Sustainable Employability in Cardiothoracic Surgery: A Systematic Review Identifying Job Demands and Resources

OBJECTIVES: To provide an overview of job satisfaction, quality of life, work-life balance, attrition, burnout, and several mental health issues among cardiothoracic surgeons, residents, and fellows, and to identify factors that have a favourable or unfavourable association with their career.

METHODS: A systematic literature review (Medline, EMBASE, Web of Science, Cochrane Library, and Google Scholar) was performed to identify articles in the last 25 years concerning cardiothoracic surgeons and topics surrounding their career. The job-demands resources model was used to categorize the outcomes.

RESULTS: Sixty-nine articles were included, comprising of 30 427 responses. Cardiothoracic surgeons had a high job satisfaction and 22 job resources were identified, regarding social, psychological, physical, and organizational support. These protective factors included mentorship, camaraderie, adequate hospital support, and designated teaching and research time. However, quality of life was relatively low, as compared with other (surgical) specialties, and attrition and mental health issues occur relatively often. Nineteen job demands were acknowledged as potentially modifiable risk factors that may negatively influence the well-being of cardiothoracic surgeons, such as a high workload, difficult work-life balance, social constructs in the workplace, and sexual harassment.

CONCLUSIONS: Cardiothoracic surgery is a profession that is both highly demanding as well as very rewarding. In addition to enhancing job resources such as mentorship and adequate support, modifiable risk factors related to workload, work-life balance, and social safety need to be addressed urgently to create a community where all cardiothoracic surgeons can thrive and provide optimal care.