The scale of the problem in such settings is stark. The authors cite a study of healthcare workers at Kenya’s largest government referral hospital that reported a burnout prevalence of 95.4 percent, a figure that approaches universality. A separate study of residents at a Kenyan tertiary academic teaching center found that 47.3 percent were at high risk for burnout. The drivers identified in both studies were systemic rather than individual: conflict between departments, relentless patient volumes, chronic workforce shortages, difficulty balancing professional and personal responsibilities, and maladaptive coping mechanisms including substance use. These conditions matter beyond the individual, the authors note, because burned-out physicians make more errors, communicate more poorly with patients, and generate lower patient satisfaction, turning a workforce crisis into a quality-of-care crisis.

RESIST takes its name from an acronym covering six domains: Rest and workload hygiene, Emotional and peer support, Skill training for residents, Institutional culture and psychological safety, Supportive faculty and role modeling, and Tracking and continuous improvement. The framework was introduced at Aga Khan University Hospital, which in 2020 became the first institution in Africa to earn accreditation from the Accreditation Council for Graduate Medical Education International, a milestone that gave the program an established accreditation foundation on which to build. The authors drew on global literature from higher-resource settings, including evidence for mindfulness training, structured mentorship, workload regulation, and organizational interventions targeting culture, and adapted those insights to their own constraints and lived experience.

The most consequential intervention, and the most expensive, was staffing. The program hired four part-time locum junior providers to cover additional shifts, academic half-days, and weekends, reducing resident fatigue while preserving protected educational time. Since implementation, tracked metrics have shown lower resident attrition and reduced self-reported burnout. The authors argue that this upfront investment may prove cost-effective relative to the downstream costs of burnout-related attrition, medical errors, and turnover, expenses they say are chronically underrecognized in training budgets across low- and middle-income countries. For programs that cannot afford locum hires, the paper proposes tiered alternatives such as rotating elective coverage or task-shifting. In parallel, the hospital adopted a lower-cost electronic health record, a change not originally part of the resiliency initiative, which further reduced the documentation burden on trainees.

Emotional support was addressed by leveraging resources the institution already had. Where access to professional counseling was limited, the program strengthened peer-support groups, faculty mentorship, and partnerships with community mental health services, alongside structured debriefing after critical clinical events. These mechanisms, the authors write, helped residents process emotionally difficult experiences, normalized help-seeking behavior, and acknowledged the emotional dimensions of patient care, an aspect of medicine that is often left unspoken in hierarchical training environments.

Skills training focused on practical, teachable defenses against stress. The program ran quarterly workshops on sleep science and fatigue management, optimized on-call rooms, and created structured opportunities for short restorative naps during overnight shifts, with facilitated discussions woven into monthly academic half-days. Substance use, which the authors describe as frequently underaddressed in training programs, was tackled through targeted educational sessions, peer-led discussions, and confidential referral pathways built on existing institutional and community resources. The authors note that formal outcome data for these measures are not yet available, though informal feedback from residents and faculty has been favorable.

Perhaps the most culturally ambitious component targets psychological safety, the shared belief that individuals can speak openly without fear of retribution. The program created quarterly town halls, small-group debriefs, and monthly wellness check-ins as protected forums for residents to raise concerns and propose solutions. To counter the barriers posed by steep hierarchies and fear of retaliation, the institution implemented an anonymous reporting system alongside a university Safe Disclosure Program. Residents were empowered to choose their own faculty mentors, and faculty were encouraged to model vulnerability by openly sharing their own professional struggles during teaching sessions, a deliberate strategy to destigmatize imperfection and encourage early help-seeking. Initial surveys and structured discussions already point to stronger one-on-one engagement between faculty and residents, and the team is extending this into a formal longitudinal evaluation.

Faculty development was embedded in the institution’s mandatory continuing education program, which trained designated wellness champions and promoted dialogue around fatigue and burnout. Biannual faculty workshops were introduced to help senior physicians recognize early signs of resident distress, complemented by informal coaching. The authors emphasize that role modeling mattered as much as formal training: faculty consistently demonstrated healthy behaviors, including respecting time off and protecting academic time, reinforcing the message that well-being is a core professional value rather than a private individual responsibility.

