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Cole-Clark D, Rashid P. Costs and challenges of the curriculum vitae for SET Urology training positions: a qualitative analysis. ANZ J Surg 2024; 94:57-62. [PMID: 38174656 DOI: 10.1111/ans.18844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Surgical training programs within Australia and Aotearoa New Zealand have become more competitive. Applicants are required to build a strong application over curriculum vitae (CV), references and interview. The building of the CV often comes at significant financial and time cost with challenges. This study explores successful applicants' experiences of the costs and challenges to build a successful CV for acceptance onto the Urology training program within Australia and New Zealand. METHODS Qualitative content analysis (QCA) was undertaken of semi-structured interviews conducted with 11 nSET Urology trainees. QCA focused on the identification and evaluation of costs and challenges experienced. Analysis was reviewed over the domain of CV components. RESULTS Costs of building each domain differed significantly between trainees as they focussed on various domains. Challenges encountered were identified with four themes were identified with associated subthemes: Passion/Commitment (two subthemes); Researching Pathways (six subthemes); Challenges (two subthemes) and Acceptance Success (two subthemes). CONCLUSIONS The commitment to a surgical specialty begins before acceptance onto a training program. A high-level CV is an integral component of acceptance onto the Urology training program. Each trainee had a different journey, including time and financial sacrifices, to obtain acceptance whilst demonstrating a strong motivation for success. The average cost of each trainee who gained acceptance was $50 779 over 3 years. Consideration should be given to making the CV component less onerous.
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Affiliation(s)
- Dane Cole-Clark
- Department of Urology, Port Macquarie Base Hospital, Port Macquarie, New South Wales, Australia
| | - Prem Rashid
- Department of Urology, Port Macquarie Base Hospital, Port Macquarie, New South Wales, Australia
- Department of Urology, Rural Clinical School, The University of New South Wales, Port Macquarie, New South Wales, Australia
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Motomura T, Iguchi T, Yoshida R, Honbo T, Ishikawa T, Shiraishi J, Ryujin K, Nakazono K, Shibuta S, Amirneni S, Sadanaga N, Matsuura H. Laparoscopic delayed and interval appendectomy in the workstyle reform era. Surg Today 2021. [PMID: 34796402 DOI: 10.1007/s00595-021-02416-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/12/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Excessive working hours have been reported to contribute to burnout among surgeons. In Japan, work-style reform is a problem that needs immediate attention. Acute appendectomy, which often occurs at nighttime, is one of the most common emergency surgeries. The feasibility of delayed and interval appendectomy remains to be investigated. METHODS Two hundred forty-five consecutive patients who underwent laparoscopic appendectomy in our hospital were enrolled. They were divided into three groups: emergency appendectomy (immediate surgery, soon after the diagnosis [EA group], n = 153), delayed appendectomy (surgery during daytime the following day [DA group], n = 38) and interval appendectomy (antibiotics treatment followed by selective surgery three to four months later [IA group], n = 54). The clinical background and surgical outcomes were compared. Next, the residents' excess working time per month was calculated. RESULTS The surgical outcomes (operation time, blood loss, length of hospital stay, postoperative complications) were similar between the EA and DA groups. However, no DA was performed during nighttime hours whereas 15.7% of EA was performed during nighttime hours (p = 0.0007). The surgical outcomes of the IA group were also comparable. The residents' excess working time declined following the introduction of DA and workstyle reform. CONCLUSION Delayed and interval laparoscopic appendectomy are feasible, and can be performed to promote workstyle reform without impairing patient safety.
