent and unignorable. Burnout was the major contributing factor, while year of training and positive attitudes towards training were protective factors. Burnout and job satisfaction also served as mediators. Interventions targeting these factors should be incorporated in the training programmes to keep a prosperous physician workforce.
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Affiliation(s)
- Xiaoting Sun
- Postdoctoral station, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
- Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
- Tongji University School of Medicine, Shanghai, China
| | | | - Zhanghong Lu
- Teaching office, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Zhaoyu Zhang
- Tongji University School of Medicine, Shanghai, China
| | | | - Liming Cheng
- Department of Orthopedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lianhua Zeng
- Tongji University School of Medicine, Shanghai, China
| | - Yingli Qian
- Tongji University School of Medicine, Shanghai, China
| | - Lei Huang
- Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
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Vega-Peña NV, Domínguez-Torres LC. ¿Se deben confiar actividades profesionales en cirugía mínimamente invasiva al médico general? Una propuesta basada en el aprendizaje experiencial. REVISTA COLOMBIANA DE CIRUGÍA 2022. [DOI: 10.30944/20117582.1445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introducción. El entrenamiento en cirugía mínimamente invasiva y la definición de las actividades profesionales específicas, socialmente responsables y seguras para el paciente, son un desafío y un deber en la educación médica. Nuestro objetivo es argumentar a favor de esta intervención y describir las especificaciones, alcances y limitaciones de las actividades profesionales confiables a este nivel, así como su lugar en un modelo de aprendizaje experiencial en cirugía mínimamente invasiva para toda la vida.
Métodos. Se evalúa el contexto de la actividad quirúrgica asistencial de los médicos generales, con relación a su participación en el equipo quirúrgico y la necesidad de incorporación en su perfil profesional de unas competencias propias de la cirugía mínimamente invasiva, acorde con su nivel y funciones. Mediante una postura académica y reflexiva, se identifican vacíos y oportunidades de avanzar en el tema.
Resultados. El perfil profesional de un médico general debe contemplar la cirugía mínimamente invasiva como una competencia dentro de su formación, de manera análoga a las propias de la cirugía tradicional abierta. Para ello, se requiere afrontar coherentemente el cambio de teoría y educación quirúrgica, el cambio en la demanda de servicios quirúrgicos y procedimientos, así como fortalecer el rol activo del médico general en el equipo quirúrgico.
Conclusiones. Es necesario modificar el paradigma educativo en cirugía, desde la formación médica en el pregrado. Se plantea un modelo de aprendizaje experiencial de cirugía mínimamente invasiva, y se establecen las competencias fundamentadas en actividades profesionales confiables, necesarias para el perfil profesional de un médico general del siglo XXI.
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Gianakos AL, Freischlag JA, Mercurio AM, Haring RS, LaPorte DM, Mulcahey MK, Cannada LK, Kennedy JG. Bullying, Discrimination, Harassment, Sexual Harassment, and the Fear of Retaliation During Surgical Residency Training: A Systematic Review. World J Surg 2022; 46:1587-1599. [PMID: 35006329 DOI: 10.1007/s00268-021-06432-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND The negative effects of bullying, discrimination, harassment, and sexual harassment (BDHS) on well-being and productivity of surgical residents in training have been well documented. Despite this, little has changed over the past decade and these behaviors continue. The purpose of this study was to determine the prevalence of each abusive behavior experienced by residents, identify the perpetrators, and examine the reporting tendency. METHODS A systematic review of articles published between 2010 and 2020 in the MEDLINE, EMBASE, and Cochrane databases was performed following PRISMA guidelines. The following search terms were used: bullying, harassment, sexual harassment, discrimination, abuse, residency, surgery, orthopedic surgery, general surgery, otolaryngology, obstetrics, gynecology, urology, plastic surgery, and training. RESULTS Twenty-five studies with 29,980 surgical residents were included. Sixty-three percent, 43, 29, and 27% of surgical residents experienced BDHS, respectively. Female residents reported experiencing all BDHS behaviors more often. Thirty-seven percent of resident respondents reported burnout, and 33% reported anxiety/depression. Attending surgeons, followed by senior co-residents, were the most common perpetrators. Seventy-one percent did not report the behavior to their institution. Fifty-one percent stated this was due to fear of retaliation. Of those who reported their experiences, 56% stated they had a negative experience reporting. CONCLUSION Our review demonstrates high prevalence rates of BDHS experienced by residents during surgical training, which have been associated with burnout, anxiety, and depression. The majority of residents did not report BDHS due to fear of retaliation. Residency programs need to devise methods to have a platform for residents to safely voice their complaints.
