Exploring work-life integration in vascular surgery and surgery

Objective

There is a growing emphasis on achieving work-life balance, defined as the balance between work and personal life. However, this concept is gradually shifting towards work-life integration (WLI), which is relevant in the health care sector, particularly surgery. We performed a literature review to evaluate factors that contribute to WLI in the field of surgery, with a particular focus on vascular surgery.

Methods

A literature review of WLI in surgery, specifically vascular surgery, was performed from inception to February 2024. PubMed was searched for papers written in the English and French languages using the MeSH terms “work-life balance” or “work-life integration” in “vascular surgery” or “surgery.” Findings were categorized in a tiered framework focused on faculty or staff, trainees (including medical students, residents, or fellows), and people identifying as underrepresented in medicine (URIM).

Results

Twenty-four articles were identified as relevant for this review. Previous reports have identified a high prevalence of burnout and suicide among the vascular surgery workforce. Collegial support and institutional culture were identified as pivotal in enhancing WLI. Inefficiencies in health care delivery, administrative burdens, and a lack of autonomy were recognized as barriers for WLI. Factors specific to gender and parenthood lead to unequal challenges in achieving WLI. Medical trainees’ WLI perceptions influenced their specialty choices and risk of burnout. Also, URIM trainees encountered additional obstacles like discrimination and attrition, though some reports indicated a resilience advantage among minority physicians.

Conclusions

This review has highlighted differences in challenges related to WLI across faculty and staff, trainees, and individuals identifying as URIM and emphasizes the need for systemic and cultural reforms, flexible work arrangements, and greater support for underrepresented groups to foster a healthier work-life ecosystem in health care.