Future Surgeon

#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

#futurefriday: factors affecting #juniordoctors' mental health "Much of the stress experienced by (Australian) junior doctors as they transition from being a student to a working doctor is related to managing #uncertainty, developing #competence, fear of making #mistakes, feeling #unsupported by senior colleagues, bullying and traineeship #demands of exams and study" In this study by Katherine Petrie et al. in BMC Health Services Research (2021) semi-structured interviews were used to investigate Junior Medical Officers (JMO's) life and well-being. Four main themes were identified: 1) professional #hierarchies 2) workplace #stress 3) emotional #labour 4) taking distress #home Key sources of workplace stress were a highly demanding workplace and adverse working conditions, time demands and lack of control over shifts and rostering, high expectations of JMOs and the continual transitions JMOs navigate. The analysis acknowledges the importance of relational connections and the workplace environment in shaping JMOs’ social and emotional #wellbeing. Furthermore, it highlights the capacities within each junior doctor for self-care and to care for patients, and the capacity for peers, team, supervisors, training programs and support networks outside medicine, encouraging a multi-level approach to #future strategies for supporting #wellbeing. Insightful results from this Australian study that we can use to support our medical students and interns in their transition to being a #juniordoctor! #futuresurgeon Future Surgeon Froukje Verdam Susanne van der Velde Sofie Fransen DOOR HET GELUID Hajar Rotbi De Geneeskundestudent Dutch Surgical Society for Medical Students VAGH De Jonge Specialist Nederlandse Vereniging voor Heelkunde Groene Hart Ziekenhuis Floortje Huizing Vincent Sier Jaco Tresfon Stijn Gorgels Begüm P. Marald Wikkeling MD MBA Heleen Snijders Joris Blok

#futurefriday: on the importance of health care promotion among #healthcareemployees "the very business that deals with people's #health does not appear to be effective in promoting the health of its own employees" 👨⚕️ 👩⚕️ 🤒 Already in 1990 Janis Huston wrote this paper on increasing and promoting #wellness for health care employees! (Health Care Superv. 1990 Dec;9(2):53-8). In addition to increased productivity, health promotion can result in increased morale, better attitudes, decreased absenteeism, and decreased health insurance costs. She suggested 10 basic changes to start a wellness movement in the workplace: 1) fill the vending machines with #healthysnacks (fruit/milk/juices/nuts) 2) health #promotionprograms (smoking cessation/stress reduction) 3) employee work #brakes (stretch and focus on something else) 4) health #screenings (cholesterol/hypertension/obesity) 5) #counseling advies (dietary/psychological) 6) #exercise classes (slimnastics/yoga 2-3 times a week at low costs) 7) #exercise equipment (that would be beneficial to the employee) 8) #music (soft background music to calm down) 9) #humor 10) #safety and #risk management (a committee that looks for risk hazards) Employees are a great resource for ideas and suggestions, and unless the health care supervisor asks, the needs of the worker may remain unfulfilled... It seems so logical, but these suggestions are already >30 years old! Maybe we can still learn from them and try to initiate some ourselves for us and our future colleagues #futuresurgeon Future Surgeon Medisch Contact VvAA Federatie Medisch Specialisten Dutch Hospital Association VAGH Nederlandse Vereniging voor Heelkunde Dutch Surgical Society for Medical Students De Jonge Specialist De Geneeskundestudent Froukje Verdam Floortje Huizing Vincent Sier Jaco Tresfon Marald Wikkeling MD MBA Begüm P. Stijn Gorgels Heleen Snijders Joris Blok

