Job satisfaction among chairs of surgery from Europe and North America

Towards a Virtual "Global Academia of Surgeons"

OBJECTIVE

To explore the prospects of academic e-learning by evaluating our long-standing internet-based surgical learning program and to assess the impact of training on the presentation skills of our residents. The eventual goal is to search whether such models could be further developed by the European Surgical Association (ESA).

BACKGROUND

E-learning has become a major educational trend particularly during the COVID-19 pandemic. For more than a decade, our academic tertiary center has released weekly video-lectures covering the entire abdominal-surgical curriculum for residents. All lessons were prepared under the supervision of specialized experts and recorded and edited by a professional film team before being released on a dedicated YouTube channel ( https://www.usz.ch/surgical-resident-lectures ).

METHODS

To date, our channel includes 120 presentations with more than 619,000 views. We conducted a survey among online users with a medical background and tested the benefits and potential for improvements of local stakeholders to collect individual reviews.

RESULTS

A total of 708 users from 106 countries participated in the survey. Continuing medical education (49%), specific questions (38%), and exam preparation (33%) were the main motivations for video viewing. The preferred topics were current guidelines (69%), latest research topics (59%), and complex surgical conditions (52%). Ninety-four percent of our local audience reported a positive learning experience.

CONCLUSION

E-learning can improve local academic training and promote the global visibility of strong academic centers. Providing free and unrestricted expertise via social media is a novel and groundbreaking opportunity that fills a global education gap by dissemination of surgical education on an unprecedented scale. Expert associations such as the ESA may adopt similar formats and foster their perception as true beacons of knowledge.

Optimizing Surgeon Well-Being: A Review and Synthesis of Best Practices

Through a systematic review and mixed-methods meta-synthesis of the existing literature on surgeon well-being, we sought to identify the specific elements of surgeon well-being, examine factors associated with suboptimal well-being, and highlight opportunities to promote well-being.

Background

Suboptimal surgeon well-being has lasting and substantial impacts to the individual surgeon, patients, and to society as a whole. However, most of the existing literature focuses on only 1 aspect of well-being-burnout. While undoubtedly a crucial component of overall well-being, the mere absence of burnout does not fully consider the complexities of being a surgeon.

Methods

We performed a literature search within Ovid Medline, Elsevier Excerpta Medica dataBASE, EBSCOhost Cumulative Index to Nursing and Allied Health Literature, and Clarivate Web of Science from inception to May 7, 2020, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies with primary data examining surgeon well-being were included. Using a predetermined instrument, data were abstracted from each study and compared using thematic analysis.

Results

A total of 5369 abstracts were identified and screened, with 184 full articles (172 quantitative, 3 qualitative, 9 mixed methods) selected for analysis. Among these, 91 articles measured burnout, 82 examined career satisfaction, 95 examined work-related stressors, 44 explored relationships and families, and 85 assessed emotional and physical health. Thematic analysis revealed 4 themes: professional components, personal components, work-life balance, and impacts to well-being.

Conclusions

Surgeon well-being is complex and multifaceted. This nuanced examination of surgeon well-being highlights the critical need to develop and provide more long-term support to surgeons-with interventions being tailored based on individual, institutional, and systemic factors.

Burnout and psychological distress between surgical and non-surgical residents

Surgical training is considered to be very stressful among residents and medical students choose less often surgery for their career. Our aim was to assess the prevalence of burnout and psychological distress in residents attending surgical specialties (SS) compared to non-surgical specialties (NSS). Residents from the University of Bologna were asked to participate in an anonymous online survey. The residents completed a set of questions regarding their training schedule and three standardized questionnaires: (1) the Maslach Burnout Inventory, assessing the three dimensions of burnout: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA); (2) the Zung Self-Rating Depression Scale; (3) the Psychosomatic Problems Scale. One-hundred and ninety residents completed the survey. Overall, the prevalence of burnout was 73% in the SS group and 56.3% in the NSS group (P = 0.026). More specifically, SS reported higher levels of EE and DP compared to NSS. No significant differences between SS and NSS emerged for PA, depression, or somatic problems. The present findings indicate that burnout is more prevalent in surgical residents than in residents attending non-surgical specialties. ClinicalTrials.gov identifier: NCT03668080.

The Correlation of Stress in Residency With Future Stress and Burnout: A 10-Year Prospective Cohort Study

BACKGROUND

Residents and practicing physicians displaying signs of stress is common. It is unclear whether stress during residency persists into professional practice or is associated with future burnout.

OBJECTIVE

We assessed the persistence of stress after residency and its correlation with burnout in professional practice. We hypothesized that stress would linger and be correlated with future burnout.

METHODS

A prospective cohort study was conducted over 10 years using survey instruments with existing validity evidence. Residents over 3 academic years (2003-2005) were surveyed to measure stress in residency. Ten years later, these residents were sought out for a second survey measuring current stress and burnout in professional practice.

RESULTS

From 2003 to 2005, 143 of 155 residents participated in the initial assessment (92% response rate). Of those, 21 were excluded in 2015 due to lack of contact information; follow-up surveys were distributed to 122 participants, and 81 responses were received (66% response rate and 57% of original participants). Emotional distress in residency correlated with emotional distress in professional practice (correlation coefficient = 0.45, P < .0001), emotional exhaustion (correlation coefficient = 0.30, P = .007), and depersonalization (correlation coefficient = 0.25, P = .029). Multivariate linear regression showed that emotional distress in residency was associated with future emotional distress (β estimate = 0.57, P = .005) and depersonalization (β estimate = 2.29, P = .028).

CONCLUSIONS

We showed emotional distress as a resident persists into individuals' professional practice 10 years later and has an association with burnout in practice.

