Self-Reported Surgeon Health Behaviours: A Multicentre, Observational Exploration With the Association of Surgeons in Training Into the Modifiable Factors That Impact Surgical Performance

Introduction: Surgeons regularly educate patients on health promoting behaviours including diet, sleep and exercise. No study thus far has explored surgeons' personal compliance with these health-behaviours and their relationship with surgical performance.

The primary outcomes this study were self-reported health, health related behaviours, wellbeing, fatigue and surgical performance. Methods: A survey of validated themes on health-related behaviours, workplace variables and performance was distributed to surgical trainees and consultants in the UK and Ireland through the Association for Surgeons in Training (ASiT). Non-parametric analysis was used to determine inferential associations. Results: Ninety five surgeons (median age 35-44, 51.5 % female, 39.9% registrars) completed the survey. 94% reported having at least 'good' overall health. . A majority (54.7%) report inconsistent sleep patterns, while less than a quarter engage in regular exercise. 74% reported having at least 'good' overall mental and emotional well being.

Sixty two and 64.2% reported being regularly fatigued and bothered by feelings of anxiety and/or depression respectively. Poor self-reported health and wellbeing were associated with poorer reported off-call performance (p<.01). Higher levels of fatigue negatively impacted self-reported surgical and non-surgical task proficiency (p<.01). Discussion and Conclusion: Surgeons reported high levels of overall health. However, healthy behaviours around sleep, diet and exercise were not consistently reported. Fatigue, anxiety and regular rumination were reported by greater than half of respondents. When compared to overall health numbers, 20% less surgeons reported overall mental health and emotional well-being that good or better. Self-reported health behaviours including sleep and physical activity were associated with surgical performance. Strategies to improve modifiable lifestyle factors, which will optimise physical health, mental wellbeing and levels of fatigue may optimise surgical performance. Further research should target these behaviours to elicit desired changes.