Job stress associated with surgical training in Nigeria

Surgical residency training is acknowledged as being stressful, however the degree of stress, factors causing it, methods of coping with it, and the incidence of substance abuse has not been previously studied in our environment. We therefore used a self-administered questionnaire to survey 100 Nigerian Surgical Residents of whom 72 responded in September 1995. Our result shows that our residents spend 39.8, 36.8 and 23.3 percent of their time on patient care, educational activities and ancillary care, respectively. Eighty-nine percent of them considered their work to be stressful mainly because of lack of facilities and the unstructured nature of the program. Physical exhaustion, irresponsible behavior and sleep disorders were some of the abnormalities suffered as a result of this. In all, 5.6% rated the stress as severe, while 69.4% considered it moderate. Examinations produced the most stress, followed by operating sessions and patient care. Overall, substance abuse was uncommon with 16.7% claiming to have used alcohol in the one month preceding the study, but 8.3% claimed to need alcohol in order to function. Tobacco, benzodiazepine and barbiturates are some of the substances that our respondents have abused. There was no reported abuse of cannabis, heroin, cocaine, LSD or other psychotropic drugs. We conclude that though stress is inevitable during surgical training, some of the causes can be ameliorated. There is need to reduce the amount of time residents spend on ancillary care, while the current methods of examinations should be reconsidered to incorporate current adult learning theories. Residents should get adequate time for rest and recreation while exposure to modern surgical training in better-endowed centers should be incorporated into the training programme.