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Affiliation(s)
- Arianna L Gianakos
- Department of Orthopaedic Surgery, Harvard-Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA.
| | | | | | | | - Dawn M LaPorte
- Department of Orthopaedic Surgery, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Mary K Mulcahey
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Lisa K Cannada
- Department of Orthopaedic Surgery, Novant Health Orthopaedics, Charlotte, NC, USA
| | - John G Kennedy
- Department of Orthopedic Surgery, New York University Langone Health, New York, NY, USA
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Messiaen M, Duba A, Boulangeat C, Boucekine M, Bourbon A, Viprey M, Auquier P, Lançon C, Boyer L, Fond G. Repeated bullying at the workplace in medical students and young doctors: the MESSIAEN national study. Eur Arch Psychiatry Clin Neurosci 2021; 271:1123-1131. [PMID: 32462290 DOI: 10.1007/s00406-020-01144-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 05/15/2020] [Indexed: 11/26/2022]
Abstract
Despite clues indicating high Bullying at the Work Place (BWP) rates in French hospitals, there has been no quantitative study so far. To determine the prevalence of repeated BWP in a national sample of French young physicians; its risk factors, and the mental health consequences of BWP. The study is a cross-sectional observational epidemiological national study addressed to young physicians. The online internet anonymous questionnaire was elaborated according to previous studies exploring BWP. In addition, we explored the quality of initial training. BWP was defined according to the French legal definition. Mental health was assessed by Hamilton Anxiety and Depression scale, psychotropic drug consumption and psychotherapy follow-up. A Structured Equation Modeling (SEM) was carried out to confirm our theoretical model. 2003 participants of the 37 French medical faculties were included. At least one history of BWP was identified in 41.7% of the participants. The SEM model showed good fit (RMSEA = 0.025, CFI = 0.93, TLI = 0.92, WRMR = 1.285). In the SEM model, BWP was associated with age and number of monthly night shifts and weekly worked hours. Obstetric gynecology, psychiatry, surgery, and medical specialties and low-quality initial training were associated with higher risk of BWP. BWP was associated with increased anxiety and depressive symptoms, daily antidepressant and anxiolytic consumption, and psychotherapy follow-up. Decreasing worked hours and night shifts and improving the quality of the initial training may help preventing BWP among medical students and young physicians. Obstetric gynecology, surgical and medical specialties, and psychiatry should be targeted with a focus on developing prevention programs.
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Affiliation(s)
- M Messiaen
- Hôpitaux Universitaires de Marseille, Faculté de Médecine-Secteur Timone, CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de Vie, HUM, Aix-Marseille Univ, 27 Boulevard Jean Moulin EA 3279, 13005, Marseille, France
| | - A Duba
- Hôpitaux Universitaires de Marseille, Faculté de Médecine-Secteur Timone, CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de Vie, HUM, Aix-Marseille Univ, 27 Boulevard Jean Moulin EA 3279, 13005, Marseille, France
| | - C Boulangeat
- Hôpitaux Universitaires de Marseille, Faculté de Médecine-Secteur Timone, CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de Vie, HUM, Aix-Marseille Univ, 27 Boulevard Jean Moulin EA 3279, 13005, Marseille, France
| | - M Boucekine
- Hôpitaux Universitaires de Marseille, Faculté de Médecine-Secteur Timone, CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de Vie, HUM, Aix-Marseille Univ, 27 Boulevard Jean Moulin EA 3279, 13005, Marseille, France
| | - A Bourbon
- Hôpitaux Universitaires de Marseille, Faculté de Médecine-Secteur Timone, CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de Vie, HUM, Aix-Marseille Univ, 27 Boulevard Jean Moulin EA 3279, 13005, Marseille, France
| | - M Viprey
- Hôpitaux Universitaires de Marseille, Faculté de Médecine-Secteur Timone, CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de Vie, HUM, Aix-Marseille Univ, 27 Boulevard Jean Moulin EA 3279, 13005, Marseille, France
| | - P Auquier
- Hôpitaux Universitaires de Marseille, Faculté de Médecine-Secteur Timone, CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de Vie, HUM, Aix-Marseille Univ, 27 Boulevard Jean Moulin EA 3279, 13005, Marseille, France
| | - C Lançon
- Hôpitaux Universitaires de Marseille, Faculté de Médecine-Secteur Timone, CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de Vie, HUM, Aix-Marseille Univ, 27 Boulevard Jean Moulin EA 3279, 13005, Marseille, France
| | - L Boyer
- Hôpitaux Universitaires de Marseille, Faculté de Médecine-Secteur Timone, CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de Vie, HUM, Aix-Marseille Univ, 27 Boulevard Jean Moulin EA 3279, 13005, Marseille, France
| | - G Fond
- Hôpitaux Universitaires de Marseille, Faculté de Médecine-Secteur Timone, CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de Vie, HUM, Aix-Marseille Univ, 27 Boulevard Jean Moulin EA 3279, 13005, Marseille, France.
