Arguments for and against a career in surgery: a qualitative analysis.
OBJECTIVE
To evaluate arguments given by board-certified surgeons in Switzerland for and against a career in surgery.


BACKGROUND
Currently, the surgical profession in most Western countries is experiencing a labor shortage because of a declining interest in a surgical career among new graduates, a changed public opinion of medicine and its representatives, and as a consequence of the increasing influence of health economists and politicians on the professional independence of surgeons. Reports that focus primarily on the reasons that board-certified surgeons remain within the surgical profession are rare.


METHODS
Surgeons were asked to answer 2 questions concerning arguments for and against a career in surgery. Of 749 surgeons the arguments of 334 (44.6%) were analyzed using Mayring's content analysis. The surgeons were also asked whether they would choose medicine as a career path again.


RESULTS
The 334 participating surgeons provided 790 statements for and 981 statements against a career in surgery. Fifty-nine surgeons (17.7%) would not choose medicine as a career again. Mayring's content analysis of the statements yielded 10 categories with arguments both for and against a career in surgery. "Personal Experience in Daily Professional Life" (18.7%) was the top-ranked category in favor of a career in surgery, and "Specific Training Conditions" (20%) was the top-ranked category against the choice of such a career. Ordinal logistic regression showed that the category "Personal Experience in Daily Professional Life" (OR, 2.39; 95%CI, 1.13-5.07) was independently associated with again studying medicine, and the category "Work-life Balance" (OR, 0.37; 95%CI, 0.20-0.70) was associated with not studying medicine again.


CONCLUSIONS
This qualitative study revealed unfavorable working conditions and regulations as surgeons' main complaints. It is concluded that new organizational frameworks and professional perspectives are required to retain qualified and motivated surgeons in the surgical profession.
Businger
Adrian
A
Department of Surgery, St. Claraspital Basel, Basel, Switzerland. adrian.businger@gmx.ch
Villiger
Peter
P
Sommer
Christoph
C
Furrer
Markus
M
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002321:Career Choice; D002322:Career Mobility; D016009:Chi-Square Distribution; D005260:Female; D013502:General Surgery; D006801:Humans; D007588:Job Satisfaction; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D013557:Switzerland; D016526:Workload