theatre and surgery
Stress immunity
in surgeons
Stress immunity is an important personality trait of doctors, with a high representation
seen in surgery. With one in five surgeons dropping out of training and 80% reporting burnout
symptoms, methods to inc rease job satisfaction and reduce burnout are required
James Pegrum MBBS
BSc (Orthopaedics)
MSc (Sports Medicine)
Diploma Mtn Med
FRCS (Trauma
& Orthopaedics)
Nuffield Orthopaedic
Centre, Oxford, UK;
Honorary Research
Associate Centre for
Sport & Exercise Medicine
Queen Mary’s University
London, UK
Robert McCulloch
MRCS MBChB
PGDME
Trauma and Orthopaedic
Department
Stoke Mandeville
Hospital, Aylesbury, UK
Oliver Pearce
FRCS (Trauma
& Orthopaedics)
Visiting Professor Bedford
University;
Trauma and Orthopaedic
Consultant,
Milton Keynes NHS
Foundation Trust, UK
In surgery, we are all too quick to judge the
psychology of our patients; however,
understanding our own personality is essential
to optimise our own performance. Our surgical
decision-making requires the ability to judge
the patient’s personality, while simultaneously
understanding our own character and
temperament, to allow a patient-centred
consultation and consent for surgery.
The psychological traits of a surgeon
It is estimated that the prevalence of a
psychopathic personality trait within the general
population is approximately 1%, however within
the world of finance, it rises to 3.5% and is even
higher among leaders. 1 Surgeons are subjected to
a high level of psychiatric morbidity with various
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HHE 2018 | hospitalhealthcare.com
factors presented in the literature; long working
hours, 2,3 working night shifts, divorce, 4 medical
lawsuits 5 or failing to meet continuing medical
demands. 6 It will therefore not be too surprising
to find out that some of the traits associated with
a psychopathic personality, such as preternatural
calmness under pressure, and an apparent
indifference to human suffering when making life
or death decisions, are perhaps selected out in
those who rise to the top of our profession.
There are traits of a subclinical psychopathy
that may benefit the surgical field. These positive
personality traits include good relationships with
others, social desirability and honesty. Subclinical
psychopathy also includes less desirable
Machiavellian tendencies that may represent
a rejection of an absolute moral standard rather