title: Career satisfaction among general surgeons in Canada:  a qualitative study of enablers and barriers to improve recruitment and retention in general surgery.
abstract: OBJECTIVE
  To understand what influences career satisfaction among general surgeons in urban and rural areas in Canada in order to improve recruitment and retention in general surgery.
  
  
  METHODS
  Semistructured interviews were conducted with 32 general surgeons in 2010 who were members of the Canadian Association of General Surgeons and who currently practice in either an urban or rural area. Interviews explored factors contributing to career satisfaction, as well as suggestions for preventive, screening, or management strategies to support general surgery practice.
  
  
  RESULTS
  Findings revealed that both urban and rural general surgeons experienced the most satisfaction from their ability to resolve patient problems quickly and effectively, enhancing their sense of the meaningfulness of their clinical practice. The supportive relationships with colleagues, trainees, and patients was also cited as a key source of career satisfaction. Conversely, insufficient access to resources and a perceived disconnect between hospital administration and clinical practice priorities were raised as key "systems-level" problems. As a result, many participants felt alienated from their work by these systems-level barriers that were perceived to hinder the provision of high-quality patient care.
  
  
  CONCLUSIONS
  Career satisfaction among both urban and rural general surgeons was influenced positively by the social aspects of their work, such as patient and colleague relationships, as well as a perception of an increasing amount of control and autonomy over their professional commitments. The modern general surgeon values a balance between professional obligations and personal time that may be difficult to achieve given the current system constraints.
authors.affiliation: Department of Surgery, Division of General Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. ahmedn@smh.ca
authors.forename: Najma
authors.initials: N
authors.lastname: Ahmed
authors.forename: Lesley Gotlib
authors.initials: LG
authors.lastname: Conn
authors.forename: Mary
authors.initials: M
authors.lastname: Chiu
authors.forename: Bochra
authors.initials: B
authors.lastname: Korabi
authors.forename: Adnan
authors.initials: A
authors.lastname: Qureshi
authors.forename: Avery B
authors.initials: AB
authors.lastname: Nathens
authors.forename: Simon
authors.initials: S
authors.lastname: Kitto
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D003299:Cooperative Behavior; D003431:Cross-Cultural Comparison; D013502:General Surgery; D006740:Hospital Administrators; D006780:Hospitals, Rural / Q000458:organization & administration; D006786:Hospitals, Urban / Q000458:organization & administration; D006801:Humans; D033183:Interdisciplinary Communication; D007400:Interprofessional Relations; D007588:Job Satisfaction; D008507:Medically Underserved Area; D010560:Personnel Selection / Q000458:organization & administration*; D010563:Personnel Turnover; D010817:Physician-Patient Relations; D017009:Professional Autonomy; D012944:Social Support; D014940:Work Schedule Tolerance; D000078329:Workforce