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Firdouse M, Chrystoja C, de Montbrun S, Escallon J, Cil T. Transition to Independent Surgical Practice and Burnout Among Early Career General Surgeons. Surg Innov 2021; 29:249-257. [PMID: 34461776 PMCID: PMC9016671 DOI: 10.1177/15533506211039682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The transition from surgical residency to independent practice is a challenging period that has not been well studied. Methods: An email invitation to complete a 55-item survey and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was sent to early career general surgeons across Canada. The chi-square test or Fisher's exact test was used to compare demographic and survey characteristics with burnout. Multivariable logistic regression was performed. Results: Of the 586 surgeons contacted, 88 responded (15%); 51/88 surgeons (58.0%) were classified as burnt out according to the MBI-HSS. Most surgeons (68.2%) were not confident in their abilities to handle the business aspect of practice. The majority (60.2%) believed that a transition to independent practice program would be beneficial to recent surgical graduates. Conclusions: Our data showed high prevalence of burnout among recently graduated general surgeons across Canada. Further, respondents were not confident in their managerial and administrative skills required to run a successful independent practice.
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Affiliation(s)
| | | | | | - Jaime Escallon
- 60329Department of Surgery, Toronto, ON, Canada.,10051Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Tulin Cil
- 60329Department of Surgery, Toronto, ON, Canada.,10051Princess Margaret Cancer Centre, Toronto, ON, Canada
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Gennissen L, Stegers-Jager K, van Exel J, Fluit L, de Graaf J, de Hoog M. Career orientations of medical students: A Q-methodology study. PLoS One 2021; 16:e0249092. [PMID: 34019546 PMCID: PMC8139450 DOI: 10.1371/journal.pone.0249092] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/09/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION In pursuing optimal health care, an adequate medical workforce is crucial. However, many countries are struggling with a misalignment of students' specialty preferences and societal needs regarding the future medical workforce. In order to bridge this gap, it is relevant to gain a better understanding of the medical career choice processes. We explored career orientations among medical students in the Netherlands and their implications for future career choices. METHODS We used Q-methodology, a hybrid qualitative-quantitative method, to explore career orientations of medical students. Medical students from two universities in the Netherlands, varying in year of progression of medical school, ranked 62 statements with regard to importance for their future career choice. Participants explained their ranking in an interview and completed a questionnaire regarding demographics. Using by-person factor analysis we identified groups of individuals with similar orientations. RESULTS Twenty-four students participated in this study, resulting in three distinct orientations towards future careers: a first career orientation that highly values lifelong self-development; a second that values work-life balance, and a third that was more concerned with achievement and recognition of their work. CONCLUSION Medical students' career orientations differed in the importance of challenge, work-life balance, and need for recognition. This knowledge can help to design interventions to shift career choices of medical students closer towards future needs in society. Offering career coaching to students that challenges them to explore and prioritise their values, needs and motivations, for example using the materials form this study as a tool, and stimulates them to consider specialties accordingly, could be a promising strategy for guiding students to more long-term satisfying careers.
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Affiliation(s)
- Lokke Gennissen
- Institute of Medical Education Research Rotterdam, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Karen Stegers-Jager
- Institute of Medical Education Research Rotterdam, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Job van Exel
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Lia Fluit
- Radboudumc Health Academy, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Jacqueline de Graaf
- Radboudumc Health Academy, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
- Department of Internal Medicine, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Matthijs de Hoog
- Institute of Medical Education Research Rotterdam, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
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Rialon KL, Mueller C, Ottosen M, Weintraub AS, Coakley B, Brandt ML, Heiss K, Berman L. Drivers of distress and well-being amongst pediatric surgeons. J Pediatr Surg 2021; 56:841-848. [PMID: 33487463 DOI: 10.1016/j.jpedsurg.2021.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/12/2020] [Accepted: 01/01/2021] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Although pediatric surgeons have lower rates of burnout compared to other surgical subspecialists, they still struggle with work-home conflict, depersonalization, and emotional exhaustion. Prior surveys have measured career satisfaction and burnout, but none have identified factors that contribute to physician well-being or provided potential solutions. METHODS Members of the American Pediatric Surgical Association were surveyed regarding sources of distress and institutional practices intended to promote well-being. Responses were analyzed using content analysis. RESULTS There was a 31.5% response rate to the survey. The most frequently cited sources of distress were administrative issues (45.2%), work/life balance (42.3%), personal issues (18.8%), and relationships with coworkers (17.9%). In open-ended questions, other sources of distress included poor leadership, loss of autonomy, lack of support and mentorship, and patient complications. Successful wellness strategies included relief from clinical burden, substantive wellness programming, surgeon inclusion in administrative decision making, support after adverse events, appropriate compensation and benefits, and opportunities for career development in research, teaching, and clinical care. CONCLUSION Pediatric surgeons are affected by multiple sources of distress. Interventions that ameliorate stress in pediatric surgeons were identified and should be considered by local institutions and national organizations to promote well-being. LEVEL OF EVIDENCE n/a.