Leadership of United States Academic Departments of Ophthalmology: Chairperson Characteristics, Accomplishments, and Personal Insights

PURPOSE

To report on the characteristics, accomplishments, and past experiences of current academic ophthalmology department chairs.

DESIGN

Cross-sectional study.

METHODS

Setting: A confidential online survey.

STUDY POPULATION

Total of 111 chairs of US academic ophthalmology departments.

MAIN OUTCOME MEASURES

Chairs' general characteristics, training/former positions held, academic accomplishments, previous organization/committee involvement, motivation/insight, and overall work satisfaction.

RESULTS

Fifty-five chair responses were received (96% male, mean age 57 years, mean term 7 years). The majority were American medical graduates (93%), full professors of ophthalmology (93%), and permanent chairs (96%). All completed their residency in the US and 96% completed a fellowship (25% vitreoretinal surgery, 22% cornea and external disease, and 20% glaucoma). On average, chairs authored 98 peer-reviewed articles, 2 books, and 11 book chapters. They were also significantly involved in peer-reviewed journal literature, serving as editors (20%), associate editors (18%), or editorial board members (60%). The majority of chairs indicated they decided to seek their position late in their career, having already become a full (33%) or associate professor (26%), primarily owing to a desire to build and promote an academic ophthalmology department (61%). Chairs regarded their experience as head of service as most important for their current performance as department heads. Their principal advice to aspiring ophthalmology chairs was to focus on developing skills as a clinician, researcher, and educator ("triple threat").

CONCLUSIONS

Overall, academic department chairs are accomplished leaders in ophthalmology and prolific authors with an established academic record. Chairs regarded their previous leadership roles within the department as invaluable to their effectiveness as chair.

The Plastic Surgeon at Work and Play: Surgeon Health, Practice Stress, and Work-Home Balance

Plastic surgeon wellness encompasses physical and mental health, considered in the context of practice stress. In addition, the challenges of work–home balance can lead to substantial negative impact on the surgeon, family, staff, and patients. The data-driven impact of each of these three components with personal vignettes, both individually and collectively, is presented by Michael Bentz, MD as the 2016 presidential address of American Association of Plastic Surgeons.

Are ENT surgeons in the UK at risk of stress, psychological morbidities and burnout? A national questionnaire survey

INTRODUCTION

Work-related stress, psychological disorders and burnout are common occupational disorders affecting UK doctors. To date, there are no studies looking at these psychosocial morbidities amongst ENT surgeons worldwide.

METHODS

The General Health Questionnaire-12 (GHQ-12) and abbreviated Maslach Burnout Inventory (aMBI) were incorporated into a questionnaire on occupational diseases amongst ENT surgeons and distributed to the entire membership of ENT-UK. The survey study also acquired demographic data on grade of respondent, years of experience in ENT and subspecialty interest.

RESULTS

We received 108 (8.1% response rate) appropriately filled GHQ-12 and 121 (9.0% response rate) aMBI questionnaires. 61 respondents (56.5%) on the GHQ-12 were at high risk of developing stress and psychological morbidity and 35 (28.9%) had high enough aMBI scores to suggested burnout. When comparing scores of both GHQ-12 and aMBI with grade of respondent, years of experience in ENT and subspecialty, statistical difference was only found on the risk of stress and psychiatric disorders amongst paediatric ENT surgeons (7 high risk vs 0 low risk, p = 0.02), however the number of these respondents was small (7 in total). Both questionnaires had been validated for use within our population.

CONCLUSION

We found high incidence rates of stress and psychological morbidity (56.5%) and a burnout prevalence rate of 28.9% amongst our responding cohort of UK Oto-rhino-laryngologists. No meaningful differences were found between stress, psychological morbidity and burnout with grade of ENT surgeon, years of experience in ENT and subspecialty within ENT.

Prevalence of job-related distress and satisfaction in a nationwide cardiology setting: The IANUS - itAliaN cardiologists' Undetected distress Study

INTRODUCTION AND OBJECTIVES

Cardiologists' work distress has been seldom studied. The ItAliaN cardiologists' Undetected distress Study survey was designed to assess prevalence of work distress and satisfaction, and to gain insight into associations among these constructs and socio-demographics and job description.

METHODS

We invited members of our national cardiological society (Associazione Nazionale Medici Cardiologi Ospedalieri) to participate in an anonymous, self-report, exclusively web-based survey, posted on the Associazione Nazionale Medici Cardiologi Ospedalieri website. ItAliaN cardiologists' Undetected distress Study included socio-demographics, job description and a 15-item questionnaire on job-related distress and work satisfaction.

RESULTS

Of 7393 invited cardiologists, 1064 completed the survey. Organizational problems and worries about medico-legal controversies were reported by 71% and 49% of participants, respectively; over one-third reported loss of enthusiasm, helplessness, work-life imbalance and lack of control over work. Conversely, 86% felt competent at work, 67% rewarded by the moral/human meaning of their work and 52% satisfied with their professional fulfilment. Factor analysis revealed a meaningful underlying structure including four factors: job strain, positive meaning, emotional fatigue and relational difficulties. Relational difficulties were more frequent in cardiologists working in primary-level than in secondary and tertiary care hospitals (P = 0.017 and P = 0.013, respectively). Interventional cardiologists reported higher positive meaning than those in the clinical inpatients area and outpatient diagnostic settings (P = 0.007 and P = 0.025, respectively) and lower emotional fatigue than subjects in the clinical inpatients area (P = 0.0005).

CONCLUSION

Cardiologists' work distress should be interpreted integrating job-related negative aspects with a reappraisal of protective personal and relational resources, which should be fostered to promote physicians' wellbeing at the individual, collective and organizational levels.