The “Vulnerable Stage” of General Surgery Residency

We read with interest the article by Sue and colleagues¹ regarding the attitudes of general surgery residents performing full-time research. We postulate 1 simple thought that, if correct, would explain many of the findings: Some general surgery residents may not find basic science research fulfilling because (1) it usually provides no patient contact (which is the reason many people choose to become physicians) and (2) there is a sense of futility in the realization that most of them will not continue any basic science endeavors in their careers, as noted by Sue et al¹ and Bhattacharya et al.² Most residents enter the field of general surgery to take care of patients, and it is this daily gratification that makes it possible to endure the arduous process of residency. It naturally follows, then, that residents with no patient contact feel, as the article¹ states, that “surgery training was too long” (because they are delaying their training for a venture that does not include patient contact), and that they “felt less positively regarding their operative experience” (because they may not have been involved in an operation for years). As expected, residents deprived of patient contact were also more likely to value this contact as stated by Sue et al: “Research residents were more likely than PGY-3 [postgraduate year 3] residents to feel a significant amount of satisfaction when working with patients.”¹