Surgery on the edge: shaping the future between motivation, burnout, and gender inequities-a narrative review

Area of Science:

• Medical Education
• Surgical Workforce Dynamics
• Physician Burnout

Background:

• A worldwide crisis in surgical vocation is evident, marked by reduced interest, higher attrition rates, and workforce shortages.
• Physician burnout is a key factor, exacerbated by generational shifts, intense training, and gender disparities.

Purpose of the Study:

• To review evidence on burnout in surgery and its links to workforce dynamics, generational expectations, and structural issues.
• To examine the impact of training pathways and gender barriers on the surgical workforce.

Main Methods:

• This study is a narrative review synthesizing existing literature.
• It analyzes data on burnout prevalence, contributing factors, and workforce trends.

Main Results:

• Burnout affects 40-70% of surgeons and trainees, with higher rates in younger doctors and women.
• Key drivers include workload, administrative tasks, poor work-life balance, and workplace culture.
• Unfilled surgical residency positions (e.g., 37.3% in Italy) highlight workforce instability.

Conclusions:

• The surgical vocation crisis is multifactorial, driven by burnout and systemic issues.
• Multilevel strategies addressing individual, institutional, and policy levels are crucial.
• Enhancing surgical training quality, sustainability, and inclusivity is vital for the future surgical workforce.