Episode 19. Purposeful Misery: Rethinking Surgical Training and Burnout

Abhishek and Corey examine what surgical training should demand—and what crosses into needless harm—through burnout data, resident wellbeing, patient ownership, fatigue, and the small forms of support that make hard work sustainable. They unpack a national study on surgical resident burnout, suicidal ideation, and what makes training feel meaningful versus merely miserable. They mix humor with a serious discussion of how surgical education shapes resilience, professional identity, and patient responsibility. Content note: the conversation includes discussion of resident suicide and suicidal thoughts. Key topics In this episode, Abhishek introduces a national study of 6,567 general surgery residents across 301 programs and highlights the alarming finding that 4% reported suicidal ideation in the prior year. Corey and Abhishek discuss how duty hour violations, blame-oriented responses to adverse events, low operative autonomy, bullying, and sexual harassment all contribute to burnout. They debate the difference between necessary hardship and gratuitous suffering in residency, especially when training feels disconnected from patient care or growth. Corey argues that early residency is disorienting because the system stops being built around the trainee and starts centering the patient, which forces adaptation and resilience. Abhishek reflects on how meaningful suffering in training came from taking ownership of a patient, staying when complications happened, and learning that the case was yours. They talk about the role of purposeful misery versus hazing, especially when residents spend hours on documentation and other tasks that may build discipline but can also feel demeaning. Connect with the Hosts: Abhishek Parmar -   / abhishek-parmar1   Douglas Corey Campbell - https://x.com/yeroc2003