Longitudinal evaluation of the surgical workforce experience during the Covid-19 pandemic

Background: An updated examination of the surgeon experience during the Covid-19 pandemic is lacking. This study sought to describe how surgeon stress levels and sources of stress evolved over the pandemic. Methods: An electronic survey was administered to surgeons at four academic hospitals at 6-months and 12-months following an initial telephone survey. The primary outcome was stress level and secondary outcomes were the individual stressors. Thematic analysis was applied to free text responses. Results: A total of 103 and 53 responses were received at 6-months and 12-months, respectively. The mean overall stress level was 5.35 (SD 1.89) at 6-months and 4.83 (SD 2.19) at 12-months. Mean number of stressors declined from 3.77 (SD 2.39) to 2.06 (SD 1.60, P < 0.001), though the "finances" stressor increased frequency (27.2% to 34.0%). Similar qualitative themes were identified, however codes for financial and capacity challenges were more prominent at 12-months. Conclusions: The surgical workforce continues to report elevated levels of stress, though the sources of this stress have changed. Targeted interventions are imperative to protect surgeons from long-term psychological and financial harm.