PS1 - 07: UNDERSTANDING STRESSORS IN SURGEONS- A UNIQUE INSIGHT
Nell Maloney Patel, MD1, Brian R Smith, MD2, Kevin Y Pei, MD3, Brian J Daley, MD4, Pamela A Rowland, PhD4; 1Rutgers-Robert Wood Johnson Medical School, 2UC Irvine, 3Yale School of Medicine, 4University of Tennessee
Purpose: Identifying stressors that impact surgeons is essential given the published 2016 suicide rate for physicians being 40% higher for males and 130% higher for females compared to a non-physician population1. The purpose of this study was to quantify stressors self-reported on an intake questionnaire collected from surgeons across 97 general surgery training programs.
Methods: One hundred and seventy-three surgeons enrolled in a general surgery certifying review course (2012-2016) were asked to self-report stressors. Additional data were collected using a written communication apprehension form2, a communication inventory form3 and follow up in person dyadic interview4. Surgeons were allowed to elaborate on self-reported stressors during the interviews conducted by three PhD scientists. For participants where stress was felt to be interfering with performance, course faculty provided specific short-term intervention for performance improvement and additional resources.
Results: All participants completed the three forms and the in-person interview. The results of the reported stressors indicated a high incidence of DSM-5 Diagnoses5. Most (86%) of the participants had completed a general surgery training program with a few still in training. All wanted to avoid the stress of current failure rates (20-28%)6 on the American Board of Surgery (ABS) examinations. Self-identified stressors included: ability to function in a sleep deprived environment; anger; death or serious illness in a family member; harassment during residency; isolation in solo practice; pregnancy or birth of a child; professional failure; and challenges with relationships. Many of these are similar to those displayed by surgeons reporting burnout or PTSD7. None of the participants reported substance abuse challenges. Many reported not seeking help due to relocation and/or concerns with confidentiality.
Conclusion: In 2016, the ACGME launched a well-being initiative8 to help physicians understand stressors and suicide warning signs, but implementation will take time. Our study provides a unique perspective, self-reported and confirmed stressors. As stressors may impact performance, as demonstrated by study participants, future studies are needed to identify steps and programs to mitigate stressors for surgeons.