Generation Z and engagement in orthopaedic trauma: A multigenerational qualitative study

Healthcare systems face increasing demand due to population ageing and workforce shortages. At the same time, Generation Z is entering surgical training. Their work values may differ from those of previous generations, potentially affecting engagement in demanding specialties such as orthopaedic trauma surgery. This study explores multigenerational perspectives on professional identity, work intensity, academic engagement, and work-life integration within orthopaedic trauma.

Prior to the 2024 Leadership Forum of the Osteosynthesis and Trauma Care Foundation (OTCF), a standardized questionnaire consisting of declarative statements rated on a five-point Likert scale was distributed to orthopaedic trauma residents and senior consultants from international chapters. During the Forum, a moderated multigenerational discussion was conducted. The session was recorded, transcribed verbatim, and analyzed using thematic qualitative analysis.

Eight residents and fifteen consultants from Europe, North America, South America, Africa, and Asia participated. Across generations, intensive training was considered essential for achieving surgical mastery. However, younger participants emphasized work-life boundaries, institutional recognition of non-clinical work, and psychological safety. Senior surgeons more frequently described their profession as central to their identity and viewed unpaid academic engagement as intrinsic to surgical responsibility.

Generation Z trainees demonstrate strong commitment to orthopaedic trauma but differ from senior surgeons in expectations regarding professional identity, uncompensated academic work, and work-life integration. Recognition of evolving professional values is critical for workforce sustainability and intergenerational collaboration in trauma surgery.