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Walker HR, Evans E, Nirula R, Hyngstrom J, Matsen C, Nelson E, Pickron B, Zurbuchen E, Morrow EH. "I need to have a fulfilling job": A qualitative study of surgeon well-being and professional fulfillment. Am J Surg 2021; 223:6-11. [PMID: 34332744 DOI: 10.1016/j.amjsurg.2021.07.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/25/2021] [Accepted: 07/19/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Burnout, often regarded as an individual failing, rather than a systemic one, negatively impacts quality of care, patient safety and healthcare costs. Focusing on improving well-being can help mitigate burnout. This study examined protective factors that promote well-being and professional fulfillment in surgeons. METHODS Using a purposive sample, 32 semi-structured 30-60-min interviews were conducted with surgeons of varying sub-specialties and rank. Abductive exploratory analysis was used to code and interpret interview transcripts and to build a conceptual model of surgeon well-being. RESULTS Emergent protective factors were placed into one of three levels of implementation: individual, team-level, and institutional (figure). Individual factors for well-being included autonomy and adequate time to pursue non-clinical endeavors. Team-level factors consisted of adaptability, boundaries, and cohesion. Institutional factors related to diversifying performance evaluations and celebrating and recognizing individual value and contributions. CONCLUSIONS The conceptual model developed from the results of this study highlights factors important to surgeons' professional well-being. This model can be used to guide quality improvement efforts.
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Affiliation(s)
| | - Ethan Evans
- University of Utah Health, Resiliency Center, United States.
| | - Raminder Nirula
- University of Utah School of Medicine, Department of Surgery, United States.
| | - John Hyngstrom
- University of Utah School of Medicine, Department of Surgery, United States.
| | - Cindy Matsen
- University of Utah School of Medicine, Department of Surgery, United States.
| | - Edward Nelson
- University of Utah School of Medicine, Department of Surgery, United States.
| | - Bartley Pickron
- University of Utah School of Medicine, Department of Surgery, United States.
| | | | - Ellen H Morrow
- University of Utah Health, Resiliency Center, United States; University of Utah School of Medicine, Department of Surgery, United States.
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Abstract
The future supply of urologists is not on pace to account for future demands of urologic care. This impending urologic shortage sits on a backdrop of multiple other workforce issues. In this review, we take an in-depth look at several pressing issues facing the urologic workforce, including the impending urology shortage, gender and diversity concerns, growing levels of burnout, and the effects of the coronavirus pandemic. In doing so, we highlight specific areas of clinical practice that may need to be addressed from a health care policy standpoint.
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Affiliation(s)
- Ryan Dornbier
- Department of Urology, Stritch School of Medicine, Loyola University Medical Center, 2160 S. First Ave., Maywood, IL 60153, USA.
| | - Christopher M Gonzalez
- Department of Urology, Stritch School of Medicine, Loyola University Medical Center, 2160 S. First Ave., Maywood, IL 60153, USA
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Celik SU, Aslan A, Coskun E, Coban BN, Haner Z, Kart S, Skaik MNI, Kocer MD, Ozkan BB, Akyol C. Prevalence and associated factors for burnout among attending general surgeons: a national cross-sectional survey. BMC Health Serv Res 2021; 21:39. [PMID: 33413318 PMCID: PMC7792210 DOI: 10.1186/s12913-020-06024-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Burnout resulting from long-term and unmanaged workplace stress is high among healthcare professionals, especially surgeons, and affects both individuals and the quality of patient care. The objective of this study was to determine the prevalence and associated factors for burnout among attending general surgeons and to identify possible preventive strategies. METHODS A national cross-sectional survey using a 35-item questionnaire was conducted among members of the Turkish Surgical Society. The survey evaluated demographics, professional and practice characteristics, social participation, and burnout as well as interventions to deal with burnout. Burnout was defined as a high score on the emotional exhaustion (EE) and/or depersonalization (DP) subscales. Surgeons with high scores on both the EE and DP and a low score on personal accomplishment (PA) were considered to have severe burnout. RESULTS Six hundred fifteen general surgeons completed the survey. The median EE, DP, and PA scores were 34 (IQR, 20-43), 9 (IQR, 4-16), and 36 (IQR, 30-42), respectively. Overall, the prevalence of burnout and severe burnout were 69.1 and 22.0%, respectively. On multivariable analysis, factors independently associated with burnout were working in a training and research hospital (OR = 3.34; P < 0.001) or state hospital (OR = 2.77; P = 0.001), working ≥ 60 h per week (OR = 1.57; P = 0.046), and less frequent participation in social activities (OR = 3.65; P < 0.001). CONCLUSIONS Burnout is an important problem among general surgeons with impacts and consequences for professionals, patients, and society. Considering that burnout is a preventable condition, systematic efforts to identify at-risk populations and to develop strategies to address burnout in surgeons are needed.