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Affiliation(s)
- Kristy L Rialon
- Department of Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
| | - Claudia Mueller
- Department of Surgery, Stanford University, Palo Alto, CA, USA
| | - Madelene Ottosen
- Department of Research, Cizik School of Nursing, Houston, TX, USA
| | - Andrea S Weintraub
- Division of Newborn Medicine, Department of Pediatrics, The Icahn School of Medicine, New York, NY, USA
| | - Brian Coakley
- Division of Pediatric Surgery, Department of Surgery, The Icahn School of Medicine, New York, NY, USA
| | - Mary L Brandt
- Department of Surgery, Children's Hospital of New Orleans, Tulane University School of Medicine, New Orleans, LA, USA
| | - Kurt Heiss
- Department of Surgery, Children's Hospital of Atlanta, Emory University, Atlanta, GA, USA
| | - Loren Berman
- Department of Surgery, Nemours AI DuPont Hospital for Children in Wilmington, DE and Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, PA, USA
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Neal MT, Lyons MK. Burnout and work-life balance in neurosurgery: Current state and opportunities. Surg Neurol Int 2021; 11:456. [PMID: 33408941 PMCID: PMC7771504 DOI: 10.25259/sni_736_2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 11/25/2020] [Indexed: 01/14/2023] Open
Abstract
Background: Burnout is a syndrome characterized by emotional exhaustion, depersonalization, and reduced sense of personal accomplishment. The syndrome has been recognized as a pandemic among physicians. The demanding nature of neurosurgery makes neurosurgeons, particularly prone to burnout. In recent years, pioneering work has shed light on burnout in the field of neurosurgery. Methods: We have reviewed the literature in PUBMED on burnout in physicians, focusing on neurosurgical publications. Results: In this manuscript, we explore the topic of burnout in neurosurgery by reviewing definitions, magnitude, etiologies, sequelae, and mitigation strategies. Conclusion: Ongoing education, recognition, and targeted interventions for neurosurgeons at different career stages are needed to manage burnout proactively and ensure a resilient neurosurgery workforce.
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Affiliation(s)
- Matthew T Neal
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States
| | - Mark K Lyons
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States
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13
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Yaow CYL, Mok HT, Ng CH, Devi MK, Iyer S, Chong CS. Difficulties Faced by General Surgery Residents. A Qualitative Systematic Review. JOURNAL OF SURGICAL EDUCATION 2020; 77:1396-1406. [PMID: 32571693 DOI: 10.1016/j.jsurg.2020.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 04/01/2020] [Accepted: 06/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND General surgery residency training is academically rigorous, taxing and involves complex operative procedures. These trainings are synonymous with alarming burnout rates, high incidence of mistreatment reports and lower job satisfaction. Moreover, the established association between residents' levels of well-being and their capacity for empathy and patient care, emphasises the urgency to mitigate the negative connotations relating to surgical training. This systematic review aims to circumnavigate the multitude of problems faced by general surgical residents in training. STUDY DESIGN Literature searches were conducted on electronic databases Medline, PsycINFO, Embase, CINAHL, and Web of Science Core Collection using specific search criteria. Studies that analyzed the difficulties faced by General Surgery residents were eligible for inclusion Qualitative analysis involved the derivation of analytical themes and grouping data extracted from the papers accordingly. RESULTS After review of the full study texts, 19 studies met the inclusion criteria. The 3 main analytical themes identified were Problems regarding the Residency Programme, Work Associated Challenges, and Personal Concerns. Problems Regarding Residency Training was associated with residents' lack of experience. Work Associated Challenges highlighted problems with peer interactions, autocratic relationships, and communication with patients. Personal Concerns includes work-life balance, personal well-being and gender biases. CONCLUSION This systematic review delves into several prevalent difficulties that general surgical residents face, ranging from work related issues to personal difficulties. The results of this review can be used to provide complementary supportive measures for general surgical residents.
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Affiliation(s)
- Clyve Yu Leon Yaow
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Hao Ting Mok
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cheng Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - M Kamala Devi
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, Singapore
| | - Shridhar Iyer
- Division of Hepatobiliary Surgery, Department of Surgery, National University Hospital, Singapore
| | - Choon Seng Chong
- Division of Colorectal Surgery, Department of Surgery, National University Hospital, Singapore.
