Impact of the 2024 work style reform on cardiovascular surgeons in Japan: a comparative cross-sectional study using pre- and post-reform survey data

Purpose: Traditionally, cardiovascular surgeons (CSs) in Japan work long hours. To evaluate the impact of the 2024 Work Style Reform on their work environment, we analyzed how the working conditions of CSs have changed since the reform’s implementation. Methods: We conducted an anonymous web-based survey during a patient-safety session at the 55th Annual Meeting of the Japanese Society for Cardiovascular Surgery. Results: Of the 1,229 respondents, 1,124 board-certified CSs were included in the analysis. Among them, 64.6% reported working over 60 h per week and 29.5% were unaware of their institution’s designated work-hour category. Younger age (adjusted odds ratio [aOR]: 0.594) and employment at a university hospital (aOR: 2.071) were independently associated with extended working hours. Over 80% of respondents reported no significant change in their working hours or job responsibilities post-reform. The availability of nurse practitioners (NPs) or nurses certified in specified medical-acts training (SNs) had no significant impact on workload, although most surgeons perceived their benefit. Conclusion: Extended working hours remain prevalent among CSs in Japan despite the implementation of the work-style reforms. Strategic adoption of task-shifting and enhanced staffing is required urgently to ensure the sustainability of cardiovascular surgical care.