Bridging generational gaps in Surgery: A narrative review on values, well-being, and training preferences.

Background and purpose: Intergenerational differences in surgery create both challenges and opportunities. While differening perspectives and expectations may deter younger generations from pursuing surgical careers, it is crucial to balance these with the core values that define the surgical profession. This narrative review was conducted to better understand how the profession needs to evolve.

Methods: A structured literature search on generational changes in surgery was conducted using PubMed and Google Scholar. Relevant search terms were employed, covering (i) surgeons/surgery, (ii) generation/cohort and (ii) culture/identity/behaviour. After independent title and abstract screening by three authors, consensus was reached to include relevant studies published in English up to November 2023.

Main findings: Full-text evaluation led to an inclusion of 50 studies, reviewed for returning themes. Identified themes included: generations (n = 9), work engagement (n = 8), work-life balance (n = 7), training and education (n = 4) and attractiveness of the profession (n = 8). An additional 14 relevant studies were included based on reference lists and external sources.

Conclusions: This review summarizes key factors contributing to surgical well-being and generational dynamics. Awareness of these factors is increasing. While generational differences exist, many distinctions may be attributed to life phases, lifestyles or systemic changes in the past decades. Addressing these topics daily can foster intergenerational dialogue and a supportive environment for future surgeons.