Promoting Longevity in Surgical Careers: A Narrative Review and Fitness Program to Reduce Occupational Pain
Bibliographic record
Abstract
IMPORTANCE: Many surgeons experience work-related musculoskeletal disorders (MSD) throughout their career. Incorporating evidence-based strategies to prevent and manage MSDs would benefit both trainees and those in practice. The present narrative review seeks to evaluate the effectiveness of current strategies to manage and prevent musculoskeletal (MSK) occupational pain among surgeons and trainees. OBSERVATIONS: Eleven studies were identified. Included studies covered 3 broad interventions: ergonomics (n = 5), intraoperative breaks/pauses (n = 7), and physical fitness (n = 1). Intraoperative breaks demonstrated improved pain, fatigue, stress, and a decrease in intraoperative errors without increasing overall surgical time. Residents that were specifically instructed in ergonomics exhibited better posture and decreased musculoskeletal (MSK) symptoms and recommended incorporating this information into their curriculum. In a program combining ergonomics, microbreaks, and stretching, 85% of residents experienced reduced discomfort, and 93% felt this training would help them "perform better in the operating room". Overall, the surgical physical fitness programs reduced surgery/occupational-related pain and increased performance measures in the OR. The study participants also found the interventions valuable and were able to use learned principles in practice. CONCLUSIONS AND RELEVANCE: The existing body of literature supports the positive impact of fitness programs in preventing and managing occupational-related pain. We propose the implementation of a comprehensive program that integrates education, intraoperative breaks, ergonomic adjustment, and physical fitness, with initiation during the first year of surgical residency. To facilitate practical integration, we propose a pilot program that may be integrated into the regular surgical work week, encompassing recommendations from the reviewed studies. Future research is recommended to explore aspects such as program effectiveness, feasibility, mental health impacts, and gender-specific differences.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.016 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".