Longer hours, limited returns? a post-hoc National survey analysis of overtime hours during surgical training in Japan

Purpose: To investigate the amount of overtime hours in relation to surgical training outcomes in Japan. Methods: Data from a nationwide online questionnaire survey of newly certified surgical trainees were analyzed based on the amount of overtime. Respondents were divided into 2 groups: Group L had worked > 80 h per month, and Group S had worked ≤ 80 h per month. Differences in training outcomes, workplace environments, and challenges were analyzed. Results: Among 1410 surgical trainees, 694 respondents who gave valid answers were classified into Group L (n = 462, 67%) and Group S (n = 232, 33%). No significant differences were observed in terms of the number of surgeries (p = 0.95), scientific papers (p = 0.38) or annual income (9.11 vs. 9.46 million JPY, p = 0.94). The proportion of respondents who considered dropping out, felt harassed, or dissatisfied was significantly higher in Group L than in Group S (p = 0.0001, p < 0.0001, and p = 0.0076, respectively). Conclusion: Increased overtime hours did not correlate with positive outcomes such as the number of surgeries performed, scientific publications, or annual income. In contrast, negative outcomes, such as dropout thoughts and feelings of harassment, increased. These findings imply that less overtime and improved overtime management could make surgery more appealing to future applicants.