A paper published by the American College of Surgeons this month has investigated the impact of personal finances on surgical residents and specifically considered its impact on burnout, depression, anxiety as well personal relationships.
In the study a survey was distributed to surgical residents in New England, USA whose ages ranged between 25-34 years (which allowed for comparison to an age and region matched cohort study group). Overall (and perhaps unsurprisingly) it found that in this well-educated and professionally employed section of society, surgical residents compared favourably to a cohort group created using data from the Financial Industry Regulatory Authority (FINRA).
Overall, financial satisfaction was similar when comparing surgical residents with their age-matched control group. Nevertheless, 17% of surgical residents reported that their out-goings were more than their total income each year with 32% of residents describing difficulties in paying monthly bills. Compared to the control group, residents were less likely to report owning a home at 29% in comparison to 44% in the control group. Residents were also more likely to report having student loans (71%) with 39% expressing concern about their ability to pay these. When compared to a historic cohort of residents the report demonstrated that today’s residents were likely to report lower rates of personal life insurance policies, lower rates of personal disability insurance and a lower likelihood of having a will. The authors consider that the increase in residents reporting student loans in excess of $300,000 (an increase from 18 to 27%) might explain the change.
Whilst there has been increasing emphasis on surgical resident well-being in recent years the authors highlight the fact that there has been less emphasis on financial health. This report highlights that whilst surgical residents do better in most categories (when compared to an age-matched cohort) they do less well in terms of financial satisfaction, anxiety concerning finances, having a will and owning a home. Large percentages of residents report significant financial stress which ultimately negatively affects overall well-being. And so whilst superficially surgical residents appear to be in good financial health there are some concerning signs in a large proportion of residents with 39% concerned about the ability to repay student loans, 24% reporting bad credit, 27% having over $300,000 student debt and 50% without access to any emergency savings. Nearly 80% have no personal life insurance policy and 75% are without personal disability insurance. 94% do not have a will and 17% are spending more than their yearly income. Overall, 1:5 surgical residents have a substantial financial stressor which corresponds to the 19% burnout rate noted in the same survey.
These findings are likely applicable across the globe. Given an international shortage of medical graduates it seems likely that financial stressors are likely to influence decisions regarding work location and ultimately re-location across national borders. It is of particular relevance to medical graduates currently working in the United Kingdom.
UK training grade doctors are currently in dispute with the UK government about a 35% real-terms fall in salaries which has seen some grades of doctor earning less than a coffee-shop Barista. Current industrial action is mirrored by an exodus of qualified doctors overseas and which has further exacerbated the staffing crisis within the UK public healthcare sector.