Crucially, the framework treats data collection as an active feedback loop rather than a bureaucratic exercise. The program monitors duty hour violations, sick leave utilization, burnout survey scores, and resident satisfaction, and uses those metrics to guide interventions. Increases in duty hour violations prompted targeted schedule adjustments, while adverse trends in burnout survey results triggered the introduction of additional peer support sessions. This iterative approach, the authors argue, kept resiliency efforts dynamic and embedded within the training environment rather than functioning as isolated, one-off interventions that fade once initial enthusiasm wanes.

The authors are candid that implementation was not without obstacles, including difficulty recruiting junior providers, building faculty capacity to address burnout, and encouraging uptake of anonymous reporting. Those barriers were managed through phased implementation, faculty development, and sustained leadership engagement. Formal outcome and cost-effectiveness data are not yet available, and the team acknowledges that early signals, such as improved faculty-resident engagement, are encouraging but not conclusive. Longitudinal evaluation, including resident-level outcomes and cost analysis, is now a priority, aimed at rigorously testing whether RESIST produces resilient and compassionate physicians, sustains a constrained workforce, and can be adapted across similar low-resource settings. If those evaluations bear out the early trends, the Nairobi experience could offer a template for training programs worldwide that have assumed, until now, that physician well-being is something only wealthy health systems can afford to protect.

Subject of Research: Resilience training and burnout prevention among medical residents in low-resource settings

Article Title: RESIST: Addressing Resident Resiliency in Low-Resource Settings

Article References: Ali, S. K., Chandani, A. K., Sayed, F., & Talib, Z. (2026). RESIST: Addressing Resident Resiliency in Low-Resource Settings. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-026-10896-4

Image Credits: AI Generated

DOI: 10.1007/s11606-026-10896-4

Keywords: physician burnout, medical residency, resilience training, low-resource settings, graduate medical education, Kenya, psychological safety, resident wellness, peer support, workforce sustainability, Aga Khan University Hospital, global health

The study matters because the nursing profession sits at a paradox. Self-care is a foundational idea in nursing theory, woven into the discipline’s classic models, and it is widely recognized as a key strategy for maintaining personal health and sustaining the quality of care that patients receive. And yet, as the authors note, the concept remains insufficiently defined in the nursing context, and it is routinely pushed aside by the realities of the job: punishing working conditions, a professional culture that celebrates self-sacrifice, and a conspicuous absence of education that teaches nurses how to care for themselves rather than for others. When a concept is vague, it is hard to measure, hard to teach, and hard to build policy around. The research team set out to fix that by giving the concept a precise, context-sensitive definition.

Methodologically, the study is a hybrid concept analysis, an approach borrowed from nursing science that deliberately combines theory with lived experience. The researchers used the Schwartz-Barcott and Kim model, a well-established framework that unfolds in three phases. In the theoretical phase, they conducted a systematic literature review with no time limitation, searching major databases up to June 2023 to extract every documented attribute, dimension, antecedent, and consequence of self-care among nurses. This produced a scholarly skeleton of the concept as it exists across decades of international writing.

The second phase took the concept out of the library and into the hospital. The team carried out a qualitative fieldwork study using semi-structured interviews with 17 nurses, selected through maximum variation sampling, a technique designed to capture as wide a range of perspectives as possible across age, experience, specialty, and workplace. The interview data were analyzed using directed content analysis, meaning the researchers coded the transcripts against the categories identified in the literature while remaining open to themes the nurses raised that theory had not predicted. This is where the cultural and professional texture of self-care emerged: what it means to care for yourself when your job is caring for everyone else, in a health system under strain, in a specific cultural setting.

