The survey, which ran from November 20, 2024, to January 7, 2025, was distributed by email to 15,112 physician members of the JSGS aged 65 or younger. Responses were collected anonymously through a web-based questionnaire, and 1,967 surgeons completed the survey, a response rate of 13.0 percent. Respondents were asked about their experiences of and exposure to harassment over the preceding ten years, a deliberately broad recall window chosen because this was the first nationwide survey of its kind conducted by the society and was intended to establish a baseline for future repeated measurements. The cohort skewed heavily male, with 87.0 percent of respondents being men, mirroring the composition of the specialty itself. The median time since medical school graduation was 21 years, meaning that the sample captured surgeons well beyond the training years, from residents and research fellows to department chiefs, professors, and hospital directors.

The study assessed five distinct categories of harassment, defined with reference to guidance from Japan’s Ministry of Health, Labour and Welfare and adapted to the surgical context. These included power harassment, sexual harassment, maternity and paternity harassment, academic harassment, and a newly formulated category called surgery-related harassment, designed to capture inappropriate behavior occurring in intraoperative and perioperative settings that exceeds what is necessary and appropriate for work. All categories were assessed on the basis of each respondent’s subjective perception, and the categories were not treated as mutually exclusive.

Overall, 66 percent of respondents reported experiencing at least one type of harassment during the preceding decade. The figure was dramatically higher among women: 87 percent of female surgeons reported harassment compared with 63 percent of male surgeons. Power harassment and surgery-related harassment were the most common forms, each affecting slightly more than half of all respondents, at 52 percent and 51 percent respectively. Academic harassment was reported by 27 percent, sexual harassment by 11 percent, and maternity or paternity harassment by 6 percent. The seemingly low prevalence of the latter two categories reflects the overwhelmingly male sample; among female surgeons, 55 percent reported sexual harassment and 24 percent reported maternity or paternity harassment, compared with just 8 percent and 4 percent of men respectively. Even for surgery-related harassment, prevalence among women exceeded that among men by 16 percentage points.

Perhaps the most striking finding concerns witnessing rather than experiencing. Eighty-eight percent of respondents reported having seen or heard about at least one type of harassment in their workplace over the past ten years, including 87 percent of men and 94 percent of women. Power harassment was the most frequently witnessed category at 78 percent, followed by surgery-related harassment at 69 percent and sexual harassment at 52 percent. For every single type of harassment, the proportion who had witnessed it exceeded the proportion who had personally experienced it. The researchers interpret this pattern as evidence that harassment is embedded in, and normalized by, the culture of surgical workplaces rather than being confined to individual perpetrator-victim dyads. When abusive conduct is visible across an entire community, they argue, the problem must be treated as organizational rather than purely interpersonal.

The career consequences were equally alarming. Among surgeons who experienced harassment, 56 percent reported that it had driven them to consider leaving the profession, with nearly identical rates among men and women. For power harassment and surgery-related harassment specifically, 57 percent of affected surgeons had contemplated exit. The corresponding figures were 46 percent for maternity or paternity harassment, 37 percent for academic harassment, and 18 percent for sexual harassment. Timing mattered: surgeons who experienced power harassment within ten years of graduation were more likely to consider leaving than those harassed later in their careers, at 61 percent versus 50 percent. Most troubling of all, respondents who reported harassment across multiple career periods were the most likely of all to consider abandoning surgery, regardless of harassment type, suggesting that cumulative exposure compounds the damage.

These results land on a specialty already under demographic strain. Despite an overall increase in the number of medical interns in Japan, applications to surgical training programs have been declining, and the JSGS has documented year-by-year decreases in its own membership even as an aging society sustains demand for operations. A 2023 Health Labour Sciences Research report found that among residents who had originally intended to pursue surgery, one reason for ultimately choosing another path was the perception that harassment was likely to be common, alongside work-life balance concerns and the image of surgery as excessively demanding. An earlier nationwide survey by the Japan Surgical Society found that roughly 40 percent of young surgeons had experienced harassment from supervising surgeons and nearly 30 percent had considered leaving their training program, with harassment accounting for more than half of the reasons for contemplating withdrawal. The new data extend this concern beyond trainees to surgeons at every career stage, indicating that harassment persists throughout professional life rather than ending with residency.

The comparison with the general workforce is stark. In a recent nationwide survey of Japanese workers commissioned by the Ministry of Health, Labour and Welfare, 19.3 percent reported power harassment and 6.3 percent reported sexual harassment. Among gastroenterological surgeons, the corresponding figures were 51 percent and 11 percent. The authors attribute this elevated prevalence to the traditional hierarchical structure of surgical training, long working hours, high clinical demands, and strongly hierarchical organizational cultures, conditions that also make harassment less visible and more likely to persist implicitly. They note that while surgical education sometimes requires strict guidance and tension-filled situations, educational quality and a healthy work environment should not be regarded as mutually exclusive, and that behaviors presented as instruction or supervision may still be perceived as harassment by younger surgeons.

Demand for institutional action proved overwhelming. Fifty-eight percent of respondents strongly agreed and 34 percent agreed that the JSGS should implement countermeasures against harassment, meaning 92 percent supported society-level intervention, while only 5 percent disagreed. The authors argue that professional societies are uniquely positioned to act in hierarchical specialties such as surgery, where institutional responses within hospitals may be constrained by power structures and conflicts of interest. Potential initiatives include structured anti-harassment education for trainers and department leaders, periodic nationwide monitoring, video-based and simulation-based training programs of the kind being explored internationally, and systems to recognize and promote institutions that maintain healthy educational environments. Japan’s Japanese Medical Specialty Board has already established a consultation pathway for trainees who suspect harassment, and international bodies have developed formal professional-society resources addressing harassment-related behaviors, although evidence for real-world effectiveness in surgery remains limited.

The researchers acknowledge limitations, including the possibility of self-selection bias among voluntary respondents, the reliance on subjective perception rather than legal determination, the unavoidable recall bias of a ten-year window, the cross-sectional design that precludes causal inference, and the exclusion of surgeons who had already left practice or the society, including those who may have departed because of harassment. Nevertheless, the large nationwide sample and the inclusion of surgeons across career stages provide an unusually comprehensive view. The survey has already fed into policy: on July 17, 2025, the JSGS issued a formal Declaration for the Eradication of Harassment, and the study’s authors say the findings underscore the importance of translating that declaration into concrete action rather than leaving it as a statement of principle. With the future of the surgical workforce at stake, they argue, harassment must be recognized not merely as an ethical failing but as a workforce policy problem that threatens the sustainability of surgical care in Japan.

Subject of Research: Prevalence and consequences of workplace harassment among gastroenterological surgeons in Japan

Article Title: Workplace Harassment and Consideration of Leaving Surgical Practice: A Nationwide Survey by the Japanese Society of Gastroenterological Surgery

Article References: Kurimoto, K., Fujii, T., Shirai, Y., Fujinaga, A., Fukumoto, M., Ishida, S., Hida, K., Tanaka, C., Mizushima, T., Nomura, S., & Shirabe, K. (2026). Workplace Harassment and Consideration of Leaving Surgical Practice: A Nationwide Survey by the Japanese Society of Gastroenterological Surgery. Annals of Gastroenterological Surgery, Article ags3.70274. https://doi.org/10.1002/ags3.70274

Image Credits: AI Generated

DOI: 10.1002/ags3.70274

Keywords: workplace harassment, gastroenterological surgery, power harassment, sexual harassment, surgeon burnout, workforce sustainability, gender disparity, surgical training, Japan, professional societies, physician attrition, organizational culture