Qualitative Exploration of Abdominal Transplant Surgeon Perception of Retirement

For many surgeons, retirement is an emotionally evocative subject, tied to a sense of loss. With minimal guidelines to facilitate a smooth transition, physicians tend to be inadequately prepared. There are few qualitative studies exploring surgeons' perspectives and none focused on transplant surgeons, a population with arguably unique challenges. We set out to define an "ideal" retirement for transplant surgeons and identify behavioral and cognitive patterns associated with optimism toward retirement.

We conducted 60-minute semistructured interviews with 30 division chiefs of transplant surgery to explore their perceptions of retirement. Thematic analysis using a framework approach was performed to identify key themes.

The cohort was predominantly male (80.0%) and White (76.7%), with 24.8 years in practice on average (range 12 to 40 years). Participants expressed desires to retire at the peak of their career trajectory and maintain autonomy in this transition. However, when naming signs of impending retirement, they often cited indicators of burnout. Attributes separating those who were optimistic from others included (1) well-rounded sense of identity, (2) holistic attitude toward one's health and well-being, (3) belief in the ability to exert autonomy over retirement process through long-range planning, (4) community-centered mindset, and (5) multifaceted and evolving view of career identity.

Although surgeons aspire to "go out on top," many could only tangibly envision working until they can no longer endure it. This discrepancy highlights the need for normalizing discussions around retirement. With their unique insights, we have the opportunity to develop supportive interventions, such that transplant surgeons retire in a manner which preserves dignity and celebrates their legacy.