In the final analytic phase, the two streams of evidence were integrated into a comprehensive definition. The result is a conceptualization of nurses’ self-care as a dynamic, intentional, and context-sensitive process, not a fixed behavior or a one-time intervention but an ongoing, deliberate practice that shifts with circumstances. Crucially, the analysis identified six interrelated dimensions. Four of them will sound familiar: physical, psychological, spiritual, and social self-care. Two are distinctive to the nursing profession: professional security and professionalism. The inclusion of these last two dimensions is perhaps the study’s most striking contribution, because it acknowledges that for a nurse, self-care cannot be separated from the occupational hazards of the job or from the professional identity and standards that govern how they work.

The professional security dimension speaks to a reality that most other self-care frameworks ignore. Nurses face physical risks, from exposure to infection and injury to workplace violence, and protecting oneself professionally is a form of self-preservation that generic wellness models simply do not capture. Professionalism, meanwhile, suggests that maintaining one’s competence, ethical standards, and sense of purpose in the role is itself an act of self-care, sustaining the internal resources that make a nursing career viable over decades. Together, these dimensions reframe self-care not as an indulgence squeezed into off-duty hours but as something woven into the fabric of professional life itself.

The researchers also mapped what comes before self-care and what flows from it. The antecedents, the conditions that enable or obstruct self-care, were consolidated into four broad areas: individual factors such as personal knowledge and motivation; work-related conditions and the pressure of juggling multiple roles, including family responsibilities layered on top of demanding shifts; support systems, both formal and informal; and cultural and environmental values, which determine whether looking after oneself is seen as legitimate or as a sign of weakness in a self-sacrificing profession. The consequences, meanwhile, fell into three categories: personal, professional, and social. Nurses in the study associated self-care with their physical, psychological, and spiritual well-being; with professional concentration, behavior, and their capacity to provide safe and attentive care; and with the quality of their interactions at work and at home.

That last set of associations is where the study’s implications for patient safety and workforce sustainability come into focus, and where the authors are careful to draw a precise scientific line. Nurses who practice self-care reported better concentration and a greater capacity to deliver safe, attentive care, and the literature has long suggested plausible pathways linking nurse well-being to care quality and workforce retention. But this concept analysis did not directly measure clinical errors, quality of care, workforce retention, or healthcare-system sustainability. The authors are explicit that these relationships should be interpreted as perceived associations and conceptually plausible pathways rather than demonstrated effects. That honesty is a strength: it distinguishes a rigorous concept analysis, which clarifies what a concept means and how its parts relate, from an intervention trial, which tests whether changing the concept changes outcomes. The framework now provides the conceptual foundation that future measurement studies and intervention trials will need.

The practical payoff of a well-defined concept is that it can be operationalized. With six clearly specified dimensions, identified antecedents, and categorized consequences, the framework offers a template for designing educational curricula that teach nurses self-care as a professional competency rather than an afterthought, and for building organizational initiatives that support it. The authors suggest the framework may inform the development and evaluation of contextually appropriate educational and organizational programs, particularly in health systems where the culture of self-sacrifice runs deep. But they attach an important caveat: such initiatives should complement, not substitute for, safe working conditions and adequate organizational resources. Teaching a nurse mindfulness techniques is no replacement for safe staffing levels, functioning equipment, and a workplace that does not treat exhaustion as a badge of honor.

The broader lesson of the study extends beyond nursing. In an era when burnout among healthcare workers has become a global concern and health systems everywhere are struggling to retain staff, the temptation is to offer individual-level wellness programs as a quick fix. This research pushes back with a more sophisticated picture. Self-care, as the nurses themselves described it, is a multidimensional and socially embedded process, shaped by the interaction of individual, occupational, organizational, and cultural factors. A nurse’s ability to care for herself depends not only on her own resolve but on the values of her workplace, the structure of her shifts, the support of her family and colleagues, and whether her culture treats self-care as a right or a luxury. Any serious effort to sustain the healthcare workforce, the study implies, has to work at all of those levels at once. By giving the concept of nursing self-care a rigorous, multidimensional definition grounded in both scholarship and lived experience, the researchers have taken the first step toward turning a vague aspiration into something health systems can actually measure, teach, and support, and toward a future in which the people who care for everyone else are finally equipped to care for themselves.