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Bustraan J, Dijkhuizen K, Velthuis S, van der Post R, Driessen E, van Lith JMM, de Beaufort AJ. Why do trainees leave hospital-based specialty training? A nationwide survey study investigating factors involved in attrition and subsequent career choices in the Netherlands. BMJ Open 2019; 9:e028631. [PMID: 31175199 PMCID: PMC6589009 DOI: 10.1136/bmjopen-2018-028631] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To gain insight into factors involved in attrition from hospital-based medical specialty training and future career plans of trainees who prematurely left their specialty training programme. DESIGN Nationwide online survey study. SETTING Postgraduate education of all hospital-based specialties in the Netherlands. PARTICIPANTS 174 trainees who prematurely left hospital-based medical specialty training between January 2014 and September 2017. MAIN OUTCOME MEASURES Factors involved in trainees' decisions to leave specialty training and their subsequent career plans. RESULTS The response rate was 38%. Of the responders, 25% left their programme in the first training year, 50% in year 2-3 and 25% in year 4-6. The most frequently reported factors involved in attrition were: work-life balance, job content, workload and specialty culture. Of the leaving trainees, 66% switched to another specialty training programme, of whom two-thirds chose a non-hospital-based training programme. Twelve per cent continued their career in a non-clinical role and the remainder had no specific plans yet. CONCLUSIONS This study provides insight in factors involved in attrition and in future career paths. Based on our findings, possible interventions to reduce attrition are: (1) enable candidates to develop a realistic view on job characteristics and demands, prior to application; (2) provide individual guidance during specialty training, with emphasis on work-life balance and fit with specialty.
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Affiliation(s)
- Jacqueline Bustraan
- Centre for Innovation in Medical Education, Leiden University Medical Centre, Leiden, The Netherlands
| | - Kirsten Dijkhuizen
- Centre for Innovation in Medical Education, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Sophie Velthuis
- Centre for Innovation in Medical Education, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - Erik Driessen
- Department of Education Development and Research, Maastricht University, Maastricht, The Netherlands
| | - Jan M M van Lith
- Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Arnout Jan de Beaufort
- Centre for Innovation in Medical Education, Leiden University Medical Centre, Leiden, The Netherlands
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15
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Dominguez LC, Dolmans D, de Grave W, Sanabria A, Stassen LP. Job Crafting to Persist in Surgical Training: A Qualitative Study From the Resident's Perspective. J Surg Res 2019; 239:180-190. [PMID: 30844632 DOI: 10.1016/j.jss.2019.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 12/30/2018] [Accepted: 02/01/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Attrition in surgical training, a result of poor well-being at work, continues to rise. Work engagement and persistence, the other side of the coin, depend on the proactivity of residents to optimize the demands and resources in the workplace to achieve a better fit with the environment. This type of proactivity refers to job-crafting. In this study, we sought to explore the specific mechanisms underlying residents' job-crafting to enhance work engagement and persistence, as well as the role of supervisors in this endeavor. MATERIALS AND METHODS We used a constructivist-grounded theory design. We conducted semistructured interviews of active residents. During the analysis of verbatim protocols, we developed codes and categories and identified the main themes (job-crafting mechanisms) related to work engagement and persistence. We anticipated procedures to engage in reflexivity. RESULTS The residents showed six job-crafting mechanisms (build trust with supervisors, manage proactively, seek help, see errors and frustrations as learning opportunities, find a suitable work-life balance, and seek challenges actively). The supervisors contributed to residents' job-crafting with four mechanisms (earning the trust of the residents, providing guidance and support, allowing residents to fulfill tasks befitting a surgeon in training, and offering increasingly challenging tasks to residents). CONCLUSIONS Work engagement and persistence in training are active processes that depend on the ability of residents to take advantage of resources and challenges and to diminish hindering demands at the workplace. Future research should focus on the perspectives of the supervisor, as well as on the effectiveness of job-crafting interventions, to enhance work engagement.
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Affiliation(s)
| | - Diana Dolmans
- Department of Educational Development and Research, School of Health Professions Education (SHE), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - Willem de Grave
- Department of Educational Development and Research, School of Health Professions Education (SHE), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - Alvaro Sanabria
- Department of Surgery, Universidad de la Sabana, Chía, Colombia
| | - Laurents P Stassen
- Department of Surgery, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
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16
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Halim UA, Riding DM. Systematic review of the prevalence, impact and mitigating strategies for bullying, undermining behaviour and harassment in the surgical workplace. Br J Surg 2018; 105:1390-1397. [DOI: 10.1002/bjs.10926] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/19/2018] [Accepted: 05/31/2018] [Indexed: 11/11/2022]
Abstract
Abstract
Background
Bullying, undermining behaviour and harassment (BUBH) have been reported in entertainment, politics and sport. Such behaviours may also be common in surgery, and are frequently associated with poor patient care and inferior outcomes. The aim was to define the prevalence and impact of this behaviour in the international surgical workplace, and to explore counterstrategies.
