Stress-Related Job Analysis for Medical Students on Surgical Wards in Germany

Working conditions in hospitals generate stress within all professional groups. The aim of this study was to find out how German medical students during their senior student clerkship in surgery perceive their own stress and the stress of surgical residents. This was measured using "Instrument zur stressbezogenen Arbeitsanalyse bei KlinikÃrztInnen (ISAK-K)," a validated questionnaire of the German statutory occupational accident insurance system (BGW).

This bi-institutional paper-and-pencil survey was performed on 52 medical students in their sixth year, who had been working in a surgical department for 4 months. Data were compared with those of the BGW on the stress perceived by physicians working in German surgical departments.

The stress levels measured with the ISAK-K were similar in students and in physicians working in surgery. Students believe that surgical residents experience a higher time pressure (p < 0.03). Those students planning a surgical career feel to be more exposed to time pressure (p < 0.01), but to be more free to decide how to work (p < 0.03) than their "nonsurgical" colleagues do. In addition, in contrast to the "nonsurgical" students, students interested in surgery believe that surgical residents have more possibilities to learn at work (p < 0.05) and that they can rely on their supervisors (p < 0.03). All students believe that surgical residents commonly need to take decisions without having enough information (p < 0.05). When compared with the BGW data students overestimate the stress of surgical residents.

Students overestimate time pressure and uncertainty of surgical residents. A possible way to increase their interest in surgery is offering a better insight in surgeons' work and strategies to deal with these stressors.