• Aaron D C Knox, Shalini Reddy, Briseida Mema, Marc DeMoya, Emily Cilli-Turner, and Ilene Harris.
• Division of Plastic Surgery University of British Columbia, Vancouver General Hospital, British Columbia, Canada. Electronic address: aknox@ualberta.ca.
• J Surg Educ. 2014 Jan 1; 71 (1): 21-31.

ObjectivesThe projected shortage of general surgeons is owing to an increased demand for surgical services and a declining pool of practicing general surgeons. Burnout and attrition of residents from surgical residencies contribute to the latter. Attrition may be caused by the choice of a career in surgery without an understanding of the realities; subsequent recognition of the realities may cause residents to reexamine the opportunity costs of a career in the field. Because weblogs (blogs) are often used for reflection, qualitative analysis of the content of blogs authored by general surgeons may provide insight into the positive and negative realities of a surgical career. These insights may be informative to students as they consider a surgical career, may better prepare residents for the reality of what is to come, and identify targets for improving the culture of surgery and mitigating sources of career dissatisfaction.DesignThis is a qualitative analysis of entries on blogs authored by practicing general surgeons. A systematic approach was used to identify a sample of blog posts. These posts were analyzed using a constant comparative analysis method associated with constructivist grounded theory.ResultsThirty-five posts drawn from 9 blogs were analyzed. Five main themes were identified in the reviewed blogs. Overall, 104 comments were positive in tone, 74 were neutral, and 147 were negative. There were 96 comments that focused on the rewards of being a surgeon, 88 concerning the practice environment, 57 about the educational environment, 54 about the toll of being a surgeon, and 30 pertaining to nostalgia. The most commonly identified subthemes focused on the training experience (38 comments), a surgical career providing personal fulfillment (35 comments), the impact of the culture of surgery (33 comments), and financial concerns (30 comments). A conceptual framework focused on balance was used to explain how the themes relate to each other.ConclusionsThemes identified are consistent with prior studies about surgeon career satisfaction. The considerable rewards of being a surgeon were outweighed by the challenges encountered in day-to-day practice. Meeting societal needs for more general surgeons would require efforts to minimize the tolls, to the extent possible, while encouraging individuals drawn to the rewarding work of being a surgeon.Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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