Subject of Research: Concept analysis of self-care among nurses using a hybrid model

Article Title: Conceptualizing self-care among nurses: a hybrid concept analysis with potential implications for workforce sustainability and quality of care

Article References: Rajai, N., Parandeh, A., Ebadi, A., Karimi, L., & Sajadi, S. A. (2026). Conceptualizing self-care among nurses: a hybrid concept analysis with potential implications for workforce sustainability and quality of care. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15705-6

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15705-6

Keywords: nursing, self-care, concept analysis, hybrid model, workforce sustainability, quality of care, burnout, occupational health, qualitative research, nurse well-being, health services research, professionalism

The context for the research is a global nursing shortage of staggering proportions. The World Health Organization projects a deficit of nearly 4.5 million nurses by 2030, driven by ageing workforces, poor working conditions, inadequate recruitment planning and the steady exit of practising nurses from clinical roles. In response, international bodies have called for expanded nurse education, and universities have enrolled more students to meet the demand. That expansion has created an urgent need for more educators, and universities have met much of it by hiring sessional staff: registered nurses employed casually to teach, mark and facilitate placements without fixed-term or continuing contracts. In Australia, nearly 60 percent of the academic workforce is now non-permanent, a figure that mirrors or exceeds the casualisation seen in the United States, where roughly 70 percent of academics are sessional, and the United Kingdom, where 54 percent hold non-continuing positions.

Despite this scale, the experiences of sessional staff specifically within pre-registration nursing education have remained poorly documented. Previous studies tended to examine permanent nursing academics or casual academics across disciplines, leaving a gap in understanding of the distinct psychosocial conditions faced by nurses teaching the next generation of registrants. The new study, led by researchers at Australian Catholic University and conducted in August 2024, aimed to close that gap using the middle-length version of the Copenhagen Psychosocial Questionnaire version III, a widely used workplace risk assessment tool comprising 26 subscales and 60 items scored on five-point Likert scales calibrated from 0 to 100. The survey was distributed through heads of discipline at 34 Australian institutions offering approved pre-registration nursing programmes, supplemented by advertising through the Australian College of Nursing and LinkedIn.

Of 99 responses received, 84 participants met the eligibility criteria, which required current registration with the Australian Health Practitioner Regulation Agency, at least 12 months of sessional experience and active work in a pre-registration programme. The respondents represented 25 of the 34 institutions contacted, an institutional coverage of 73.5 percent. The demographic profile was striking. More than half of the participants were over 50 years old, 83.3 percent were female, and 89.2 percent had more than a decade of experience as registered health professionals. Yet 58.3 percent had fewer than five years of experience as sessional university staff, indicating that many were recent arrivals to academia, bringing deep clinical expertise but limited teaching tenure. Nearly two-thirds still worked clinically, and 71.4 percent carried carer responsibilities.

The psychosocial findings defied expectations. Participants reported favourable scores on ten resource-related subscales, with the highest mean score, 79.61 out of 100, recorded for meaning of work, followed by role clarity at 74.66. Job satisfaction averaged 61.85, and social support from supervisors and colleagues, vertical and horizontal trust, sense of community, quality of work and possibilities for development all clustered above 60. On the demand side, the picture was equally benign: insecurity over working conditions scored just 22.07, work-life conflict 27.64, emotional demands 30.15 and job insecurity 32.57, all indicating low perceived strain. For a workforce typically described as precarious, hourly-paid and hired at short notice, these figures suggest that the sessional nurses in this sample did not experience their employment as threatening or destabilising.

The correlation analysis revealed which factors travelled together. Job satisfaction correlated strongly with organisational justice (r = 0.82), vertical trust (r = 0.81), quality of leadership (r = 0.79) and role clarity (r = 0.70), all statistically significant at p < 0.001. Sense of community was tightly bound to social support from colleagues (r = 0.77) and supervisors (r = 0.70), while supervisor support itself correlated with quality of leadership (r = 0.73) and vertical trust (r = 0.73). In plain terms, sessional nurses who felt fairly treated, trusted by management, clearly briefed and well led were also the ones who enjoyed their work and felt they belonged. The authors used Spearman rank correlations appropriate to the ordinal Likert data, with confidence intervals derived through Fisher’s r-to-z transformation, and framed the analysis as exploratory, without adjustment for multiple testing.

