Fleming Christina A, Augustinus Simone, Lemmers Daan H L, López-López Victor, Nitschke Christine, Farges Olivier, Salminen Paulina, O'Connell P Ronan, Campos Ricardo Robles, Caiazzo Robert
Department of Colorectal Surgery, University of Limerick Hospital Group, Limerick, Ireland.
PROGRESS Fellow, Royal College of Surgeons in Ireland, Dublin, Ireland.
Ann Surg. 2023 Nov 1;278(5):655-661. doi: 10.1097/SLA.0000000000006014. Epub 2023 Jul 19.
Over the past 2 decades, physicians' wellbeing has become a topic of interest. It is currently unclear what the current needs are of early career academic surgeons (ECAS).
Consensus statements on academic needs were developed during a Delphi process, including all presenters from the previous European Surgical Association (ESA) meetings (2018-2022). The Delphi involved (1) a literature review, (2) Delphi form generation, and (3) an accelerated Delphi process. The Delphi form was generated by a steering group that discussed findings identified within the literature. The modified accelerated e-consensus approach included 3 rounds over a 4-week period. Consensus was defined as >80% agreement in any round.
Forty respondents completed all 3 rounds of the Delphi. Median age was 37 years (interquartile range 5), and 53% were female. Majority were consultant/attending (52.5%), followed by PhD (22.5%), fellowship (15%), and residency (10%). ECAS was defined as a surgeon in 'development' years of clinical and academic practice relative to their career goals (87.9% agreement). Access to split academic and clinical contracts is desirable (87.5%). Consensus on the factors contributing to ECAS underperformance included: burnout (94.6%), lack of funding (80%), lack of mentorship (80%), and excessive clinical commitments (80%). Desirable factors to support ECAS development included: access to e-learning (90.9%), face-to-face networking opportunities (95%), support for research team development (100%), and specific formal mentorship (93.9%).
The evolving role and responsibilities of ECAS require increasing strategic support, mentorship, and guidance on structured career planning. This will facilitate workforce sustainability in academic surgery in the future.
在过去20年里，医生的幸福感已成为一个备受关注的话题。目前尚不清楚早期职业学术外科医生（ECAS）当前的需求是什么。
在德尔菲法过程中制定了关于学术需求的共识声明，参与人员包括之前欧洲外科协会（ESA）会议（2018 - 2022年）的所有演讲者。德尔菲法包括：（1）文献综述，（2）德尔菲表单生成，以及（3）加速德尔菲法过程。德尔菲表单由一个指导小组生成，该小组讨论了文献中确定的研究结果。改进后的加速电子共识方法在4周内进行了3轮。共识定义为任何一轮中达成>80%的一致意见。
40名受访者完成了德尔菲法的所有3轮调查。中位年龄为37岁（四分位间距为5），53%为女性。大多数是顾问/主治医师（52.5%），其次是博士（22.5%）、研究员（15%）和住院医师（10%）。ECAS被定义为相对于其职业目标处于临床和学术实践“发展”阶段的外科医生（达成87.9%的一致意见）。获得学术与临床分开的合同是可取的（87.5%）。对导致ECAS表现不佳的因素达成的共识包括：职业倦怠（94.6%）、资金不足（80%）、缺乏导师指导（80%）以及临床工作负担过重（80%）。支持ECAS发展的理想因素包括：获得电子学习资源（90.9%）、面对面交流机会（95%）、对研究团队发展的支持（100%）以及特定的正式导师指导（93.9%）。
ECAS不断演变的角色和职责需要在结构化职业规划方面获得越来越多的战略支持、导师指导和引导。这将有助于未来学术外科领域劳动力的可持续发展。
