Career-stage differences in work expectations, training conditions, and exhaustion among surgeons in Germany

Objective Surgical disciplines are undergoing a generational transition. The authors examined differences across surgical career stages in Germany in work and research expectations, the perceived fulfillment of these expectations, and physical and emotional exhaustion. Design Nationwide cross-sectional online survey conducted in Germany in 2024 using a 68-item questionnaire on demographics, work and research expectations, their fulfillment, and physical and emotional exhaustion. Participants Board-certified surgeons and surgical residents in Germany; data from 379 respondents were included in the analysis. Results Residents most worked full-time (OR 8.64, 95% CI 4.84–17.09 vs. part-time), whereas specialists (OR 0.15, 95% CI 0.06–0.33) and attendings (OR 0.24, 95% CI 0.11–0.49) more often worked part-time. Joy at work and a good working atmosphere were rated as important or very important by 94.7%; residents had higher odds than chiefs of rating joy at work as very important (OR 1.78, 95% CI 1.16–2.78), but lower odds of reporting this expectation as fully fulfilled (OR 0.26, 95% CI 0.15–0.42). Structured training within regular working hours was particularly important to residents (OR 1.83, 95% CI 1.20–2.86). Among residents wishing to do more research, 68.0% (n=70) cited lack of time within working hours (OR 2.33, 95% CI 1.53–3.65). Physical and emotional exhaustion were frequent, especially among residents and specialists, while household and childcare responsibilities clustered in mid-career. Conclusions This study demonstrates a career-stage-dependent gap between surgeons’ work and research expectations. Younger surgeons are not less ambitious, but expectations regarding joy at work, training and planning security are insufficiently met. Aligning training structures, research opportunities and working-time models with these expectations, and supporting mid-career surgeons, will be crucial to sustain a healthy surgical workforce.