Future Surgeon

#futurefriday: barriers among #medicalstudents to pursue a #surgicalcareer "Sixty-nine percent of all students and 75% of those pursuing surgery reported verbal #discouragement from pursuing a surgical career" 😱😱 In this study by Alexandra Giantini Larsen et al. in the Annals of Surgery in 2021 a survey was conducted among medical students to investigate their perceptions on barriers to a career in #surgery. (Ann Surg 2021;273:1120–1126) Interesting results: - There was no significant gender difference in intention to pursue surgery (27% of men👨⚕️ vs. 22% of women👩⚕️ ) --> #Women were significantly more likely to perceive that the verbal discouragement was based on gender, age and family aspirations 👨👩👦👦 compared to men. The greatest deterrents for both genders were --> Surgical work hours 🔪 👨⚕️ 👩⚕️ ⏰ --> Time for outside interests 🏃♂️ 🏃♀️ More women reported concerns about time to #date or marry, time to spend with #family, finding time during residency to have a #child, taking maternity/paternity #leave during residency, and being too #old after residency to have a child The authors conclude that additional support within the surgical field is needed to mitigate these concerns and support trainees in both their career and familial aspirations. This study gives a clear signal on topics that are important to #futuresurgeons that should be addressed to keep our profession interesting and attractive to the current generation of #medicalstudents! #mentorship #openspookhuis Alexandra Giantini Larsen Faith Robertson MD MSc MBA Harvard Medical School Future Surgeon Groene Hart Ziekenhuis De Geneeskundestudent Hajar Rotbi Marijn Houwert VAGH Nederlandse Vereniging voor Heelkunde LUMC Women Dutch Surgical Society for Medical Students Medisch Contact Susanne van der Velde Floortje Huizing Vincent Sier Begüm P. Stijn Gorgels Marald Wikkeling MD MBA Abbey Schepers Heleen Snijders Joris Blok

#futurefriday: back to the #surgicalfuture "Interestingly, there is also a strong wish among #maletrainees to work part-time. Of the male trainees, 23% expressed the wish to take #parentalleave at some stage during their training." In this publication from 2008 (!) by Bas Wijnhoven et al. on behalf of the Dutch Association of Surgical Trainees (VAGH) several important issues were addressed that are still relevant today: --> It is important to ensure that #surgicaltraining and a #career as a surgeon are attractive options for medical school graduates, as these are the candidates for training in general surgery --> Reduction in working hours has not led to a measurable decrease in the trainees’ operative experience or quality of their training, but it does seem to increase the #qualityoflife for the #trainee --> Having a #mentor has been shown to play an important role in a medical student’s decision to pursue a surgical residency --> Besides surgical faculty members, surgical trainees themselves serve as important #rolemodels for medical students, thereby influencing their career choice It seems that the same issues from 16 years ago are still relevant today (and tomorrow)! At the same time it is remarkable that these issues are still to be resolved...more work to do #futuresurgeon Future Surgeon Groene Hart Ziekenhuis Bas Wijnhoven Esther van den Ende Willem Hueting VAGH Marijn van Berckel Claar van Leeuwen Nederlandse Vereniging voor Heelkunde Dutch Surgical Society for Medical Students De Jonge Specialist Floortje Huizing Vincent Sier Begüm P. Stijn Gorgels Marald Wikkeling MD MBA Abbey Schepers Heleen Snijders Joris Blok

