Burnout affects nearly half of US physicians and disproportionately affects women.¹ Compared with men, women report lower satisfaction with work-life integration in medicine generally¹ and surgery specifically.² Conflicts between one’s professional life and personal life are a major contributor to burnout in surgery, and women experience work-home conflicts at higher rates than men.² Multiple gender differences in domestic and parenting responsibilities have been reported among early-career surgeon scientists,³ and a 2019 survey of physicians who are mothers demonstrated an association between greater domestic responsibilities and lower career satisfaction among women in procedural fields.⁴ It is unclear whether these findings are generalizable to surgeons without children and across practice types.

Objectives. To determine the prevalence of COVID-19–related discrimination among major US racial/ethnic groups and estimate associations between discrimination, race/ethnicity, and other sociodemographic characteristics. Methods. We conducted a nationally representative online survey of 5500 American Indian/Alaska Native, Asian, Black/African American, Hawaiian/Pacific Islander, Latino (English and Spanish speaking), White, and multiracial adults from December 2020 to February 2021. Associations between sociodemographic characteristics and COVID-19–related discrimination were estimated via multinomial logistic regression. Results. A total of 22.1% of the participants reported experiencing discriminatory behaviors, and 42.7% reported that people acted afraid of them. All racial/ethnic minorities were more likely than White adults to experience COVID-19–related discrimination, with Asian and American Indian/Alaska Native adults being most likely to experience such discrimination (discriminatory behaviors: adjusted odd ratio [AOR] = 2.59; 95% confidence interval [CI] = 1.73, 3.89; and AOR = 2.67; 95% CI = 1.76, 4.04; people acting afraid: AOR = 1.54; 95% CI = 1.15, 2.07; and AOR = 1.84; 95% CI = 1.34, 2.51). Limited English proficiency, lower education, lower income, and residing in a big city or the East South Central census division also increased the prevalence of discrimination. Conclusions. COVID-19–related discrimination is common, and it appears that the pandemic has exacerbated preexisting resentment against racial/ethnic minorities and marginalized communities. Efforts are needed to minimize and discredit racially driven language and discrimination around COVID-19 and future epidemics. (Am J Public Health. 2022;112(3):453–466. https://doi.org/10.2105/AJPH.2021.306594 )

An impending surgeon shortage looms in the US due to increasing demand and a stagnant number of surgeons entering practice. We sought to evaluate the state of our surgical workforce by exploring current practice patterns, job satisfaction, and reasons why surgeons consider leaving surgery. In 2018, a link to a detailed survey was distributed by email to Fellows of the American College of Surgeons (ACS) who actively practice in the US and have completed a general surgery residency or integrated cardiothoracic, vascular, or plastic surgery fellowship. Detailed questions regarding practice attributes, surgical training, professional choices, and career satisfaction were included. Nonresponse weights were adjusted for respondent sex, age, and presence of subspecialty training between respondents and the total surveyed ACS population. All estimates and analyses were weighted to account for potential nonresponse bias. There were 3,807 surgeons who responded (15% response rate). Overall, 81% reported career satisfaction and 80% would choose surgery over again. Twenty-six percent were considering leaving surgery within the next 2 years. Stratified by age groups 40 to 49, 50 to 59, and 60 to 69 years, the survey found that 9%, 17%, and 45% of respondents were considering leaving surgery within the next 2 years, respectively. Thirteen percent of surgeons less than 60 years old were considering leaving surgery, and only 49% of these surgeons reported career satisfaction. Among surgeons less than 60 years old who were considering leaving surgery, the top 3 reasons rated as very important were overall stress (79%), work time demands (77%), and personal time requirements (73%). Reported surgeon job satisfaction was high, but a surprising number of surgeons reported that they were considering leaving surgery. Work time requirements and lack of personal time are leading factors contributing to surgeons leaving practice.