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Affiliation(s)
- Suleyman Utku Celik
- Department of General Surgery, Ankara University School of Medicine, Ibn-i Sina Hospital, 06100, Ankara, Turkey.,Department of General Surgery, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Alperen Aslan
- Ankara University School of Medicine, Ankara, Turkey
| | - Eylul Coskun
- Ankara University School of Medicine, Ankara, Turkey
| | | | - Zeynep Haner
- Ankara University School of Medicine, Ankara, Turkey
| | - Selin Kart
- Ankara University School of Medicine, Ankara, Turkey
| | | | | | - Bahar Busra Ozkan
- Department of General Surgery, Ankara University School of Medicine, Ibn-i Sina Hospital, 06100, Ankara, Turkey
| | - Cihangir Akyol
- Department of General Surgery, Ankara University School of Medicine, Ibn-i Sina Hospital, 06100, Ankara, Turkey.
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Kinslow K, Sutherland M, McKenney M, Elkbuli A. Reported burnout among U.S. general surgery residents: A survey of the association of program directors in surgery members. Ann Med Surg (Lond) 2020; 60:14-19. [PMID: 33072313 PMCID: PMC7556262 DOI: 10.1016/j.amsu.2020.10.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 12/19/2022] Open
Abstract
Introduction The literature remains unclear on the development, consequences, and interventions for burnout in resident populations. We aim to identify the prevalence and nuances of reported burnout in general surgery resident physicians to better understand which factors contribute the greatest risk. Methods A 42-question anonymous online survey was distributed by the Association of Program Directors in Surgery (APDS) to general surgery resident physicians. ANOVA, chi-square and multinomial regression analyses were performed with significance defined as p < 0.05. This survey was reported in line with the STOCSS criteria. Results 81 survey responses were received. Burnout was reported by 89.5% of university-hospital affiliated respondents and 95.2% of community teaching hospital affiliated respondents. After adjustment, community respondents showed a nearly fifteen times greater likelihood of burnout (aOR = 14.735, 95% CI: 0.791,274.482). Females were 2.7 times as likely as males to report burnout (aOR = 2.749, 95% CI: 0.189,39.960) and nearly twice as likely to report contemplating suicide (aOR = 1.819, 95% CI: 0.380,8.715). Burnout rates by hours worked/week revealed that 100% of those working ≥80 h/week report experiencing burnout. Conclusion Overall burnout rates reported by surgical residents respondents were high. Community teaching hospital setting, female gender, and increased number of hours worked per week may be associated with higher rates of burnout. Both female and community-affiliated residents were at increased risk of reporting suicidal ideation. Targeted interventions are needed to adequately address program-specific causes for resident burnout and reduce its prevalence in high-risk cohorts. Burnout as self-reported by general surgery residents is exceptionally high. Risk factors associated with increased reporting of burnout include female gender, community affiliated teaching hospitals, and increased work hours. Residents reporting burnout are more likely to consider leaving the medical field altogether, report their burnout affects their ABSITE performance and aspects of daily life.
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Affiliation(s)
- Kyle Kinslow
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA
| | - Mason Sutherland
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA
| | - Mark McKenney
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA.,Department of Surgery, University of South FL, Tampa, FL, USA
| | - Adel Elkbuli
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA
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Beasley SW, Smith K, Watters D. What leadership means as a core surgical competence in everyday practice. ANZ J Surg 2020; 90:154-158. [DOI: 10.1111/ans.15640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/29/2019] [Accepted: 12/03/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Spencer W. Beasley
- Department of Paediatric SurgeryChristchurch Hospital and Christchurch School of Medicine, University of Otago Christchurch New Zealand
| | - Kyleigh Smith
- Education DevelopmentPeter MacCallum Cancer Centre Melbourne Victoria Australia
| | - David Watters
- Department of SurgeryDeakin University and Barwon Health Geelong Victoria Australia
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