Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study
Authors: Podda Mauro , Di Martino Marcello , Pata Francesco , Nigri Giuseppe , Pisanu Adolfo , Di Saverio Salomone , Pellino Gianluca , Ielpo Benedetto ,   the LIONESS study group, Tolla Ashenafi Negash , Abdelkhalek Mohamed , Emile Sameh , Dinagde Tesfaye Aga , Bouzid Chafik , Mansour Ahmed Mohammed Farid Mahmoud , Garzali Ibrahim Umar , Aregawi Alazar Berhe , Zaghloul Tarek M. , Kchaou Ali , Awad Selmy S. , Souadka Amine , Ted Tedla Gebretsadik , Saumtally Mohammad Saad , Awad Selmy S. , Ahmed Bensaad , Bayileyegn Nebiyou Simegnew , Nunziante Marco , Shalaby Mostafa , Debena Dawit Gebregiorgis , Zena Alemayehu Shanko , Adewunmi Olayinka Lukman , Negasa Tolera A. , Bourguiba Mohamed Aboulkacem , Feituri Nura , Kebede Kirubel Abebe , Elfeki Hossam , Anas Abdelhmed , Awad Ahmed K. , Ermias Nebiyou , Hailemariam Dagnachew H. , Bejiga Gosa Hundie , Imana Ruhama Yoseph , Taffese Abebe , Feleke Tsega Terefe , Elghadban Hosam Mohamed , Debela Bizuneh Sime , Shiferaw Desta , Tadesse Robel , Chukwu Isaac Sunday , Mohammed Abdullahi Ibrahim , Hassen Khalid Arebo , Obiagwu Ndubuisi K. , Tense Tadesse H. , Taeme Mulugeta , Biniam Ewnte , Tesfay Goytom Knfe , Tegegn Ayenachew Getachew , Teddy Tewodros Abule Bilata , Bekana Bekana L. , Nidaw Melkamu Kibret , Ali Mahmoud Ibrahim , Gonfa Kebebe Bekele , Kiros Samuel , Belay Tatek , Yallew Gebeyaw Mengist , Wassie Chekol , Ayalew Alem Mekete , Asfaw Fitsum Terefe , Aimal Aimal Khan , Casas Maria Agustina , Madrid Fausto A. , Diaz-Elizondo Jose Antonio , Merlo Ignacio Guillermo , De Campos Tercio , Schlottmann Francisco , Gomes Carlos Augusto , Hernández Edgard Efrén Lozada , Moncada-Ortega Augusto , Ramos-De la Medina Antonio , Vanerio Patricio , Diaz-Elizondo Jose Antonio , Morales Emilio J. , Stringfield Sarah Beth , Gallardo Cristian , Fonseca Vinicius Cordeiro , Muriel Maria Emilia , Cantarino Frederico , Morales Emilio J. , Fichera Alessandro , Rodriguez Agustin E. , Salinas Roberto Paúl Andrade , Crosbie Gonzalo Gabriel , Menegozzo Carlos Augusto Metidieri , Avellaneda Nicolas , Briones Cristhian Gonzalo Aspiazu , Varela Cristopher , Lichliter Warren E. , Varela Cristopher L. , Koppel Darren , Lenz Jorge Godoy , Pascual Franco , Sibaja-Matamoros Dauber A. , Johnson Benjamin E. , Mercado Octavio Avila , Tita Agustín , Mukherjee Indraneil , Lorenzo Irving , Rueda Erick , Rico Douglas , Terwes Natasha Loria , Visag-Castillo Victor , Escalante Karol S. , Salvador Alan Francisco Alfaro , Pio Luca , Rodas Edgar B. , Aguilar Juan Carlos Cardozo , Neri Ignacio , Barzola Ernesto J. , Barba Leonardo A. , Zuchini Andrés Mendoza , Acevedo Ana Karen Radilla , Gachabayov Mahir , Gonsaga Ricardo Alessandro Teixeira , Bonilla Fernando , Knickerbocker Chase Barrett , Tsouknidas Ioannis , Salamea Juan C. , Travers Lawrence Albert Salter , Nari Gustavo Adrian , Pachajoa Diana Alejandra