J.Jpn. Surg. Soc.. 127(5): 492-495, 2026

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Feature topic

CURRENT STATUS AND CHALLENGES IN IMPROVING THE WORK ENVIRONMENT FOR CARDIOVASCULAR SURGERY

Since its implementation in April 2024, Japan’s physician work-style reform has significantly affected not only individual physicians but also labor–management systems within healthcare institutions. Prior to its enforcement, four thoracic surgery-related academic societies submitted a proposal to the Ministry of Health, Labour and Welfare, emphasizing that the reform should involve more than simply reducing working hours. They argued that the essential issues in thoracic surgery include the establishment of team-based care, task shifting, centralization of surgical services, introduction of closed ICU systems, and sustainable workforce models. Following the reform, several reports have described its impact on clinical practice, particularly in regional university hospitals. Questionnaire-based studies have examined the role of task shifting, collaboration with nurse practitioners, and the perspectives of young cardiovascular surgeons regarding working conditions and career sustainability.
In Europe and the USA, strict regulations on physician duty hours and mandatory leave have already been implemented. However, cardiothoracic surgeons continue to face major challenges, including burnout, depression, and impaired self-wellness. These findings suggest that reducing working hours alone is insufficient and that establishing a sustainable, healthy working environment for cardiothoracic surgeons remains a major challenge worldwide.

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