The burden of unwanted e-mails in academic surgery: a cross-sectional study

Background Unwanted e-mails (UEM) constitute a futile problem for academic surgeons. However, data investigating the magnitude of this concern and its determinants are lacking. Objective To assess the burden UEM in academic surgery and to identify factors associated with a high burden of UEM. Methods Cross-sectional study conducted in a division of visceral surgery of a tertiary center, between May 1-31, 2024. Participants included physicians of the division; UEM received by the participants during the study period were collected and examined. Primary outcome was the absolute number of UEM. High burden of UEM was defined as participant UEM number ≥ percentile 75 of UEM number. Results Participants included 36 physicians (13 residents, 14 fellows and 9 consultants). A total of 2934 UEM were examined; among them, 1707 (58.2%) solicited scientific contributions, including invitations to submit manuscripts (n = 910, 31%). Number of UEM per participant was heterogenous (range 0-601), with a median of 16 (0-106). The latter also showed differences between residents 0 (0-1), fellows 34 (5-70), and consultants 147 (101-402) (p<0.001). Finally, high burden of UEM was associated with surrogates of experience and research activity, such as age (OR, 1.21; 95% CI, 1.04-1.41; p = 0.011), board certification in visceral surgery (OR, 11.50; 95% CI, 2.01-65.91; p = 0.006), number of peer-review publications (OR, 1.12; 95% CI, 1.01-1.24; p = 0.027) or H-index (OR, 1.36; 95% CI, 1.07-1.73; p = 0.012). Conclusions UEM represent a major concern for academic surgeons. Exposure to UEM varies proportionally to professional experience and research activity.