#futurefriday: are recent #generations really that different...? "The modern trainee wants exactly what doctors have always wanted: to see patients regularly, to diagnose, to treat, and to learn" In this viewpoint by Matthew Roycroft in the BMJ several important issues with regard to the effects generation and #intergenerational differences are discussed. BMJ 2018;362:k3102 -> substantial intergenerational differences have evolved over the past 50 years -> recent generations, although remaining career motivated, are far more #demanding of #flexibility and a #worklifebalance than previous generations -> it is imminent to see the #changes that have happened to both medicine itself and our training over the same period of time So what has changed in the past decades? For example: - training grade doctors work shorter hours than their predecessors, but those hours are incredibly #demanding - treatment options for most conditions have #evolved and consequently the potential for doctors to get it wrong - more #complex decision making due to the growth in treatment options (for almost every condition); requiring greater #knowledge and increasing the chance of #error, both of omission and commission - -> The stress of long hours has simply been replaced by a different kind of stress: that of shorter but more intense working 😰😰 On the other hand senior clinicians 👴👨⚕️ are also overloaded with increasing demands, which means that there is less time for training, placing a strain on the trainee-trainer relationship. Conclusions: -->> If trainees can appreciate that their #abilities are #different from those of equivalently experienced doctors a decade or two before, and if their supervisors can appreciate that trainees themselves aren’t to blame for that, then hopefully we can move the discussion on to something more useful. "let’s start thinking about what we can do to improve things within the constraints of the present system" An important message, that is still applicable, in general and for #surgery in specific #futuresurgeon Matthew Roycroft Future Surgeon Groene Hart Ziekenhuis Federatie Medisch Specialisten NHS VAGH Dutch Surgical Society for Medical Students De Geneeskundestudent Marijn Houwert Menno Vriens Inne Borel Rinkes VvAA Sofie Fransen Susanne van der Velde Floortje Huizing Vincent Sier Stijn Gorgels Begüm P. Marald Wikkeling MD MBA Jaco Tresfon Heleen Snijders Abbey Schepers Joris Blok

#futurefriday: on medical students’ perspectives on the development of #familyplanning “I think in surgical specialties, you #dedicate your #life to becoming a #surgeon, and so that’s my understanding and that’s okay with me.” (Female participant) This qualitative study found that there is a #hiddencurriculum in medical school that actively discourages family building during training, particularly in #surgicalspecialties. In this study by Dason et al. in JAMA Surgery (2024) fourth-year medical students were interviewed with regard to their perceptions of personal #familyplanning goals, #support currently in place, family planning #education in medicine and factors contributing to their choice of specialty and program. Four main themes were identified: (1) there is no #ideal time to family build in a medical career (2) family planning is a #taboo topic (3) surgical specialties offer #lesssupport for family building (4) residents who have children are perceived to place a #burden on their colleagues --> Medical students considered their family planning while deliberating among specialty choices and their experiences were highly influential in shaping their specialty selection. As the authors suggest: - integration of family planning discussions and support for family building into medical curricula is needed along with efforts to improve #culture by supporting team dynamics and workload when students take parental leave. It seems there is more work to be done with regard to informing #medicalstudents on their career opportunities and the impact of a surgical career on #familyplanning (and also actually changing these perceptions...) #openspookhuis Future Surgeon Marijn Houwert Jesper Hjortnaes Abbey Schepers Susanne van der Velde Hajar Rotbi Groene Hart Ziekenhuis De Geneeskundestudent Dutch Surgical Society for Medical Students VAGH De Jonge Specialist Nederlandse Vereniging voor Heelkunde Floortje Huizing Heleen Snijders Vincent Sier Begüm P. Stijn Gorgels Marald Wikkeling MD MBA Joris Blok

#futurefriday: how to attract medical students to #surgery "While many factors influence #medicalstudent career choice, interactions with attending and resident physicians during clinical rotations are particularly important."  "Interestingly, both attendings and residents often underestimate their own influence on #students’ decision to pursue careers in surgery." 👨🎓 🔪 👨⚕️ In this study by Kevin H. et al. (Journal of Surgical Research 2022) sent out a survey to fourth-year medical students to evaluate the influence of attending and resident physicians on medical students’ career choices. Interesting results: - 👨🎓 👩🎓 Students pursuing general surgery rated residents greater than or equal to attendings on 7 of 8 key mentoring characteristics.  - Of students choosing a different specialty than the one they intended to pursue upon entering medical school, the #influence of residents was cited by 100% of the students pursuing general surgery - Identification of a #rolemodel and perceived personality fit were significantly more important than other factors The authors conclude the following: --> Residents have greater influences on medical students’ career choice compared to attendings. --> Students pursuing a surgical specialty, particularly general surgery, considered the influence of role models and perceived personality fit to be the most important factors in their specialty decision.  Altogether, we should not underestimate the important role our #futuresurgeons have on the choices of our #futuresurgicalresidents...so our residents should also be encouraged to interact and mentor medical students! #futuresurgeon Future Surgeon Groene Hart Ziekenhuis De Geneeskundestudent Dutch Surgical Society for Medical Students VAGH De Jonge Specialist Nederlandse Vereniging voor Heelkunde Floortje Huizing Heleen Snijders Vincent Sier Begüm P. Stijn Gorgels Marald Wikkeling MD MBA Susanne van der Velde Marijn van Berckel Joris Blok