Methods
A systematic review was conducted by searching EMBASE, Medline, PsycINFO and the Cochrane Database of Systematic Reviews in August 2017. Original research studies (Oxford Centre for Evidence-based Medicine levels 1–4) investigating the prevalence and impact of BUBH in surgery, and/or counterstrategies, were eligible for inclusion. The review was conducted in accordance with PRISMA guidelines.
Results
Of 2692 papers, 32 were eligible for inclusion. Twenty-two reported the prevalence of BUBH in surgery, 11 studied the impact of this behaviour and six investigated counterstrategies. Prevalence data showed that BUBH are common in the surgical workplace. Their impact can be profound, compromising mental health, reducing job satisfaction, and inducing suicidal ideation. Formal reporting systems were perceived as ineffective and even potentially harmful to victims.
Conclusion
Bullying, undermining behaviour and harassment are highly prevalent within surgery, and extremely damaging to victims. There is little high-quality research into counterstrategies, although professionalism training using simulated scenarios may be useful.
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Affiliation(s)
- U A Halim
- Academic Surgery Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Southmoor Road, Manchester M23 9LT, UK
| | - D M Riding
- Academic Surgery Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Southmoor Road, Manchester M23 9LT, UK
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Dominguez LC, Stassen L, de Grave W, Sanabria A, Alfonso E, Dolmans D. Taking control: Is job crafting related to the intention to leave surgical training? PLoS One 2018; 13:e0197276. [PMID: 29856750 PMCID: PMC5983422 DOI: 10.1371/journal.pone.0197276] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 04/30/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The intention to leave surgical training, hereinafter referred as proxy of "attrition," is associated with poor well-being in the workplace. Attrition is suggested to diminish when residents possess job-crafting skills, that is, the ability to redefine their job in meaningful ways and maximize well-being at work by increasing structural and social resources and challenges and decreasing hindering demands. However, the evidence supporting this relationship is scant. This study sought to: 1) investigate to what extent residents possess job-crafting skills and compare residents' levels of job-crafting skills across years of residency training; 2) investigate the relationship between job crafting, well-being as measured by burnout and work-engagement rates, and the intention to leave; and 3) compare the levels of job-crafting skills and well-being between residents with and without serious intentions to leave. METHODS This cross sectional study was conducted in fifteen residency programs in Colombia. Surgical residents completed different questionnaires including the Dutch Job Crafting Scale (DJCS), MBI-Human Services Survey (MBI-HSS), Utrecht Work Engagement Scale (UWES-17) and an adapted version of the Nurse Turnover Intention Scale (NTIS). The objectives were addressed by independent analyses of variance (ANOVA), structural equation modeling techniques (SEM) and independent t-tests, respectively. RESULTS A total of 202 residents participated. Residents generally scored high on their job-crafting skills to increase structural and social resources as well as challenging demands, but were less positive about their skills to reduce hindering demands. No differences across years of training were found. Job crafting correlated positively with work-engagement, which was inversely related to the intention to leave. Conversely, job crafting correlated negatively with burnout, which bore a positive relationship to the intention to leave. Residents with serious intentions to leave exhibited lower levels of most job-crafting skills and work-engagement, compared to those without such intentions. CONCLUSIONS This study adds evidence that attrition is a process mediated by residents' well being at work, which can be molded by their job-crafting endeavors. Future research is needed to evaluate the effectiveness of interventions aimed at cultivating resident's job-crafting abilities in order to reduce attrition.
