Surgeons’ pursuit of professional achievement and work-life balance in a demanding working environment: An exploratory qualitative study in Japan

Background: A challenging working environment discourages younger generations from pursuing a surgical career, contributing to the decline in the number of surgeons in Japan. However, current surgeons' perceptions of their work environment remain poorly understood. To address this gap, an exploratory qualitative study was conducted. Methods: Two semi-structured interviews were conducted in person or via email: (i) focusing on surgeons' primary interests, career goals, and perceptions of daily workloads, and (ii) focusing on issues affecting work-family balance. A total of 24 interview transcripts were collected across two interviews (12 participants in Interview 1 and 12 in Interview 2, with partial overlap between them). Participants were recruited through purposive and snowball sampling. Data were analyzed using reflexive thematic analysis to identify patterns across datasets. Results: In the first interview, participants showed diverse priorities: approximately one-quarter prioritized pursuing professional mastery, one-quarter prioritized family life, and a similar proportion reported aiming to balance both domains. Half of the participants accepted multitasking as part of their daily role, although many preferred to limit it to tasks directly related to surgery. More than half expressed frustration with workload disparities and indicated that salaries did not always correspond to actual duties. In the second interview, two-thirds of participants reported strong concern about night and weekend calls while raising children, and several described feelings of guilt regarding limited family time. Conclusions: Many participants described efforts to balance professional achievement with work-family considerations, while highlighting multitasking, workload disparities, and unpredictable after-hours calls as challenges. These findings provide insight into factors affecting surgeons' work experiences in Japan and may inform strategies to support work-life balance and surgical workforce sustainability in similar contexts.