Retired Surgeons’ Reflections on Their Careers

Abstract

This survey study explores how retired surgeons reflect on their careers and their attitudes toward career decisions.

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

Table. Characteristics of Survey Respondents^a.

Characteristics	No. (%)
Sex
Male	2276 (99.2)
Female	19 (0.8)
Surgical specialty
General	1382 (60.2)
Vascular	416 (18.1)
Cardiothoracic	330 (14.4)
Colorectal	167 (7.3)
Practice environment
Private	1523 (66.4)
Academic	276 (12)
Combined academic/private	260 (11.3)
Community hospital/health system employee	148 (6.4)
Veterans Affairs hospital	63 (2.7)
Military hospital	23 (1)
Native American health service	2 (0.09)

^aRepublished with permission.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).

Figure. What Retired Surgeons Would Have Done Differently.

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.^4,5,6 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.