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Affiliation(s)
| | - Laurents Stassen
- Department of Surgery, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands
| | - Willem de Grave
- Department of Educational Development and Research, School of Health Professions Education (SHE), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
| | - Alvaro Sanabria
- Department of Surgery, Universidad de la Sabana, Chía, Colombia
- Fundación Colombiana de Cancerología—Clínica Vida, Medellín, Colombia
| | - Edgar Alfonso
- University of Lyon, University Jean Monnet-St-Etienne, LASPI, Saint-Etienne, France
| | - Diana Dolmans
- Department of Educational Development and Research, School of Health Professions Education (SHE), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
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Moris D, Karachaliou GS, Pawlik TM, Nwomeh B. Attrition in general surgery residency: can global and rural surgery shift the paradigm? J Surg Res 2018; 224:166-168. [DOI: 10.1016/j.jss.2017.12.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 12/02/2017] [Accepted: 12/13/2017] [Indexed: 10/18/2022]
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Shweikeh F, Schwed AC, Hsu CH, Nfonsam VN. Status of Resident Attrition From Surgical Residency in the Past, Present, and Future Outlook. JOURNAL OF SURGICAL EDUCATION 2018; 75:254-262. [PMID: 28760500 DOI: 10.1016/j.jsurg.2017.07.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/13/2017] [Accepted: 07/13/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate the current rate of attrition in general surgery residency, assess the risk factors, and identify prevention strategies. DESIGN A literature review of the PubMed and MEDLINE databases, from January 1, 1980 to February 1, 2016, for relevant articles. The calculated attrition rate and the statistically significant influencing factors were the main measures and outcomes. SELECTION All English language articles that described attrition from a general surgery residency were included. Articles that performed an assessment of attrition rates, academic performance, reasons for resident loss, and demographics were identified and data from these studies were collected. Random-effect meta-analysis and meta-regression based on a generalized mixed-effects model was performed. RESULTS A total of 26 studies were included. Reported attrition rates ranged from 2% to 30% over the course of residency training. Random-effect meta-analysis is indicative of a yearly attrition rate of 2.4% (95% CI: 1.3%-3.5%) and a cumulative 5-year attrition rate of 12.9% (95% CI: 7.9%-17.8%). Most of them leave residency during their first 2 years, and the rate significantly decreases with increasing postgraduate year (p < 0.0001). The Accreditation Council for Graduate Medical Education mandated 80-hour week is associated with a higher rate, though not significantly (3.2% [95% CI: 1.3%-5.1%] vs. 2.2% [0.9%-3.5%], p = 0.37). Pooled analysis demonstrates no statistically significant difference in the rate of attrition between males and females (2.1% [95% CI: 1.1%-3%] vs. 2.9% [95% CI: 1.6%-4.1%], p = 0.73). Most remain in graduate medical education and pursue residency training in other specialties. CONCLUSION Attrition in general surgery most commonly occurs within the first 2 years of training and, in contrast to previous findings, is not related to female sex. Restrictions on work hours seem to have increased the rate, whereas remediation practices can prevent it. Training programs should direct efforts towards attrition-prevention strategies.
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Affiliation(s)
- Faris Shweikeh
- Department of Surgery, University of Arizona College of Medicine, Tucson, Arizona; Department of Epidemiology and Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona.
| | | | - Chiu-Hsieh Hsu
- Department of Epidemiology and Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona
| | - Valentine N Nfonsam
- Department of Surgery, University of Arizona College of Medicine, Tucson, Arizona
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Forel D, Vandepeer M, Duncan J, Tivey DR, Tobin SA. Leaving surgical training: some of the reasons are in surgery. ANZ J Surg 2018; 88:402-407. [DOI: 10.1111/ans.14393] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 12/19/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Deanne Forel
- Royal Australasian College of Surgeons, Research and Evaluation, Incorporating ASERNIP-S; Adelaide South Australia Australia
| | - Meegan Vandepeer
- Royal Australasian College of Surgeons, Research and Evaluation, Incorporating ASERNIP-S; Adelaide South Australia Australia
| | - Joanna Duncan
- Royal Australasian College of Surgeons, Research and Evaluation, Incorporating ASERNIP-S; Adelaide South Australia Australia
| | - David R. Tivey
- Royal Australasian College of Surgeons, Research and Evaluation, Incorporating ASERNIP-S; Adelaide South Australia Australia
| | - Stephen A. Tobin
- Royal Australasian College of Surgeons; Melbourne Victoria Australia
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Demographics, Interests, and Quality of Life of Canadian Neurosurgery Residents. Can J Neurol Sci 2017; 45:214-220. [DOI: 10.1017/cjn.2017.263] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground:Neurosurgical residents face a unique combination of challenges, including long duty hours, technically challenging cases, and uncertain employment prospects. We sought to assess the demographics, interests, career goals, self-rated happiness, and overall well-being of Canadian neurosurgery residents.Methods:A cross-sectional survey was developed and sent through the Canadian Neurosurgery Research Collaborative to every resident enrolled in a Canadian neurosurgery program as of April 1, 2016.Results:We analyzed 76 completed surveys of 146 eligible residents (52% response rate). The median age was 29 years, with 76% of respondents being males. The most popular subspecialties of interest for fellowship were spine, oncology, and open vascular neurosurgery. The most frequent self-reported number of worked hours per week was the 80- to 89-hour range. The majority of respondents reported a high level of happiness as well as stress. Sense of accomplishment and fatigue were reported as average to high and overall quality of life was low for 19%, average for 49%, and high for 32%. Satisfaction with work-life balance was average for 44% of respondents and was the only tested domain in which significant dissatisfaction was identified (18%). Overall, respondents were highly satisfied with their choice of specialty, choice of program, surgical exposure, and work environment; however, intimidation was reported in 36% of respondents and depression by 17%.Conclusions:Despite a challenging residency and high workload, the majority of Canadian neurosurgery residents are happy and satisfied with their choice of specialty and program. However, work-life balance, employability, resident intimidation, and depression were identified as areas of active concern.
