Surgery resident working conditions and job satisfaction

Introduction: Medical students demonstrate decreased interest in surgical residencies and resident attrition after entry into programs has been reported at 14% to 20%. This study surveyed surgery residents regarding working conditions and how those conditions influenced their job satisfaction. Methods: A new survey was developed to measure residents' working conditions. Questions generated from literature review were expanded and validated through focus groups at 2 academic medical centers. The resulting survey was administered on general/vascular surgery services at 52 hospitals along with a job-satisfaction scale. Questions were grouped into composite measures using factor analysis. Correlations were calculated between working conditions and job satisfaction at the individual and the hospital level. Results: In 844 returned surveys, resident job satisfaction did not correlate with age, sex, or postgraduate year. Perceived quality of patient care was the strongest (R = .51) of 68 items that did correlate (P < .01). Duty hours correlated less strongly (R = -.17). At the aggregate hospital level, effective ancillary staff/services (R = .77), empathetic nurses (R = .69), and attending teaching, appreciation and openness to suggestions (R = .49) correlated positively; scutwork (R = -.63) and erroneous paging (R = -.37) correlated negatively. Conclusions: Our data confirm prior studies indicating that the teaching skills of the attending and the duty hours influence resident satisfaction. More important than these factors, however, were the effectiveness of systems and staff that facilitate the residents' job-care of the patient. Resident satisfaction and student recruitment efforts could be enhanced by the Program and Hospital Director's correction of deficiencies in these areas.