Retired Surgeons’ Reflections on Their Careers | Surgery | JAMA Surgery | JAMA Network
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Figure.  What Retired Surgeons Would Have Done Differently
What Retired Surgeons Would Have Done Differently
Table.  Characteristics of Survey Respondentsa
Characteristics of Survey Respondentsa
1.
Baker  CC, Clancy  TV, James  A,  et al.  Retired surgeons as peer teachers in resident medical education: an underused resource.   Bull Am Coll Surg. 2018;103:56-59. http://bulletin.facs.org/2018/03/retired-surgeons-as-peer-teachers-in-resident-medical-education-an-underused-resource/. Accessed October 2, 2019.Google Scholar
2.
Aly  S, Stolarski  A, Whang  E,  et al.  The current status of retirement mentoring in academic surgery in the United States.   J Surg Res. 2019;2:70-76. doi:10.26502/jsr.10020022Google ScholarCrossref
3.
Kim  NE, Moseley  JM, O’Neal  P, Whang  E, Itani  KMF, Kristo  G.  Retired surgeons as mentors for surgical training graduates entering practice: an underutilized resource [published online March 19, 2019].   Ann Surg. doi:10.1097/SLA.0000000000003272PubMedGoogle Scholar
4.
Entezami  P, Franzblau  LE, Chung  KC.  Mentorship in surgical training: a systematic review.   Hand (N Y). 2012;7(1):30-36. doi:10.1007/s11552-011-9379-8PubMedGoogle ScholarCrossref
5.
Waljee  JF, Chopra  V, Saint  S.  Mentoring millennials.   JAMA. 2018;319(15):1547-1548. doi:10.1001/jama.2018.3804PubMedGoogle ScholarCrossref
6.
Desy  JR, Reed  DA, Wolanskyj  AP.  Milestones and millennials: a perfect pairing-competency-based medical education and the learning preferences of Generation Y.   Mayo Clin Proc. 2017;92(2):243-250. doi:10.1016/j.mayocp.2016.10.026PubMedGoogle ScholarCrossref
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    Research Letter
    January 22, 2020

    Retired Surgeons’ Reflections on Their Careers

    Author Affiliations
    • 1Department of Surgery, Veterans Affairs Boston Healthcare System, Boston, Massachusetts
    • 2Boston Medical Center, Department of Surgery, Boston University, Boston, Massachusetts
    • 3Harvard Medical School, Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts
    JAMA Surg. 2020;155(4):359-361. doi:10.1001/jamasurg.2019.5476

    With accumulated life and professional experience, retired surgeons have developed a valuable perspective on the life and career of a surgeon.1,2 This study evaluated retired surgeons’ reflections on their lives and careers. Understanding what retired surgeons would have done differently in their past can provide insights to younger surgeons for building a rewarding and healthy career.

    Methods

    A survey approved by the institutional review board of the Veterans Affairs Boston Healthcare System regarding retirement experience was mailed nationwide in April 2018 to retired general, colorectal, vascular, and cardiothoracic surgeons who remain members of the American College of Surgeons. Participants were informed in writing that by answering the questions and returning the survey, they were providing and documenting their consent. SAS, version 9.4 (SAS Institute) was used and statistical significance was set at P <.05.

    Results

    A total of 2295 of 5282 surveys (43.4% response rate) were completed. The mean (SD) age of responders was 79.0 (0.8) years, the mean (SD) retirement age was 63.9 (0.1) years, and the mean (SD) interval since retirement was 15.2 (0.9) years. Other characteristics of survey respondents are displayed in the Table.3

    Most participants (2153 of 2295 [93.8%]) answered the free-text question on whether they would have done anything differently in their life and career as a surgeon. More than half (1128 of 2153 [52.4%]) wished to have done some things differently during their career. The most common thing they would have changed was spending more time with family and taking better care of themselves (295 of 1233 [23.9%]), followed by joining a less stressful practice environment (236 [19.2%]; preference ratio of 3.8 to 1 for academic vs private practice and 23 to 1 for private group vs solo practice); pursuing a less demanding and better reimbursed surgical specialty (156 [12.7%]; plastic, orthopedic, and pediatric surgery being the top 3 preferences); choosing a nonmedical career (74 [6.0%]); postponed retirement by gradually slowing down or working part-time (57 [4.6%]); being more involved in teaching and mentoring (52 [4.2%]); practicing in a different geographical location (37 [3.0%]); embracing new surgical technology sooner (34 [2.8%]); better family planning (32 [2.4%]); more volunteer work (28 [2.3%]); being more outspoken in protecting the surgery profession against regulatory overreach (23 [1.9%]); being humbler and more collegial (18 [1.5%]); and making more money (14 [1.1%]) (Figure).

