Factors associated with general surgery residents' decisions regarding fellowship and subspecialty stratified by burnout and quality of life

Natalie C McClintock; Kelsey E Gray; Angela L Neville; Amy H Kaji; Mary M Wolfe; Kristine E Calhoun; Farin F Amersi; Timothy R Donahue; Tracey D Arnell; Benjamin T Jarman; Kenji Inaba; Marc L Melcher; Jon B Morris; Brian R Smith; Mark E Reeves; Jeffrey M Gauvin; Edgardo S Salcedo; Richard A Sidwell; Daniel L Dent; Kenric M Murayama; Richard B Damewood; Venkateswara P Poola; Christian M de Virgilio

doi:10.1016/j.amjsurg.2019.08.003

Factors associated with general surgery residents' decisions regarding fellowship and subspecialty stratified by burnout and quality of life

Am J Surg. 2019 Dec;218(6):1090-1095. doi: 10.1016/j.amjsurg.2019.08.003. Epub 2019 Aug 8.

Authors

Natalie C McClintock¹, Kelsey E Gray², Angela L Neville³, Amy H Kaji⁴, Mary M Wolfe⁵, Kristine E Calhoun⁶, Farin F Amersi⁷, Timothy R Donahue⁸, Tracey D Arnell⁹, Benjamin T Jarman¹⁰, Kenji Inaba¹¹, Marc L Melcher¹², Jon B Morris¹³, Brian R Smith¹⁴, Mark E Reeves¹⁵, Jeffrey M Gauvin¹⁶, Edgardo S Salcedo¹⁷, Richard A Sidwell¹⁸, Daniel L Dent¹⁹, Kenric M Murayama²⁰, Richard B Damewood²¹, Venkateswara P Poola²², Christian M de Virgilio²³

Affiliations

¹ Harbor-UCLA Medical Center, 1000 W. Carson St, Torrance, CA, 90509, USA. Electronic address: [email protected].
² Harbor-UCLA Medical Center, 1000 W. Carson St, Torrance, CA, 90509, USA. Electronic address: [email protected].
³ Harbor-UCLA Medical Center, 1000 W. Carson St, Torrance, CA, 90509, USA. Electronic address: [email protected].
⁴ Harbor-UCLA Medical Center, 1000 W. Carson St, Torrance, CA, 90509, USA. Electronic address: [email protected].
⁵ University of California San Francisco at Fresno, 2823 Fresno St, Fresno, CA, 93721, USA. Electronic address: [email protected].
⁶ University of Washington, 825 Eastlake Ave, E Seattle, WA, 98109, USA. Electronic address: [email protected].
⁷ Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA. Electronic address: [email protected].
⁸ University of California Los Angeles, 200 UCLA Medical Plaza Ste 214, Los Angeles, CA, 90095, USA. Electronic address: [email protected].
⁹ Columbia University, 177 Fort Washington Ave Floor 7, New York, NY, 10032, USA. Electronic address: [email protected].
¹⁰ Gundersen Health System, La Crosse Clinic, Level 5, 1900 South Ave, La Crosse, WI, 54601, USA. Electronic address: [email protected].
¹¹ University of Southern California, 1520 San Pablo St, HCT-4300, Los Angeles, CA, 90033, USA. Electronic address: [email protected].
¹² Stanford University Medical Center, 750 Welch Rd, Ste 200 MC 5785, Palo Alto, CA, 94304, USA. Electronic address: [email protected].
¹³ Hospital of the University of Pennsylvania, 3400 Spruce St, 4 Silverstein, Philadelphia, PA, 19104, USA. Electronic address: [email protected].
¹⁴ University of California Irvine, 333 City Blvd, West, Ste 1600, Orange, CA, 92868, USA. Electronic address: [email protected].
¹⁵ Loma Linda University Health, 11175 Campus St, #21108, Loma Linda, CA, 92354, USA. Electronic address: [email protected].
¹⁶ Santa Barbara Cottage Hospital, 400 W Pueblo St, Santa Barbara, CA, 93105, USA. Electronic address: [email protected].
¹⁷ University of California Davis, 2315 Stockton Blvd, Sacramento, CA, 95817, USA. Electronic address: [email protected].
¹⁸ Iowa Methodist Medical Center, 1415 Woodland Ave, Ste 140, Des Moines, IA, 50309, USA. Electronic address: [email protected].
¹⁹ University of Texas Health San Antonio, 7703 Floyd Curl Dr MC7740, San Antonio, TX, 78229, USA. Electronic address: [email protected].
²⁰ John A. Burns School of Medicine at University of Hawaii, 1356 Lusitana St, Honolulu, HI, 96813, USA. Electronic address: [email protected].
²¹ York Hospital, 1001 S George St, York, PA, 17403, USA. Electronic address: [email protected].
²² Southern Illinois University, 315 W, Carpenter St, Springfield, IL, 62702, USA. Electronic address: [email protected].
²³ Harbor-UCLA Medical Center, 1000 W. Carson St, Torrance, CA, 90509, USA. Electronic address: [email protected].

PMID: 31421896
DOI: 10.1016/j.amjsurg.2019.08.003

Abstract

Background: Although most surgery residents pursue fellowships, data regarding those decisions are limited. This study describes associations with interest in fellowship and specific subspecialties.

Methods: Anonymous surveys were distributed to 607 surgery residents at 19 US programs. Subspecialties were stratified by levels of burnout and quality of life using data from recent studies.

Results: 407 (67%) residents responded. 372 (91.4%) planned to pursue fellowship. Fellowship interest was lower among residents who attended independent or small programs, were married, or had children. Residents who received AOA honors or were married were less likely to choose high burnout subspecialties (trauma/vascular). Residents with children were less likely to choose low quality of life subspecialties (trauma/transplant/cardiothoracic).

Conclusions: Surgery residents' interest in fellowship and specific subspecialties are associated with program type and size, AOA status, marital status, and having children. Variability in burnout and quality of life between subspecialties may affect residents' decisions.

Keywords: Burnout; Fellowship; Quality of life; Subspecialty; Surgery.

MeSH terms

Adult
Career Choice*
Education, Medical, Graduate*
Fellowships and Scholarships*
Female
General Surgery / education*
Humans
Male
Specialization
Surveys and Questionnaires
United States