Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Why ethics in research are crucial?

Ethical norms are so everywhere that one might be tempted to consider them as simple rational. Most civilizations use laws to implement widely accepted moral standards and legal rules. It is important to know that ethics and law are not the same. An act may be lawful but immoral/unethical or unlawful but moral/ethical. There are a number of reasons why it is essential to stick to ethical norms in conducting research. First, is to support the aims of research, such as knowledge, truth, and avoidance of error. For example, preventions of fabricating, falsifying, or misrepresenting research data support the truth and avoid error. Second, ethical standards promote the values that are vital to collaborative work, such as trust, accountability, joint respect, and fairness since research usually involves cooperation and coordination among many researchers in a mixture of disciplines and institutions. For example, many ethical standards in research, such as copyright, patenting policies, data sharing policies, and confidentiality rules in peer review, are deliberated to protect intellectual property interests as well as encouraging collaboration. Third, some ethical norms help to guarantee that researchers can be held responsible to the public. For instance, federal policies on research misconduct, conflicts of interest, the human subjects‘ protections, and animal care and use are necessary in order to make sure that researchers who are funded by public money can be held accountable to the public. Fourth, ethical norms in research also help to build community support sustainability for research. Fifth, many of the ethical standards of research promote a variety of other moral and social values, such as human rights, animal welfare and compliance with the law, health and safety. Ethical descends in research can significantly harm the whole society and animal subjects. For example, a researcher who fabricates data in a clinical trial may harm or even kill patients. Also a researcher who fails to stand for guidelines and regulations relating to radiation or biological safety may endanger health and safety of himself, staff and students

Why ethics in research are crucial?

Ethical norms are so everywhere that one might be tempted to consider them as simple rational. Most civilizations use laws to implement widely accepted moral standards and legal rules. It is important to know that ethics and law are not the same. An act may be lawful but immoral/unethical or unlawful but moral/ethical. There are a number of reasons why it is essential to stick to ethical norms in conducting research. First, is to support the aims of research, such as knowledge, truth, and avoidance of error. For example, preventions of fabricating, falsifying, or misrepresenting research data support the truth and avoid error. Second, ethical standards promote the values that are vital to collaborative work, such as trust, accountability, joint respect, and fairness since research usually involves cooperation and coordination among many researchers in a mixture of disciplines and institutions. For example, many ethical standards in research, such as copyright, patenting policies, data sharing policies, and confidentiality rules in peer review, are deliberated to protect intellectual property interests as well as encouraging collaboration. Third, some ethical norms help to guarantee that researchers can be held responsible to the public. For instance, federal policies on research misconduct, conflicts of interest, the human subjects’ protections, and animal care and use are necessary in order to make sure that researchers who are funded by public money can be held accountable to the public. Fourth, ethical norms in research also help to build community support sustainability for research. Fifth, many of the ethical standards of research promote a variety of other moral and social values, such as human rights, animal welfare and compliance with the law, health and safety. Ethical descends in research can significantly harm the whole society and animal subjects. For example, a researcher who fabricates data in a clinical trial may harm or even kill patients. Also a researcher who fails to stand for guidelines and regulations relating to radiation or biological safety may endanger health and safety of himself, staff and students

X-ray of the left shoulder joint showing soft tissue mass, complete destruction of the humeral head, and multiple cavities in glenoid cavity and coracoid process.

<p>X-ray of the left shoulder joint showing soft tissue mass, complete destruction of the humeral head, and multiple cavities in glenoid cavity and coracoid process.</p

Ultrasound scan showing multiple thick-walled pockets containing multiple echogenic grains, with minimal subcutaneous oedema.

<p>Ultrasound scan showing multiple thick-walled pockets containing multiple echogenic grains, with minimal subcutaneous oedema.</p

Photograph showing the mycetoma lesion around the left shoulder region.

<p>Photograph showing the mycetoma lesion around the left shoulder region.</p

MRI showing innumerable soft tissue lesions infiltrating the rotator cuff muscles with extension into the humeral head, proximal humeral shaft, and glenoid aspect of the scapula.

<p>The acromioclavicular and glenohumeral joints were also affected, causing widening of the joint spaces. Multiple collections within affected bones and subcutaneous soft tissues consistent with abscess formation were seen. Joint effusion was noted, along with enlarged left axillary lymph nodes.</p