Pantoja , Valadez Michel Hernandez , Hale Lyman Lansing , Perez Guillermo , Choudhry Asad , Foreman Michaael L. , Brito Ismael , Ciro Mauricio Pedraza , Newton Carla Joyce , Souza Hamilton Petry , Davis Daniel G. , Ferreira Rodrigo Vaz , Keller Deborah S. , Miguel Gustavo Machain , Singh-Ranger Gurpreet , Linares Neiling Massiel Oviedo , Singares Eduardo Smith , Valdivieso Xavier HGarcía , Teran Alfonso Ivan Sanchez , Vargas Luis Felipe Cabrera , Valinoti Agustín , Milne David M. , Fleming Andrew Martin , Quiroga-Garza Alejandro , Espino Eduardo Morales , Bedros Nicole Mary , Funk Geoffrey A. , Neves Fernanda V. S. , Supit Tommy , Baba Arshad Ahmed , Chalkoo Mushtaq A. , Kucuk Gultekin Ozan , Sarmiento Ray Inocencio , Galeev Shamil I. , Korkoman Mohammed J. , Yang Wah , Medappil Noushif , Athar Rahmatullah , Subramaniam Ravichandran , Chia Chi Fung , Alhazmi Ahmad , Halder Subhadip , Rusli Siti Mayuha , Rashid Arshad , Gülcü Barış , Nagarajan Prasanth , Rida Khaled , Jamiri Al-Radjid , Batıkan Oğuzkağan , Khan Huma Ahmed , Mitul Ashrarur Rahman , Efetov Sergey , Junior Marcelo A. F. Ribeiro , Gulcu Baris , Farooqui Marryam Riaz , Mulpuri Venu Bhargava , Bagaria Dinesh , Yusoff Ahmad Ramzi , Wani Rauf , Younis Muhammad Umar , Khobragade Krunal H. , Marwat Muhammad Ibrahim , Bains Lovenish , Kobe Yoshiro , Koh Peng Soon , Tantravahi Umasankar , Mohamad Mohamad Ikhwan Sani , Abu-Arish Hamdoon , Yildirim Ali Cihat , Ibrahim Aini Fahriza , Tan Jih Huei , Siagian Dumaria Ketty , Bhattacharya Neela , Chiu Jennifer H. F. , Paramasvaran Ganendra , Voon Kelvin , Göktepe Berk , Lee Lee Yeong Sing , Gupta Amit , Rasheed Faaiz , Al-Shehari Mohammed , Syed Syed Muhammad Ali , Bhat Pawan Singh , Erdoğan Emre , Roat Rajesh , Nacion Aeris Jane D. , Saraiya Swapnil Mukesh , Afolabi Akinwale Ibrahim , Chai Feng Yih , Ghannam Wagih , Bhattacharya Kaushik , NL Harish , Aloun Ali , Bhatti Hamza Waqar , Koneti Akshadhar J. , Klib Mohamad , Qureshi Ahmad Uzair , Syn Nicholas L. , Wani Ajaz , Saeidi Sara , Zeb Muhammad , Bandaru Kalyan Vijay Kumar , Di Saverio Salomone , Menna Maria Paola , Morales-Conde Salvador , Gessa Emanuela , Sánchez-Cabús Santiago , Spartalis Eleftherios , Antropoli Carmine , Manigrasso Michele , Sica Giuseppe S. , Ercolani Giorgio , Chitul Andrei , Bacchiocchi Giulia , Azevedo José , Karamarkovic Aleksandar , Bonavina Luigi , Piozzi Guglielmo N. , Migueláñez Isabel Pascual , Merlini David , Major Piotr , Grimaldi Luciano , Calu Valentin , Karamarkovic Aleksandar , Curro Giuseppe , Cotsoglou Christian , Baldini Edoardo , Delis Spiros , Kovacevic Bojan , Masetti Michele , Selvaggi Francesco , Scabini Stefano , Reiti Andrian , Zullo Alessia , Giuliani Antonio , Alesina Pier Francesco , Massey Lisa H. , Slesser Alistair A. P. , Neary Peter M. , Sahnan Kapil , Tan Jessica J. , Colucci Gianluca , Brady Richard R. W. , Mihailescu Andrei , Adamina Michel , Gerogiannis Ioannis , van Ramshorst Gabrielle , Paradiso Giulia , Poto Gianmario Edoardo , Massaro Daniele , Nazir Fozia , Stubbs Benjamin M. , Tasselli Francesco Menegon , Muñoz-Cruzado Virginia Durán , Sabia Domenico , Vannelli Alberto , Marsella Valentina Enrica , Tomada Elisa Paoluzzi , Giambusso Mauro , Davies Justin , Karamarkovic Aleksandar , Uzzau Alessandro , Balla Andrea , Scaringi Stefano , Nazir Fozia , Lancellotti Francesco , Douka Eleftheria , Argenio Giulio , Scaringi Stefano , Cassese Gianluca , Ammendola Michele , Morelli Luca , Francone Elisa , Bala Miklosh , Thambi Prem , Iacobone Maurizio , Campisi Andrea , Tejedor Patricia , Spoletini Gabriele , Mascherini Matteo , Belia Francesco , Sahnan Kapil , Uzzau Alessandro , Idiz Ufuk Oguz , Francone Elisa , Colak Elif , Peters Paul Adewunmi , Pellino Gianluca , Ros Emilio Peña , Aytac Erman , Vilallonga Ramon , Serrablo Alejandro , Muttillo Edoardo Maria , Di Franco Gregorio , Vanni Gianluca , Isik Arda , Sbacco Valentina , Tropeano Francesca Paola , Porcellini Iride , Butler Rebecca Jayne , Fernandez Carmen Cagigas , Papadopoulos Aristeidis , Salvans Silvia , Khan Jan Sher , Bellver Pedro Palazón , Mc Farlane Sebastian Jeri , Apostolou Konstantinos , Tur-Martinez Jaume , Castellano Javier Rivera , Santoliquido Matteo , Tallon-Aguilar Luis , Celentano Valerio , Aliyev Vusal , Mihailescu Andrei , al-Najami Issam , Grama Florin A. , Tur-Martinez Jaume , Masior Łukasz , Ciesielski Wojciech J. , Luberto Antonio , Sparavigna Marco , Klimczak Tomasz Jerzy , Negoi Ionut , Serradilla-Martín Mario , Marinis Athanasios , Cammarat Roberto , Bellido-luque Juan , Manzo Carlo Alberto , Milana Flavio , Luglio Gaetano , Zarnescu Narcis Octavian , Martínez Isidro , Olmi Stefano , Costea Radu V. , Cerdán-Santacruz Carlos , Gica Nicolae , Rompianesi Gianluca , Gallo Gaetano , Ridolfi Cristina , Sahid Saidah , CC Tommaso , López-Soler Guillermo , Díaz Carlos JGómez , Mccawley Niamh , Luzzi Andrea Pierre , Abelló David , Bonito Alba Correa , Ntomi Vasileia , Gourgiotis Stavros , Pazos Natalia Suárez , Toscano Marta Jiménez , Zafra David Ambrona , Beisani Marc , Oliva Alba , Guler Mert , Gómez Marta Jiménez , Oddis Lidia , Montcusí Blanca , Delgado Ander Timoteo , Lasarte Mateusz PJęckowski Aingeru Sarriuga , Antonacci Nicola , Sartori Alberto , Taylor John Vincent , de Santos Iglesias Francisco Juan , Mastronardi Manuela , Gunay Emre , Yiu Andrew , Cano-Valderrama Oscar , Costantini Giulia , Digne-Malcolm Holly Jane , Petropoulou Thalia , Gómez Marta Jiménez , Horesh Nir , Kelly Michael E. , Ahmed Nauman , Wyroslak-Najs Justyna , Naik Prashant , Vigorita Vincenzo , Michael Michael , Castro Ernest , Paspala Anna , D’Ambrosio Marco , Pangeni Anang , Dziakova Jana , Milana Flavio , Terés Lara Blanco , Lorente-Poch Leyre , Di Carlo Isidoro , Spartalis Michael , Moro-Valdezate David , Davey Matthew G. , Turrado-Rodriguez Victor , Tryliskyy Yegor , Calussi Marco , Farré Silvia Pérez , Labat Miriam Cazador , Marafante Chiara , Takkenberg Marijn , Brookes Charlotte Elisabeth , Soares Antonio S. , Gialamas Eleftherios , Caputo Damiano , Corrons Laia Codina , Antonacci Nicola , Capitano Sante , Charalabopoulos Alexandros , Don Cristine Brooke Pathirannehalage , Marrano Enrico , Giuffrida Maria Carmela , Tomasicchio Giovanni , Bellato Vittoria , Stijns Jasper , Creavin Ben , Schizas Dimitrios , Blanco-Antona Francisco , Kykalos Stylianos , Tartaglia Nicola , Pelegrina Amalia , Barranquero Alberto G. , Schena Carlo Alberto , Cremona Simone , Baili Efstratia , Cianci Pasquale , Di Bella Annamaria , Forcignanò Edoardo , Fabbrizio Tiziana , Salvetti Francesco , Inama Marco , Campagnaro Tommaso , Deerenberg Eva B. , Reccia Isabella , Rocca Aldo , Fazio Federico , Tampakis Athanasios , Tepelenis Kostas , Di Meo Giovanna , Konstantoudakis Georgios , Manatakis Dimitrios K. , Charalabopoulos Alexandros , Mineccia Michela , Delvecchio Antonella , Faro Carmelo Lo , Rosso Edoardo , Bandyopadhyay Samik K. , Queffurus Michael , Marin Jacopo Nicolò , Corvasce Arianna , Chillarge Gauri , Mohammed Mohammed Mustafa , Reid Rebecca , Gherardi Dario , Naeem Awais , Pandanaboyana Sanjay , Tayeh Salim , Chevallay Mickael , Sergeant Gregory , Cuccomarino Salvatore , Salimian Nick , Kapsampelis Panagiotis , Ferretti Carlotta , Glasbey James , Harvitkar Rafique Umer , Iqbal Muhammad Rafaih , de Oliveira Gabriel Paiva , Pérez-Bertólez Sonia , Bergna Alessandro , Brisinda Giuseppe , Rottoli Matteo , Roscio Francesco , Pedrazzani Corrado , Meyer Jeremy , Marino Marco V. , Brasset Camille , Daniel Clerc , Devriendt Stefanie , Soldini Gabriele , Pennisi Damiano , Richards Chris B. , Fiore Felicia , Bocchino Antonio , Au Stephanie , Hernandez-Garcia Miguel , Frontali Alice , Grossi Ugo , Lolis Evangelos , Miotto Marco , Di Filippo Giacomo , Seretis Charalampos , Barberis Andrea , De Luca Raffaele , Levi Sandri Giovanni Battista , Reitano Elisa , Mattioli Marco , Efetov Sergey , Sciaudone Guido , Fuschillo Giacomo , Schiltz Boris , Low Juin , Bointas Georgios , Cozza Valerio , Delaune Vaihere , D’Ambrosio Marco , Vescio Francesca , Curcio Silvia , Sevik Husnu , Santocchi Pietro , Stecca Tommaso , Balaphas Alexandre , Chessa Antonella , Leo Cosimo Alex , di Mola Fabio F. , Tarallo Mariarita , Martini Francesco , Lisi Giorgio , Khan Mansoor , Nicolazzi Marco , Pinotti Enrico , Morini Andrea , Esposito Giuseppe , Buonomo Oreste Claudio , Corallino Diletta , Aytac Erman , Demir Anıl , Roesel Raffaello , De Lucia Chiara , Maruccia Michele , Tekin Oguzhan , Pavone Giovanna , Gupta Ashish , Pradelle Irene , Chrysikos Michael , Farrukh Maira , Baiocchi Gian Luca , Piras Carla , Abellán Antonio Melero , Olivieri Laura , Materazzo Marco , Carbone Ludovico , Dulskas Audrius , Mulita Francesk , Corronca Federico , Cappuccio Micaela , Tasselli Francesco Menegon , Smerieri Elia , Sotiropoulu Maria , Violante Tommaso , Moletta Lucia , Rutegård Martin , Brillantino Antonio , Pata Francesco , Landaluce-Olavarria Aitor , Ossola Paolo , Bono Dario , Rosés Helena Salvador , Perez-Sanchez Luis E. , Sabbatini Sonia , Scotti Mauro Alessandro , Cammarata Roberto , Ibáñez Noelia , Materazzo Marco , Marano Alessandra , Palmisano Silvia , Cascales-Sanchez Pedro , Mosca Vinicio , Ballester Cristina , Iordache-Petrescu Madalina Ionela , Pozza Gioia , Akay Omer , Bollino Ruggero , Vanni Gianluca , Toti Johannes M. A. , Mascianà Gianluca , Pach Radoslaw , Sensi Bruno , Natalia Savvala N. , Coppola Alessandro , Altinel Yuksel , Brucchi Francesco , Guitart Marc Pérez , Salido Andrea Jiménez , Tamini Nicolò , Garoufalia Zoe , Mifsut Patricia , Wilkins Alex , Navarro-Sánchez Antonio , Cestaro Giovanni , Conti Luigi , Carvas João M. B. , Gazia Carlo , Alonso Patricia , Spiezio Giovanni , Ielpo Benedetto , Maggi Giulia , Juloski Jovan , Braccio Bartolomeo , Pañella Clara , Freixa Celia Caula , Petrakis Georgios , Folliero Cristina , De Andrés-Asenjo Beatriz , Iodice Alessandra , Jansson Hannes , González Tomas Elosua , Ortega Irene , Castro Maria J. , Fernicola Agostino , Aparicio Antonio Carlos Maya , Ortega Nuria , Chouliaras Christos , Tura Marina Vila , Sidiropoulou Zacharoula , Gonzalez Ana , Augustin Goran , Segura-Sampedro Juan J. , Cuk Vladica , Piccolo Gaetano , Ingallinella Sara , Ortenzi Monica , Uggeri Fabio , Carrabetta Salvatore , Tolonen Matti , Formisano Giampaolo , Manfredelli Simone , Perra Teresa , Esposito Francesco , Perrone Gennaro , Zacharis Georgios , Menéndez Jaime Iturbe , Bottcher Sofia Maria Jaume , Ioannidis Orestis , Borges Nuno , Sousa Xavier , Colombari Renan C. , Tellez Clara , Capolupo Gabriella Teresa , Giuliani Giuseppe , Mastella Federica , González Lluis García , Merlini Ilenia , Ghignone Federico , de Sa Tiago Correia , Mangana Orsalia , Rodriguez-Lopez Mario , Alvarez-Gallego Mario , Chowdhury Ashim , Di Lascio Pierpaolo , Carneros Virginia Jiménez , Angrisani Marco , Conte Luigi E. , Montiel Carmen Galiana , Ascari Francesca , Dajti Irida , Lapolla Pierfrancesco , Sperotto Beatrice , Mazzarella Gennaro , Capuano Marianna , Lopez Maria Martinez , Ferrario Luca , Bulte Joris P. , López María Martínez , Guerci Claudio , Marra Angelo Alessandro , Belkacem Acidi , Pérez Raquel Escalera , Panyko Arpád , Dimitrov Evgeni , Luque Eduardo J. , Manrique Mario Montes , Paranyak Mykola , Manrique Mario Montes , Kaur Mandeep , Barugola Giuliano , Farazi-Chongouki Christos , Estaire-Gómez Mercedes , del Olmo Juan Carlos Martín , Nardo Bruno , Mutlu Arda Ulaş , Rubio Ainhoa Valle , Merlini David A. , Marchegiani Francesco , Cereda Marco Angelo , Vinci Danilo , Komaei Iman , Petrucciani Niccolo , Seyfried Steffen , Krsicka Petr , Medas Fabio , Lesko Dusan , Murzi Valentina , Manfredelli Simone , Siragusa Leandro , Guerrero