Workload demands, surgical education and training among resident surgeons in Germany: a cross-sectional...

The medical system is experiencing increasing systemic workload pressures and a developing shortage of doctors, making the well-being of resident surgeons a critical factor for sustainable healthcare delivery. By highlighting the surgical residents' perspectives through a direct questionnaire, the current study aimed to provide an exploratory basis for discussing reform possibilities that better support current and future demands on surgeons.

This cross-sectional study used a custom-developed questionnaire to collect data from resident surgeons across multiple surgical specialties, predominantly at university hospitals in Germany. It was designed to assess the quality of resident surgeons' training experiences and gauge their perceptions of their career progression and workload distribution. Furthermore, the questionnaire assessed emotional well-being, workload demands, training sufficiency, satisfaction with career progression, and the allocation of time between administrative and patient care tasks. Data collection was conducted through an anonymous online questionnaire platform.

One hundred eighty-six surgical residents responded fully to the survey. Most participants worked excessive hours, with 44.1% working over 55 h weekly, and administrative tasks dominating their time (72.0% ranked first), compared to surgical procedures (4.3% ranked first). Structured training programs were lacking in 88.7%, and 74.2% reported insufficient surgical exposure. Professional readiness was mixed: 67.2% felt confident in their ability to adapt to emerging technology, but 51.0% felt unprepared for independent research. The career outlook appeared concerning, with 42.9% considering leaving within three years, and 67.7% pessimistic about work-life balance. The residents' assessment of the healthcare system's readiness for future challenges was poor, with 81.1% disagreeing that the healthcare system is prepared for surgical innovation and 88.7% citing insufficient staffing to meet demographic changes.

The current view of surgical residency at university hospitals in Germany reveals gaps in structured training programs and surgical exposure, which could lead to staff shortages and insufficient preparation for independent research and professional fulfillment in the future.