INNOVATIONS“Back in the Day”… What are Surgeon Bloggers Saying About Their Careers?
Section snippets
Problem and Background Literature
In 2006, the Association of American Medical Colleges6 called for an increase in the number of medical school graduates, reflecting concerns about a physician workforce that would be inadequate to meet population needs.7 While the shortage of primary care physicians has been widely reported in the lay press and professional publications, the shortage of general surgeons has received less attention.1 The cause of this shortage of general surgeons is multifaceted and reflects both an increased
Methodology
This study design was a qualitative analysis of entries on popular medical blogs authored by practicing general surgeons. A blog is defined as a Web-based narrative written in a first-person journal style.12
Results
A total of 35 blog posts were analyzed ranging from 126 to 3663 words, with the average length of 835 words.23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55 Demographic information was gleaned from information available on the blogs. All blogs reviewed were written by male surgeons, with the possible exception of the “Throckmorton’s Other Signs” where this information could not be determined. All bloggers were
Personal Fulfillment (35 comments)
The hard work of being a surgeon was inherently enjoyable and was fortified by the reward of helping patients. Bloggers expressed a feeling of intense personal fulfillment from being able to positively impact a patient in a tangible and immediate way, which made a difference in another person’s life.
Surgery as a Calling (23 comments)
Almost all comments focused on the challenges of surgery also indicated that surgery was more than a career, but rather a “calling” and lamented that new trainees view it as simply being a “job.”
Culture of Surgery (33 comments)
A hierarchical organizational structure, combined with an aggressive “strong work” mentality and very little tolerance for mistakes or weakness, was viewed as typical of the culture of surgery. “If you have masochistic tendencies, then by all means come join our club.”25 A lack of collegiality and a culture of blame were described as a negative aspect of the practice environment.
Finances (30 comments)
Some bloggers felt that compensation was not consistent with the years of training, large debt, and lifestyle
Training Experience (38 comments)
Thirty-eight comments pertained to the impact of the training experience on career selection and work ethic. Surgeons lamented that training in medical school and residency had changed to a degree that diminished the educational value of the learning experience. Bloggers also commented on failings of a “toxic” medical education process in providing students with critical thinking skills necessary for independent practice. They expressed frustration at the slow pace of curricular change.
Some
Personal Life (20 comments)
Twenty comments reflected the impact of a surgical career on life outside of work. Comments were largely negative, describing how the demands of work placed a strain on surgeons’ free time and often served as catalysts for domestic conflict even during times of relative calm.
Laments about the negative impact of surgery were tempered with statements about a sense of duty and an obligation to patients that superseded the needs of the individual surgeon. Some bloggers commented that the stress
Nostalgia (30 comments)
Many comments were written with a nostalgic tone, with a sense of longing for those “good old days.”
A number of comments highlighted the generational gap between surgeons who have been practicing for many years and current surgical trainees. Most focused on medical students’ lack of work ethic and reluctance to go into surgery because of long hours and diminishing reimbursements, viewed as a drastic change from the attitude of the ‘old guard’, who were willing to sacrifice their personal lives
Discussion
Our qualitative analysis of blogs written by general surgeons provides a view into surgeons’ perceptions of their careers. They shared candid and emotional, personal and professional stories that give readers a view of the complexity of their lives. Even though we identified many comments about rewards, the majority of comments described challenges or were neutral in tone.
Based on our analysis, we conceptualized that surgeons view their careers as a delicate balance between the tolls and
Limitations
Owing to our selection criteria for the blog posts, we have a relatively small sample size in this study. Despite this, theme saturation was achieved, in that themes were consistently reiterated across blogs, suggesting that the blogs reviewed are a representative sample of what surgeon bloggers are writing about their career.
It is possible that only unhappy or burnt out surgeons blog about their careers, which would result in selection bias. Although blogs have been shown to serve a cathartic
Conclusion
We identified 5 main themes pertaining to a career in surgery; toll on the surgeon, rewards of being a surgeon, practice environment, educational environment, and nostalgia. The insights gained from this qualitative analysis may help advisors counsel students who express an interest in surgery, inform students in their assessment of surgical careers, acculturate those who have already made their choices to better prepare them for what is to come, and help practicing surgeons identify and
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NB: The corresponding author has full access to the data in this study and takes responsibility for the integrity of the data and accuracy of the data analysis.