    Other self-reported regrets (179 [14.5%]) included more involvement in research, selecting better practice partners, being more adaptable to change, taking more risks, finding better mentors, spending more time with patients, saving earlier for retirement, having less 1-way institutional loyalty, asking more often for help, and paying more attention to institutional politics. The responses were comparable when stratified by sex, surgical specialty, practice environment, and interval since retirement.

    Discussion

    To our knowledge, this is the first study evaluating the reflections of retired US surgeons on their life and career. Results show that more than half (52.4%) of retired surgeons wish they would have done something differently in the past. The most common (762 of 1233 [61.8%]) wish was to have achieved a healthier work-life balance, even if that required joining a different practice environment, pursuing a different surgical specialty, or choosing a nonmedical career.

    These findings seem to contradict the generally held perception that older generations of surgeons placed less emphasis on their personal and family life than the newer surgeons.4-6 A possible explanation for this contradiction could be that, despite their desire for a healthier work-life balance, earlier generations of surgeons practiced in an era when workplace requirements, professional regulations, and cultural norms were not conducive to a constructive debate on work-life balance. With their more experienced life and work perspective, retired surgeons have a great potential for mentoring younger surgeons3 to achieve a rewarding career and avoid future regrets.

    Conclusions

    By learning what retired surgeons would advise their younger selves, this survey brings awareness to potentially modifiable factors that could make the life and career of a surgeon healthier, more fulfilling, and without regrets.

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    Article Information

    Corresponding Author: Gentian Kristo, MD, MPH, Department of Surgery, Veterans Affairs Boston Healthcare System (112-C), 1400 VFW Pkwy, West Roxbury, Boston, MA 02132 (gentian.kristo@va.gov).

    Published Online: January 22, 2020. doi:10.1001/jamasurg.2019.5476

    Author Contributions: Dr Kristo had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

    Concept and design: All authors.

    Acquisition, analysis, or interpretation of data: Stolarski, O'Neal, Whang, Kristo.

    Drafting of the manuscript: Stolarski, O'Neal, Kristo.

    Critical revision of the manuscript for important intellectual content: All authors.

    Statistical analysis: Stolarski, Kristo.

    Administrative, technical, or material support: Kristo.

    Supervision: Kristo.

    Conflict of Interest Disclosures: None reported.

    References
    1.
    Baker  CC, Clancy  TV, James  A,  et al.  Retired surgeons as peer teachers in resident medical education: an underused resource.   Bull Am Coll Surg. 2018;103:56-59. http://bulletin.facs.org/2018/03/retired-surgeons-as-peer-teachers-in-resident-medical-education-an-underused-resource/. Accessed October 2, 2019.Google Scholar
    2.
    Aly  S, Stolarski  A, Whang  E,  et al.  The current status of retirement mentoring in academic surgery in the United States.   J Surg Res. 2019;2:70-76. doi:10.26502/jsr.10020022Google ScholarCrossref
    3.
    Kim  NE, Moseley  JM, O’Neal  P, Whang  E, Itani  KMF, Kristo  G.  Retired surgeons as mentors for surgical training graduates entering practice: an underutilized resource [published online March 19, 2019].   Ann Surg. doi:10.1097/SLA.0000000000003272PubMedGoogle Scholar
    4.
    Entezami  P, Franzblau  LE, Chung  KC.  Mentorship in surgical training: a systematic review.   Hand (N Y). 2012;7(1):30-36. doi:10.1007/s11552-011-9379-8PubMedGoogle ScholarCrossref
    5.
    Waljee  JF, Chopra  V, Saint  S.  Mentoring millennials.   JAMA. 2018;319(15):1547-1548. doi:10.1001/jama.2018.3804PubMedGoogle ScholarCrossref
    6.
    Desy  JR, Reed  DA, Wolanskyj  AP.  Milestones and millennials: a perfect pairing-competency-based medical education and the learning preferences of Generation Y.   Mayo Clin Proc. 2017;92(2):243-250. doi:10.1016/j.mayocp.2016.10.026PubMedGoogle ScholarCrossref
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