Perhaps the most consequential finding concerns career aspiration. Only 26.2 percent of participants intended to seek a permanent academic position, while 40.5 percent said maybe and 27.4 percent said no. This pattern likely reflects both preference and pragmatism. Sessional work offers flexibility that permanent roles rarely match, allowing nurses to combine teaching with clinical practice, caring duties and personal commitments, and to work remotely on lecturing, facilitation and marking. For some, sessional teaching is a pathway into academia; for others, it is a deliberately bounded form of engagement that avoids the heavier research, administrative and service load of continuing appointments. The authors suggest universities should read this as a signal to support both trajectories, offering professional development in teaching pedagogy for those who want to grow, and respecting the flexibility that draws others to casual work in the first place.

The study’s authors are careful to temper these rosy findings with methodological caveats. No national sampling frame exists for the Australian sessional nursing academic workforce, so convenience sampling was unavoidable and representativeness could not be verified. Self-selection bias is a real possibility: staff with more positive or stable experiences may simply have been more likely to respond, which could partly explain the low reported job insecurity and the complete absence of negative correlations between the focal subscales and other measures. Internal consistency of the questionnaire subscales varied, with Cronbach’s alpha values ranging from 0.564 to 0.922, and the work pace subscale performed so poorly (alpha = 0.285) that it was excluded entirely. The middle-length instrument also omitted stress, burnout, violence and harassment, domains covered in the long version that might have surfaced darker aspects of the experience. As a cross-sectional design, the study can report associations but cannot establish causation.

Even with those limitations, the study carries practical weight for workforce planning. The age profile of the sample, with over half of participants above 50, contrasts sharply with the registered nursing workforce at large, where only about 30 percent fall into that age bracket. Nurses appear to move into teaching later in their careers, often after establishing clinical credentials, motivated by a desire to give back to the profession, to escape clinical burnout or to transition toward retirement while staying engaged. These educators bridge theory and practice, contextualising real-world clinical realities for students in ways that purely academic staff cannot. But heavy reliance on them carries risks: high turnover and short tenure can disrupt teaching continuity, assessment consistency and the sustained mentorship relationships that help students develop clinical reasoning and professional identity. Universities may also face repeated onboarding costs as casual teaching teams change each semester.

The study’s conclusion is a call for balance rather than alarm. Sessional nursing educators in this sample reported trusting relationships with leadership, fair conflict resolution, autonomy in their work and a genuine sense of shaping the future nursing workforce, and those conditions correlated closely with their satisfaction. The authors argue that universities should continue engaging clinical experts within a balanced staffing model, one that strengthens organisational support for sessional staff through clear role expectations, timely communication, quality leadership and professional development, while ensuring that the administrative and coordination burdens of nursing programmes do not simply accumulate on permanent academics. As the global nurse shortage deepens and student numbers climb, the mostly invisible casual teachers standing at the front of the classroom may prove to be one of the most valuable, and most fragile, assets in the effort to educate the nurses the world will need by 2030.

Subject of Research: Psychosocial working conditions and job satisfaction of sessional teaching staff in pre-registration nursing education programmes in Australia

Article Title: Work Experience of Sessional Teaching Staff in Pre‐Registration Nursing Programmes: A Cross‐Sectional Study

Article References: Ricks, T. A., Jacob, E., & Lam, L. (2026). Work Experience of Sessional Teaching Staff in Pre‐Registration Nursing Programmes: A Cross‐Sectional Study. Nursing Open, 13(10), Article e70862. https://doi.org/10.1002/nop2.70862

Image Credits: AI Generated

DOI: 10.1002/nop2.70862

Keywords: nursing education, sessional staff, casual academics, job satisfaction, psychosocial work environment, COPSOQ-III, nursing workforce shortage, Australia, pre-registration nursing, higher education casualisation, cross-sectional study, workforce sustainability

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