Perceptions and Impact of Grief Among Surgical Trainees.

INTRODUCTION: Grief is an underrecognized yet pervasive occupational exposure in surgical training. Surgical residents routinely encounter patient death, devastating complications, and ethically complex decisions, often without adequate time or institutional structures to process the emotional consequences. Neurosurgery, in particular, may place trainees at heightened risk given the frequency of catastrophic neurological injury and end-of-life care. This study sought to quantify the prevalence, intensity, and correlates of professional grief among surgical trainees. METHODS: An anonymous, cross-sectional survey was distributed to residents across multiple surgical specialties at a tertiary academic medical center. Participants reflected on experiences from the prior three months. Professional grief was defined as grief occurring in the setting of patient care. Responses were measured using 5-point Likert scales and analyzed across specialties and training levels. RESULTS: Fifty-nine of 194 eligible surgical residents (30%) completed the survey. Overall, 76% of respondents reported experiencing professional grief at least sometimes, often, or daily. Grief-provoking events included traumatic injury, death of long-term patients, and perceived clinical or intraoperative mistakes. Over 75% of residents reported that grief had affected their work at some point, and 40% acknowledged that patient loss had contributed to thoughts of leaving residency. Most residents preferred to discuss grief with co-residents or trusted attendings and 41% had participated in a debrief, nearly all of whom found it helpful. Neurosurgery residents reported significantly higher grief frequency than most other surgical subspecialties and trended toward greater functional impact. CONCLUSIONS: Professional grief is a common and consequential feature of surgical training, with neurosurgery residents bearing a disproportionate burden. Without structured support, unresolved grief may undermine well-being, professional identity, and workforce retention. Culturally embedded, peer-supported debriefing represents a promising strategy to normalize emotional processing and mitigate the cumulative toll of professional grief.