ReviewPlastic surgery (Oakville, Ont.)2026
From Tradition to Wellness: A Systematic Review of Changing the Surgical Training Culture in Canada.
Review in Plastic surgery (Oakville, Ont.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Surgical training, historically characterized by long hours, hierarchical culture, and critical feedback, has been associated with burnout and mental health challenges. Reforms, including duty-hour limits, competency-based education, and initiatives promoting wellness, equity, and psychological safety, have begun reshaping training in Canada. This review provides a national overview of these cultural shifts, mapping recommendations for best practices and research. Design: A systematic review identified studies on Canadian surgical residency culture. Two reviewers independently screened and extracted data, with risk of bias (ROB) assessed. Results: Twenty-one studies were included. Key themes were wellness and mental health (19 studies), feedback and learning environments (20), evolving surgical culture (17), equity, diversity, and inclusion (12), duty-hour reforms (14), and international transferability (8). ROB was low in 44.00%, medium in 36.00%, and high in 20.00% of studies. Discussion: This review of 25 studies highlights evolving themes in Canadian surgical training culture. Traditional endurance-based models are shifting toward inclusivity, wellness, and equity, with increasing attention to mental health, mentorship, and structured feedback. Duty-hour reforms, parental leave policies, and competency-based initiatives indicate generational and structural changes, though implementation varies across programs. Studies emphasize culturally responsive mentorship, psychological safety, and systemic supports to improve learning environments. While Canadian experiences provide valuable insights, differences in legal, institutional, and cultural contexts limit direct transferability internationally. Recommendations include implementing fatigue management plans, mentorship, simulation-based learning, and national coordination to foster a sustainable, learner-centered surgical culture. Conclusion: Canadian surgical training is evolving through duty-hour reforms, wellness initiatives, and equity-focused policies. While progress has been made, challenges remain in mentorship and cross-provincial consistency.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.