A study by the Yale School of Medicine and the Yale School of Public Health published in this week’s Journal of the American Medical Association reports that the majority of general surgery residents in the United States say they are satisfied with their training and confident of their ability to perform. However, a significant number believe that the hours and stress are straining their family life. In addition, many express uncertainties about future income and career prospects.

The survey is considered to be the largest of its kind. It involved 4,402 surgery residents from practically every residency program in the country to classify existing attitudes, training experiences, professional expectations and reasons for failing. More than 85 percent reported being satisfied with their particular program. But almost 37 percent stated that they were worried about making enough money as a surgeon. In addition, almost a third considered that the stress of their work was causing a tension on family life. More than 15 percent thought at some time of leaving the program. The researchers identified the second and third years as the most difficult.

Heather Yeo, M.D., M.H.S.R., the study’s lead author and a fourth-year surgery resident at Yale said: “Surgery is a rewarding and exciting career. But many surgery programs are losing qualified and talented trainees. These losses are devastating to programs and the profession.”

Findings also indicated that more men were satisfied with their residency training than women. In addition, women were more likely to contemplate leaving. “These differences may highlight opportunities for intervention or prevention,” remarked Yeo, who conducted the study while a Robert Wood Johnson Foundation Clinical Scholar at the Yale School of Medicine.

Leslie Curry, Ph.D., a research scientist at the Yale School of Public Health and the study’s senior author explained: “The surgical profession as a whole is at a crossroads. The profession has to find ways to develop and retain a diverse workforce and to address the shortage of general surgeons on the horizon.” She added, “Understanding the experiences of residents is key to these efforts. While supported, they also feel vulnerable at multiple levels, suggesting that new and enhanced supports are needed.”

This study was supported by the Robert Wood Johnson Clinical Scholars program at the Yale School of Medicine. The American Board of Surgery assisted with study design and survey implementation.

“Attitudes, Training Experiences, and Professional Expectations of US General Surgery Residents”

Heather Yeo, MD, MHSR; Kate Viola, MD; David Berg, PhD; Zhenqiu Lin, PhD; Marcella Nunez-Smith, MD, MS; Cortland Cammann, PhD; Richard H. Bell Jr, MD; Julie Ann Sosa, MD, MA; Harlan M. Krumholz, MD, SM; Leslie A. Curry, PhD, MPH

JAMA. 2009;302(12):1301-1308

Journal of the American Medical Association

Written by Stephanie Brunner (B.A.)