#futurefriday: losing #experiencedsurgeons to retirement "Those who postpone #retirement often do so for professional #satisfaction, institutional #flexibility, a sense of #responsibility toward patients, and a desire to remain #active" "The voluntary approach is crucial to respecting the freedom of choice for older physicians" In this article by Luca Bertolaccini et al. (Front. Surg., 12 March 2024) the issue of the aging surgical workforce is discussed. Two important remarks: --> there is a nearly linear relationship between the surgeon's age and a decrease in complication and postoperative mortality rates  --> 50% of healthcare professionals have reported burnout episodes more than once a year, significantly associated with #age<40, fear of legal issues, unhealthy lifestyle, abstaining from recreational activities, depersonalisation during patient care, fatigue at the end of the day, and job dissatisfaction  Recognising variability in cognitive function among individuals and rejecting a one-size-fits-all solution, attention shifts toward assessing functional age rather than imposing an arbitrary retirement age. Potential solutions to tackle these age related isues could be the introduction of new new technologies, such as #surgicalrobots or #artificialintelligence The authors conclude the following: --> Managing the ageing of the surgical workforce requires a balanced approach that recognises the diversity of individual capabilities and promotes sustainable working conditions --> The medical community, healthcare institutions, and regulatory bodies must collaborate to develop policies and programs that preserve the quality of patient care while ensuring the #wellbeing and #satisfaction of surgeons of all ages. Important suggestions to improve #workengagement for all #generations! #futuresurgeon Luca Bertolaccini Monica Casiraghi Lorenzo Spaggiari Future Surgeon Roderick F. Schmitz VAGH Nederlandse Vereniging voor Heelkunde De Jonge Specialist Dutch Surgical Society for Medical Students Floortje Huizing Vincent Sier Begüm P. Stijn Gorgels Marald Wikkeling MD MBA Abbey Schepers Heleen Snijders Joris Blok

#futurefriday: a new perspective; from #worklifebalance to #worknonworkbalance "Work-nonwork balance acknowledges that achieving #balance involves, managing the demands of work with the wide array of nonwork activities and roles an individual might have (not limited to family or care responsibilities and including volunteer work, hobbies, sports, or music)." In this extensive study by Philipp Kerksieck et al. the concept of work–nonwork balance crafting (WNBC) was investigated in three European countries, looking at the influences of job/home demands and resources as antecedents of work–nonwork balance crafting. Work #engagement, work-related #burnout, mental #wellbeing and detachment from work were investigated as outcomes.  BMC Public Health (2024) 24:1099  WNBC: an individual’s unofficial techniques and activities to shape work–nonwork balance by considering their life domain boundary preferences. --> WNBC involves adjusting the increasingly permeable and flexible boundary between life domains  This new perspective allows for a more personalized approach to balance; understanding that what constitutes meaningful or necessary nonwork activities can vary significantly from person to person. It’s a recognition of the complexity of #modernlives and the many different aspects that contribute to an individual’s overall well-being. Results: --> Work–nonwork balance crafting was predictive for important employee health and well-being outcomes over three months, mainly in a positive and health-promoting way.  An interesting perspective to look at this important topic; how can we shape our personal lives and working lives in order to keep being engaged in the long-run...#futuresurgeon Future Surgeon Anne PJ de Pagter Nederlandse Vereniging voor Heelkunde VAGH De Jonge Specialist Groene Hart Ziekenhuis Floortje Huizing Vincent Sier Jaco Tresfon Begüm P. Stijn Gorgels Abbey Schepers Marald Wikkeling MD MBA Heleen Snijders Joris Blok

#futurefriday: life happens, even to #surgicaltrainees "As more women choose to have #children during #surgicalresidency, it is imperative that these challenges are addressed, because these are likely the same factors deterring women from a surgical career at the outset" In this invited commentary by George et al. (JAMA Surgery 2021) the #surgicalculture with regard to pregnancy leave policies is addressed, referring to the study by Castillo-Angeles et. al. (doi:10.1001/jamasurg.2021.1807; https://lnkd.in/eMjePn-6). The authors addresss two important issues: (1) redundancy in surgical residency is lacking and (2) most child care and sick care options do not meet the needs of surgical trainees. Suggestions for improvement: 1. Create more #redundancy in the system through expansion of the number of residents, so that leave does not place undue burden on fellow trainees 2. Make affordable, flexible, and extended-hours #childcare available to trainees 3. Make maternity leave and lactation #policies 4. Modernize graduate medical #education so that trainees are able to learn skills, care for themselves and their families, and attend to important life events without jeopardizing their careers 5. #Destigmatize extended training by making fellowship start dates flexible All of the above suggest that there is still (a lot of) room for improvement with regard to our female colleagues; during and post-pregnancy. #futuresurgeon Future Surgeon Mary Hawn Loes Knaapen Jennifer Jongen LUMC Women JAMA Surgery VAGH De Jonge Specialist Nederlandse Vereniging voor Heelkunde Floortje Huizing Vincent Sier Begüm P. Stijn Gorgels Marald Wikkeling MD MBA Abbey Schepers Heleen Snijders Joris Blok

