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Residency Is Breaking My Back: Development Of Musculoskeletal Symptoms In Plastic Surgery Residency

Johnson C, Foglio A, Grossman S, Fishman J, De La Cruz C
University of Pittsburgh Medical Center
2019-02-15

Presenter: Aaron Foglio

Affidavit:
I affirm the work performed in this study was entirely original.

Director Name: Vu N

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction

BACKGROUND: The importance of assessing resident well-being has been recognized by the ACGME and is now a program requirement. A common physical complaint among plastic surgeons is work-related musculoskeletal symptoms. The aim of this study is to identify when these symptoms develop, common causes, how to prevent them from occurring, and how to inhibit the symptoms progressing.

METHODS: A survey was created and approved by our IRB to gather information on participant demographics, operating history, development of musculoskeletal symptoms, and potential causes of these symptoms. This was then distributed to all U.S. Plastic Surgery residents.

RESULTS: There were 68 respondents. The majority of residents (74%) reported musculoskeletal symptoms developed while in residency. Of these residents, symptoms begin within the first three years of training (80%), which correlated to operating on a more consistent basis. The most common symptoms were pain (72%), stiffness (57%), and fatigue (47%) of the neck (66%) and lower back (58.8%). Methods to alleviate mal-positioning by adjusting the OR table height was rarely requested with only 13% of residents feeling "extremely comfortable" asking for in the presence of the attending. No residents reported having formal curriculum on basic knowledge of body positioning and conditioning.

CONCLUSIONS: Plastic Surgery residents are at high risk for developing musculoskeletal symptoms, which can substantially impact their careers. Identifying causes and mitigating risk is essential and should be addressed prior to the third year of residency when symptoms most often begin. Formal education and mindfulness of ergonomics has immediate benefits mitigating musculoskeletal symptoms.

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