Black cloud in digestive surgery: Myth or reality?

Area of Science:

• Surgery
• Surgical Workforce Management
• Medical Education

Background:

• Digestive surgery is characterized by a high workload, including demanding training programs and frequent emergent procedures during night shifts.
• The concept of a "black cloud" describes staff experiencing disproportionately heavy workloads during on-call shifts, but its existence in surgical fields remains debated.
• Understanding workload distribution is crucial for resident training and overall departmental efficiency in high-pressure surgical environments.

Purpose of the Study:

• To investigate the existence of the
• To analyze workload distribution among surgical staff during emergent procedures in digestive surgery.
• To determine if specific individuals or groups within a digestive surgery department experience a significantly heavier workload, a phenomenon termed the "black cloud".

Main Methods:

• A prospective study was conducted over six months, including all emergent surgeries performed under general and local anesthesia in a tertiary referral digestive surgery department.
• Data were collected on the number of emergent procedures performed by attending surgeons and residents.
• Statistical analysis was used to compare the mean number of interventions across different surgeon levels and training programs.

Main Results:

• A total of 423 emergent digestive procedures were performed by 9 surgeons and 8 residents.
• No significant difference was found in the mean number of emergent procedures between attending surgeons and senior residents (2.3±1.5 vs 2.4±1.6, P=0.49).
• A significantly lower number of emergent procedures were performed during the day on Sundays (0.9±0.9) compared to other weekdays (P=0.03).

Conclusions:

• The study did not identify a
• No evidence of a
• A statistically significant reduction in emergent procedures was observed on Sundays, suggesting a potential weekly pattern in surgical emergencies.