title: A 25-year single institution analysis of health, practice, and fate of general surgeons.
abstract: OBJECTIVE
  The objective of this study was to analyze nearly 3 decades of surgical residents from an established training program to carefully define individual outcomes on personal and professional health and practice satisfaction.
  
  
  BACKGROUND
  A paucity of data exists regarding the health and related practice issues of surgeons post-residency training. Despite several studies examining surgeon burnout and alcohol dependency problems, there have been no detailed reports defining health problems in practicing surgeons or preventive health patterns in this physician population. Important practice factors, including family and practice stress, that may impact on surgical career longevity and satisfaction have similarly received minimal focused examination.
  
  
  METHODS
  All former surgery residents at the University of Wisconsin from 1978 to 2002 were contacted. Detailed direct interview or phone contact was made to ensure confidentiality and to obtain reliable data. Interviews concentrated on serious health and practice issues since residency completion.
  
  
  RESULTS
  One hundred ten of 114 (97%) former residents were contacted. There were 100 males and 14 females with 2 deaths (accident, suicide). Including deaths and those lost to follow up, 15 (13.2%) were non-practicing; 5 voluntarily (3 planned, 1 accident, 1 arthritis) and 4 involuntarily (alcohol/substance dependency). Eighty-nine percent were married or remarried with a 21.4% divorce rate post-residency. Major health issues occurred in 32% of all surveyed and in 50% of those ages > or =50. Only 10% reported complete lack of weekly exercise activity with 62% exercising at least 3 times per week. Body mass index increased from 23.9 +/- 1.5 kg/m (age <40) to 26.6 +/- 3.0 kg/m (P = 0.009) by age > or =50. Alcohol dependency was confirmed in 7.3%. Overall, 75% of surgeons surveyed were satisfied with their practice/career.
  
  
  CONCLUSIONS
  Despite a high job satisfaction rate, surgeon health may be compromised in up to 50% by age > or =50, with a 20% voluntary or involuntary retirement rate. Alcohol dependency occurred in up to 7.3% of surgeons, which contributed to the practice attrition rate. The success and length of a career in surgery is defined by post-residency factors rarely examined during training and include major and minor health issues, preventive health patterns/exercise, alcohol use or dependency, family life, and practice satisfaction. Surgeons mentoring during the course of surgical training should be improved to inform of important health and practice issues and consequences.
authors.affiliation: Division of General Surgery, University of Wisconsin, Madison, Wisconsin 53792, USA. harms@surgery.wisc.edu
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Harms
authors.forename: Charles P
authors.initials: CP
authors.lastname: Heise
authors.forename: Jon C
authors.initials: JC
authors.lastname: Gould
authors.forename: James R
authors.initials: JR
authors.lastname: Starling
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional; D005260:Female; D005500:Follow-Up Studies; D013502:General Surgery; D006801:Humans; D007396:Internship and Residency; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D010549:Personal Satisfaction; D010815:Physician Impairment; D010820:Physicians / Q000523:psychology*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014922:Wisconsin