Surgeon well-being: a systematic review of stressors, mental health, and resilience.

Background: Surgeons work in high-pressure environments, predisposing them to psychological distress. High rates of burnout and workforce shortages highlight the critical importance of understanding and improving surgeon well-being to sustain healthcare delivery. The multifactorial challenges to surgeon well-being remain insufficiently addressed. This study systematically synthesizes evidence on occupational stressors, burnout, mental health challenges, and resilience strategies among surgeons, and identifies evidence-based interventions to enhance well-being and workforce sustainability.

Methods: A systematic search of PubMed, Scopus, Web of Science, and Google Scholar (2000-2025) identified peer-reviewed studies on surgeon well-being, burnout, mental health, and resilience. Editorials and non-empirical studies were excluded. Sixty-six studies were included following application of inclusion/exclusion criteria and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework screening. A narrative synthesis identified thematic domains and intervention outcomes. Primary outcomes included the prevalence of burnout, anxiety, and depression among surgeons, sources of occupational stress, and descriptions of interventions promoting resilience or institutional wellness.

Results: The literature search identified 534 records through database searching, and an additional 22 records from other sources. After removing duplicates, 356 records remained. 253 records were excluded after initial screening. 103 full-text articles were assessed for eligibility, and 27 were excluded, leaving 76 studies for qualitative synthesis. Surgeons experience high levels of burnout (30-60%) and elevated risks of anxiety, depression, and attrition. Key stressors include long work hours, high patient responsibility, and insufficient institutional support. Individual-level strategies (e.g., mindfulness, physical activity, peer support) offer some benefit but are insufficient alone. Organizational interventions-such as flexible scheduling, resilience training, and embedded mental health services-show promise but are inconsistently implemented. Stigma and licensing concerns remain systemic barriers to seeking help.

Conclusions: Surgeon well-being is crucial for both provider and patient outcomes. Addressing this requires coordinated efforts at the individual, institutional, and policy levels. Prioritizing surgeon well-being is essential for safeguarding the surgical workforce and ensuring quality patient care in modern healthcare systems.