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Delisle M, Rivard J, Hebbard P, McCarthy B, Wirtzfeld D. National survey of mentorship in Canadian general surgery residency programs: Where are we and what do we need? CANADIAN MEDICAL EDUCATION JOURNAL 2017; 8:e42-e53. [PMID: 29354196 PMCID: PMC5766218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND The benefits of mentorship on residents are well established. The current state of mentorship in General Surgery (GS) residency programs in Canada is unknown. The objectives of this study were to obtain GS residents' and program directors' (PD) perspectives on resident mentorship. STUDY DESIGN An electronic survey was developed and distributed to all 601 GS residents in Canada. All 17 PDs were invited for telephone interviews. RESULTS A total of 179 of the 601 residents responded. Ninety-seven percent (n=173) felt mentorship was important. Only 67% (n=116) identified a mentor and only 53% (n=62) reported a mentorship program. Most who identified a mentor (n=87/110, 79%) were satisfied with the mentorship received. Significant variations in mentorship existed between demographic subgroups and mentorship program types. Overall, residents (n=121, 74%) favoured having a required mentorship program.A total of 11 out of 17 PDs participated in the telephone interviews. The majority of PDs (n=9, 82%) were satisfied with current resident mentorship but most acknowledged that barriers exist (n=8, 73%). CONCLUSION GS programs in Canada should ensure they are providing equal opportunities for mentorship across demographic subgroups. Programs are encouraged to examine both their program's and their residents' needs as well as local barriers to improve mentorship.
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Affiliation(s)
- Megan Delisle
- Section of General Surgery, Faculty of Health Sciences, University of Manitoba, Manitoba, Canada
| | - Justin Rivard
- Section of General Surgery, Faculty of Health Sciences, University of Manitoba, Manitoba, Canada
| | - Pamela Hebbard
- Section of General Surgery, Faculty of Health Sciences, University of Manitoba, Manitoba, Canada
| | - Brendan McCarthy
- Section of General Surgery, Faculty of Health Sciences, University of Manitoba, Manitoba, Canada
| | - Debrah Wirtzfeld
- Section of General Surgery, Faculty of Health Sciences, University of Manitoba, Manitoba, Canada
- Center for Healthcare Innovation, University of Manitoba, Manitoba, Canada
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Adams S, Ginther DN, Neuls E, Hayes P. Attitudes and factors contributing to attrition in Canadian surgical specialty residency programs. Can J Surg 2017; 60:247-252. [PMID: 28562235 DOI: 10.1503/cjs.004616] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND We recently studied attrition in Canadian general surgical programs; however, there are no data on whether residents enrolled in other surgical residencies harbour the same intents as their general surgical peers. We sought to determine how many residents in surgical disciplines in Canada consider leaving their programs and why. METHODS An anonymous survey was administered to all residents in 9 surgical disciplines in Canada. Significance of association was determined using the Pearson χ2 test. The Canadian Post-MD Education Registry (CAPER) website was used to calculate the response rate. RESULTS We received 523 responses (27.6% response rate). Of these respondents, 140 (26.8%) were either "somewhat" or "seriously" considering leaving their program. Residents wanting to pursue additional fellowship training and those aspiring to an academic career were significantly less likely to be considering changing specialties (p = 0.003 and p = 0.005, respectively). Poor work-life balance and fear of unemployment/underemployment were the top reasons why residents would change specialty (55.5% and 40.8%, respectively), although the reasons cited were not significantly different between those considering changing and those who were not (p = 0.64). Residents who were considering changing programs were significantly less likely to enjoy their work and more likely to cite having already invested too much time to change as a reason for continuing (p < 0.001). CONCLUSION More than one-quarter of residents in surgical training programs in Canada harbour desires to abandon their surgical careers, primarily because of unsatisfactory work-life balance and limited employment prospects. Efforts to educate prospective residents about the reality of the surgical lifestyle and to optimize employment prospects may improve completion rates.
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Affiliation(s)
- Simon Adams
- From the Department of General Surgery, University of Saskatchewan, Royal University Hospital, Saskatoon, SK
| | - David Nathan Ginther
- From the Department of General Surgery, University of Saskatchewan, Royal University Hospital, Saskatoon, SK
| | - Evan Neuls
- From the Department of General Surgery, University of Saskatchewan, Royal University Hospital, Saskatoon, SK
| | - Paul Hayes
- From the Department of General Surgery, University of Saskatchewan, Royal University Hospital, Saskatoon, SK
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