Self-reported harassment during Japanese surgical residency: secondary analysis of a nationwide survey of newly board-certified surgeons.

Abstract

Purpose: To assess the prevalence of self-reported harassment during surgical residency in Japan, identify independent risk factors, and examine its impact on early career intentions among newly board-certified surgeons.

Methods: We conducted a prespecified secondary analysis of a 2023 nationwide survey of surgeons certified between 2021 and 2022 (N = 1410). Respondents answering "Yes" to the perceived harassment item were assigned to the harassment group, while those answering "No" constituted the control; respondents selecting "Prefer not to answer" were excluded from this prespecified secondary analysis to avoid interpretive ambiguity. Complete‑case multivariable logistic regression produced adjusted odds ratios (aORs) for trainee, program, and workload level correlates.

Results: Among the respondents, 304 (41.5%) reported harassment by instructors. In the multivariable model, low instructor teaching ability (adjusted odds ratio [aOR] 2.75; 95% CI] 1.72-4.41) and overtime > 80 h/month (aOR 2.28; 95% CI 1.57-3.30) were the primary factors independently associated with self-reported harassment. Furthermore, experiencing harassment was significantly associated with overall program dissatisfaction, lack of intention to return to the training institution, and a higher likelihood of dropping out (p < 0.001).

Conclusions: Self-reported harassment experiences are associated with an excessive workload and unsatisfactory surgical instruction, threatening trainee retention. Duty hour limits, instructor education, and confidential reporting systems should therefore be prioritized.