Surgical Residents more health complaints than other employees


In a recent study in The Netherlands the researchers found that surgical residents experienced more health complaints than the average member of the Dutch working population (4.0 versus 2.5; p = 0.000). Residents in training (n= 400) were sent self report questionnaires of which 254 of 400 (64%) residents returned questionnaires that were eligible for analysis.

Why is surgical residency a stressful period?

Surgical residency is a stressful period in the lives of future surgeons because it is characterised by high levels of job-related pressure and long, irregular working days. The job-associated demands on residents are high because these doctors-in-training need to fulfil different roles in the hospital and to perform at a high intellectual level and under strict time constraints. These demands require that residents simultaneously perform the roles of student, manager, medical professional and teacher.

Surgical residency is not the only medical specialty with these problems, specialties do not differ in these health problems. In this study the 5 most mentioned health complaints were: tiredness and lack of rest (both 73%), feeling drowsy or dull (35%), headache (34%) and back pain (28%).

Other main findings of this study were:

  • social support by supervisors strongly predicted health
  • men and senior residents were healthier than women and junior residents,
  • a high level of support by colleagues predicted health in female residents,
  • low job related autonomy and less support by consultants predicted prolonged stress-related health complaints
  • Residents working in university hospitals experienced lower levels of job-related autonomy and less support from colleagues in comparison with those working in general teaching hospitals

Emotional support from the consultant was of eminent importance for the well being of residents. In university hospitals outcome was worse. The authors state:

The average university hospital is a larger organization and has a bigger surgical staff, the members of which have multiple tasks outwith patient care and resident training, than the average general teaching hospital.

Less time, more hierarchy, to me are the possible explanation for this as well as the fact that patient care is often more complicated in these settings. Moreover, the lack of a reciprocal relationship in university hospital is recognizable for me. I can’t support the argument by the authors of more abusive interactions in university hospitals. What do you think?
Boerjan, M., Bluyssen, S., Bleichrodt, R., Van Weel-Baumgarten, E., & Van Goor, H. (2010). Work-related health complaints in surgical residents and the influence of social support and job-related autonomy Medical Education, 44 (8), 835-844 DOI: 10.1111/j.1365-2923.2010.03724.x