J.Jpn. Surg. Soc.. 127(5): 485-491, 2026

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Feature topic

CURRENT STATUS OF AND CHALLENGES IN IMPROVING THE WORKPLACE ENVIRONMENT IN THORACIC SURGERY

The volume of thoracic surgical procedures has increased in recent years, with minimally invasive approaches, including video-assisted thoracoscopic surgery and robot-assisted thoracic surgery, now accounting for the majority of operations for primary lung cancer. In parallel, the scope of thoracic surgeons’ responsibilities has expanded substantially beyond operative care to include preoperative diagnosis, molecular testing, systemic therapy, perioperative management, outpatient care, treatment of recurrence, palliative care, education, research, and clinical database registration. A recent survey of members of the Japanese Association for Chest Surgery highlighted persistent challenges related to overtime work, on-call duties, holiday coverage, compensation, and leave acquisition. Although the implementation of physician work-style reform in 2024 has promoted working-hour management and operational efficiency, it may also reduce opportunities for operative exposure and self-directed training among early-career surgeons.
To ensure sustainable thoracic surgical practice, further promotion of task shifting and task sharing with nurse practitioners, nurses trained in specified medical actions, medical clerks, and other healthcare professionals is essential. Moreover, although the number of female thoracic surgeons is increasing, their representation among board-certified specialists and leadership positions remains limited. Structured support for career continuity, including return-to-work programs, flexible work arrangements, and continued surgical training, is required.

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