#futurefriday: career #stress among medical students "Most medical students experience stress when having to make a #careerdecision, with around 15% still undecided about their preferred career direction after graduation" In this publication by Daan Fris et al. (Perspect Med Educ 2022; doi 10.1007/s40037-022-00734-8) the survey data from medical master students (n= 507) was used to analyze several factors in relationship to career decision-making stress. Results: --> A clearer future #workself and higher career decision self-efficacy were associated with lower career decision-making #stress --> Experienced #timepressure, #competition, and #studyload were associated with higher career decision-making stress Conclusion: Clinical #clerkships help students to form a clearer future work self, which can diminish career decision-making stress. Yet, students also experience more time pressure as the period of clerkships lengthens, which can increase career decision-making stress. This publication gives us some interesting guidance on how to support medical students in chosing the right career (#surgery ? ) and confirms the importance of proper role models in our profession. #futuresurgeon Future Surgeon Daan Fris Anne PJ de Pagter Susanne van der Velde Hajar Rotbi Dutch Surgical Society for Medical Students VAGH De Jonge Specialist Nederlandse Vereniging voor Heelkunde Floortje Huizing Vincent Sier Begüm P. Stijn Gorgels Marald Wikkeling MD MBA Heleen Snijders Joris Blok

#futurefriday: spreading #positivity in the #surgicalworkplace "A positive work environment for healthcare professionals (and particularly for surgeons) is important for good patient care" In this edition of The Bulletin (Vol. 106, No. 4) of the The Royal College of Surgeons of England written by Michael El Boghdady several surgeons in training were interviewed to ask them how they think we can spread more positivity in the workplace. Some examples: --> focus on why people went into surgical training and what makes the job #enjoyable --> helping enthusiastic junior colleagues progress in their training --> cultivating a positive work culture in an organisation with team building activities --> supporting each other and giving opportunities to celebrate good moments or achievements outside the sphere of medicine As concluded by the author; having a positive attitude at work will be reflected in the team members’ #wellbeing, job #satisfaction, #productivity, and #communications with patients and colleagues. By focussing on the positive we can show the next generation why they should choose for a #surgicalcareer Future Surgeon Michael El Boghdady The Royal College of Surgeons of England Groene Hart Ziekenhuis VAGH Medisch Contact Dutch Surgical Society for Medical Students Nederlandse Vereniging voor Heelkunde Floortje Huizing Vincent Sier Begüm P. Stijn Gorgels Marald Wikkeling MD MBA Menno Vriens Marijn Houwert Heleen Snijders Joris Blok

#futurefriday: on #wellbeing during #residency "The intensity of #training is associated with significant reduction in well-being markers in #residents, including sleep, exercise, family interactions, religious activity, and an increase in missing significant events." In this systematic review by Kristin Raj (J Grad Med Educ. 2016 Dec; 8(5): 674–684.) factors associated with well-being 😃 were identified in the literature. Some of the results (presented in Table 2): - Resident well-being overall was lower than population well-being! - More residents reported a worse #worklifebalance than faculty, indicated more work-life conflicts, and reported they felt too tired or irritable after work to participate in home life 😤 - Autonomy, competence, and social relatedness were the areas found to be widely associated with greater resident well-being - A greater amount of sleep, physical activity, and time in nature were associated with measures of greater well-being or less burnout 😴 - Time away from work and being in a relationship are associated with greater well-being 🤗 --> Being a woman, under age 32, and Caucasian were each associated with not using a resident mental well-being program because of feeling unable to take time for an appointment... Conclusions: -->> The major factors associated with resident well-being are #autonomy, building of #competence, strong social #relatedness, #sleep, and #timeaway from work. -->> #Perseverance is predictive of well-being, and greater wellbeing is associated with increased resident empathy. The results in this study can be used to support and advise our residents on these important topics; how can we improve their residency and create a greater feeling of well-being #futuresurgeon Future Surgeon Groene Hart Ziekenhuis VAGH Marijn van Berckel De Jonge Specialist Dutch Surgical Society for Medical Students De Geneeskundestudent Nederlandse Vereniging voor Heelkunde Floortje Huizing Vincent Sier Begüm P. Stijn Gorgels Marald Wikkeling MD MBA Abbey Schepers Susanne van der Velde Heleen Snijders Joris Blok

#futurefriday: formal vs. informal #mentorship for junior #surgeons "#Mentorship is critical for professional #development and career #advancement in surgery, especially for junior faculty during their formative years." In this recent publication in JAMA Surgery by Yu et al. (2024) the role of mentorship was investigated in academic surgery. Semi-structured interviews were conducted in 18 academic surgery programs across 5 US regions. Participants were junior surgical faculty and had either a #formal or #informal mentor, both formal and informal mentors or neither. “formal” mentor: assigned by the department “informal” mentor: sought out by the faculty Results showed the following: --> 6 main themes with regard to mentorship were identified: absence of mentorship infrastructure, mentee burden and responsibility, informal mentorship, mentor mentee fit and relationship, preferred mentor characteristics, and optimizing mentorship - Nearly all survey participants (319 [95.8%]) strongly agreed/agreed that mentorship is important totheir surgical career - Characteristics faculty valued in a mentor: being #knowledgeable, #approachable and having #integrity - Respondents reported no gender or race preference - A higher proportion of those with informal mentors reported they were highly satisfied/satisfied with the mentorship provided compared with those with a formal mentor The authors conclude the following; --> Mentorship is vital for career advancement, but mentorship for junior surgical faculty needs more attention and active efforts for improvement --> Formal mentorship programs are both less common and less effective in establishing strong mentor-mentee relationships than informal mentorship Intestesing and important findings that can assist us in provinding a suitable working environment for the younger and upcoming generations of surgeons! Future Surgeon Groene Hart Ziekenhuis VAGH Dutch Surgical Society for Medical Students De Jonge Specialist De Geneeskundestudent Nederlandse Vereniging voor Heelkunde Froukje Verdam Lidewij Hoorntje Floortje Huizing Vincent Sier Stijn Gorgels Begüm P. Abbey Schepers Marald Wikkeling MD MBA Heleen Snijders Joris Blok

#futurefriday: effect of #sleep on #burnout and surgeon #wellbeing "both 'home call' and 'in house call' have the potential to #damage the health and well-being of surgeons by disrupting normal circadian sleep patterns." -->> "sleep loss from call, of any amount, is not fully regained" 😴 🛌 💤 👨⚕️ 👩⚕️ In this publication by Jamie Jones Coleman et al. the effect of #sleep is investigated in with data from 224 acute care #surgeons over 6 months. Participants wore a physiological tracking device and responded to daily surveys. Results showed the following: - home call without calls was associated with 3 minutes of sleep loss - home call with 1 or more call resulted in a further 14 minutes of sleep los - home call with a return to the hospital led to an additional 70 minutes of sleep loss -->> All variations of home call resulted in decreased feelings of #restedness and increased feelings of daily #burnout 😩😩 The emotional impact of call stems from both #direct and #indirect opportunity costs: 😴 direct costs: the inability to participate in social activities or be more than 30 minutes away from the hospital, being tied to a phone or pager, the need to have a plan for childcare in case of a return to hospital ---> direct opportunity costs result in an increase in stress and mental workload 😴 indirect costs: feelings of uncertainty inherent to home call—uncertain if they will be called, when they might be called, and even what work might be required if they are called ---> This environment of uncertainty has wide-reaching effects on sleep, behavior, and mood. Conclusions: - home call resulted in #sleepdisruption as well as increased feelings of #burnout, even on nights in which the surgeon was never called. - home call contributes to the development of burnout via physical and emotional factors. As suggested by the authors, the intensity and impact of home call should be taken into consideration when looking at the solutions and achieving a workable #worklifebalance where we are all #fittoperform and keep our profession durable #futuresurgeon You can listen to the interview with the authors in 'The Operative Word from JACS' podcast here: https://lnkd.in/eCcYfQYR Future Surgeon Koen van der Bogt Thomas Varghese Jr. MD, MS, MBA, FACS Lillian Erdahl, MD Groene Hart Ziekenhuis VAGH De Jonge Specialist Nederlandse Vereniging voor Heelkunde American College of Surgeons Floortje Huizing Vincent Sier Begüm P. Stijn Gorgels Marald Wikkeling MD MBA Heleen Snijders Joris Blok