María Alejandra , Iranzo Marina Alarcón , Cestino Luca , Pasculli Alessandro , Smerieri Nazareno , Benzoni Ilaria , Festa Federico , Brillantino Antonio , Jordão Daniel Filipe Martins , Licardie Eugenio , Nicolaescu Diana C. , Balassone Valerio , La Vaccara Vincenzo , Romano Fabrizio , Adamovich Dmitry Mikhailovich , Papatheodorou Panayiotis , Nigri Giuseppe , Maroni Norvana , Colás-Ruiz Enrique , Melberga Liene , Chimenti Federica , Ferrari Davide , Arcudi Claudio , Police Andrea , De Simone Belinda , Sánchez-Guillén Luis , Parreño-Manchado Felipe Carlos , Rachadell Juan José , Coletta Diego , Saroglu Azize , Pattacini Gianmaria Casoni , Antonelli Amedeo , Anania Marco , Litta Francesco , Lafranceschina Stefano , Bottari Andrea , Pavlovic Mladen , Rojas-Bonet Noel , Tampaki Ekaterini Christina , Kosir Jurij A. , Anelli Ferdinando M. , de las Casas Sara Gortázar , Kucukarslan Rabia , Pierobon Elisa Sefora , Milanesi Maria , Drogouti Maria , Sotiropoulou Maria , Di Marco Federica , Bannone Elisa , Sliwinski Svenja Christin , Yildiz Ishak , Pellicciaro Marco , Celotti Andrea , Malerba Michele , Marino Fabio , Bourmpouteli Eirini , Bianco Giuseppe , Charitaki Evgenia , Pascale Marco Maria , Ioannidis Argyrios , Maraska Fatlum , Petagna Lorenzo , Turri Giulia , Vailas Michail , Romanzi Andrea , Pouwels Sjaak , Rosa Fausto , Clocchiatti Lucrezia , Rosa Fausto , Andreuccetti Jacopo , Machairas Nikolaos , Frountzas Maximos , Lasithiotakis Konstantinos , Barone Mirko , Christodoulou Prokopis , Potkonjak Dario , Aiolfi Alberto , de Vries Hilbert S. , Napetti Sara , Castaldi Antonio , Botelho Pedro , Marziali Irene , Uccelli Matteo , Pisano Michele , Veroux Massimiliano , Locci Eleonora , Romano Angela , Cero Mariagiulia Dal , Cicerchia Pierfranco Maria , Baldi Caterina , Russo Iris Shari , Tenconi Silvia Maria , Malerba Michele , Saliu Fatmir , Bondurri Andrea , Cardinali Luca , Laracca Giovanni Guglielmo , Martín-Pérez Beatriz , Scotti Mauro Alessandro , Felsenreich Daniel M. , Cunha Miguel , Zerbo Domenico , Clementi Marco , Delogu Daniele , Iossa Angelo , Bavikatte Akshay Prasannakumar , Saracoglu Can , Di Marco Federica , Pecorelli Nicolò , Tufo Andrea , Faro Carmelo Lo , Biloslavo Alan , Lianos Georgios D. , Carannante Filippo , Costanzo Antonio , Montuori Mauro , Cigognini Maria , Silvestro Roberto , Atici Semra Demirli , Milito Pamela , Ferronetti Antonio , Güngör Mert , Chessa Antonella , Di Venere Beatrice , Puccioni Caterina , Calussi Marco , De Nobili Giovanni , Selvaggi Lucio , Farolfi Tommaso , Aeschbacher Pauline , Olivier James B. , Frazzetta Giuseppe , Andriola Valeria , Giordano Alessio , De Luca Alessandro , Ferrara Francesco , Casagranda Biagio , Sammartano Fabrizio , Russo Alfio Alessandro , Rossi Stefano , Pacilli Mario , Synekidou Eirini , Tutino Roberta , Ceresoli Marco , De Rosa Michele , Di Santo Albini Andrea G. , Vincenzi Paolo , Vellei Samantha , Benzoni Enrico , Murillo Gabriela Aracelly Arroyo , Izzo Giuliano , Scotto Bruno , Caruso Riccardo , Colombo Francesco , D’Acapito Fabrizio , Lostoridis Eftychios , Saladino Edoardo , Poillucci Gaetano , Moeckli Beat , Veroux Massimiliano , Manto Ottavia , Kara Yasin , Tatar Cihad , Cioffi Stefano Piero Bernardo , Mambrilla Sara , Bianchi Valentina , Mambrilla Sara , Scopelliti Michele , Agresta Ferdinando , Andriola Valeria , Nava Andrea Kazemi , Di Martino Marcello , Franchi Eloisa , Fransvea Pietro , Prieto Mikel , Picardi Biagio , Rizzuto Antonia , Panaccio Paolo , Gussago Stefano , Marra Ester , Addeo Pietro , Fernández Fernández June , Gulmez Mehmet , Pisaniello Donatella , Menna Maria Paola , Cannavo Maurizio , López-López Victor , Avella Pasquale , Peloso Andrea , Oddis Lidia , Bellanova Giovanni , Candilio Giuseppe , Perotti Bruno , Granata Roberta , Florio Gaetano , Roesel Raffaello , Ioia Giovanna , Iannone Immacolata , Lisi Giorgio , Ammerata Giorgio , Zambon Martina , Romano Francesco Maria , Del Monte Simone Rossi , Sasia Diego , Fortuna Laura , Giuffrida Mario , Litvin Andrey , Cannistra Marco , De Padua Cristina , Sánchez Tatiana Gómez , Ingallinella Sara , Paniagua-Garcia-Señorans Marta , Guevara Jenny , Perfecto Arkaitz , Alconchel Felipe , Campanelli Michela , Keci Laura , Cricrì Michele , Kampouroglou Georgios , Bagaglini Giulia , Farrarons Sara Sentí , Greco Antonio , Walędziak Maciej , Carvas João M. , Serrano-Navidad Monica , Van Doorn Berend , Schiavo Ciro , Fabbri Nicolò , Wani Ishfaq Ahmad , Mondi Isabella , Castaldi Antonio , Anestiadou Elissavet , Mendes Beatriz ISilva , Verdi Daunia , Dorovinis Panagiotis , Vinci Danilo , Cacciaguerra Andrea Benedetti , Di Marco Federica , Caldeira Beatriz , Canonico Giuseppe , Dardanov Dragomir , D’Ugo Stefano , Francis Fayez Maged , Meneghini Simona , Pesce Antonio , Puglisi Silvana Bernadetta , Bellini Maria Irene , Pisano Marcello , Giordano Marco , Capuano Marianna , Fleres Francesco , Campus Federica , Cillara Nicola , Moggia Elisabetta , Ciarleglio Francesco A. , Podda Mauro , Calini Giacomo , Gravante Gianpiero , De Carlis Riccardo , Altomare Michele , Martines Gennaro , Miggino Marco , Marano Luigi , Stocco Alberto , Porcu Alberto , Pham Thuy Vy , Gervasi Maria Clelia , Pilia Tiziana , Palomba Giuseppe , Picchetto Andrea , Spampinato Marcello Giuseppe , Cannistra Marco , Vailas Michail , Tandoi Francesco , Piccoli Micaela , Gall Malina ECaraiman , Yiu Andrew , Dulskas Audrius , Santos Bárbara Ribeiro , Agastra Ervis , Koëter Tijmen , Samadov Elgun , Marsanic Patrizia , Serena De Fatico Gilda , Uzunoglu Mustafa Yener , Zanus Giacomo , Braholli Eriol , Giovine Gennaro , Galiffa Giampaolo , Lauricella Sara , Lukmonov Saidrakhim , Leventoglu Sezai , Chooklin Serge , Dudi-Venkata Nagendra N. , Gauci Chahaya M. 
Published: April 2024

AbstractThe workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI.