Surgeons had 1.16 times the odds of divorce compared with nonsurgeon physicians, according to a cross-sectional analysis of American Community Survey data from 2018 to 2023 published in the Journal of the American College of Surgeons. The prevalence of divorce among surgeons was 21%, exceeding the 18% observed in nonsurgeon physicians and approximating the 21% rate in the general US population.
The study analyzed more than 68,000 physicians from the American Community Survey (ACS), of whom 4,167 were surgeons, alongside nearly 13,000 dentists, more than 309,000 advanced practice providers (APPs), and nearly 550,000 allied health care workers. The cohort had a median age of 49 years, with most physicians identifying as male (62%) and White (69%), wrote study author Timothy M. Pawlik, MD, of The Ohio State University Wexner Medical Center, and colleagues.
Notably, the researchers found that the overall lower divorce rate among physicians relative to other health care professionals was primarily attributable to nonsurgeon physicians. Surgeons were more likely to have been married more than once (14% vs 11%). On multivariable analysis adjusting for age, sex, race, geographic region, total annual income, and hours worked per week, the odds of divorce were higher among male surgeons (1.30 times the odds) and White surgeons (1.28 times the odds) compared with their female and non-White counterparts.
The analysis identified several factors independently associated with divorce risk across all physicians. Divorce risk increased in a stepwise fashion with age: physicians aged 35 to 44 years had 2.5 times the odds of divorce compared with those younger than 35 years, rising to 4.6 times the odds for those aged 45 to 54 years and 5.4 times the odds for those 65 years or older. Female physicians had 1.5 times the odds of divorce compared with male physicians. Conversely, parenthood was associated with lower odds of divorce, as was increasing income.
The ACS, administered by the US Census Bureau, employs a randomized, multistage, stratified sampling methodology with response rates ranging from 93% to 98% annually. Respondents were classified as having experienced divorce if they were currently divorced at the time of the survey or had been married more than once. Physicians were identified using Standard Occupational Classification codes. Physicians worked a mean of 45 hours per week compared with 33 hours for dentists, 33 hours for APPs, and 31 hours for allied workers.
Racial disparities in divorce rates persisted after adjustment. Black physicians experienced higher divorce rates than White physicians (1.15 times the odds), whereas Asian physicians demonstrated lower divorce risk (0.49 times the odds). Geographic variation was also observed, with divorce rates among physicians varying considerably across US regions.
Dr. Pawlik and colleagues attributed the elevated divorce risk among surgeons to the unique demands of surgical practice. They noted that surgeons married later on average (mean age at first marriage, 31.4 years) than nonsurgeon physicians (30.7 years). Despite higher marriage rates overall—83% of surgeons were married compared with 78% of nonsurgeon physicians—the data suggest that marital instability is more pronounced in the surgical population.
The study findings align with prior American College of Surgeons survey data indicating that 64% of surgeons felt their demanding schedules left insufficient time for personal relationships. The researchers reported that one-third of surgeons experience emotional exhaustion severe enough to affect their work, and another third screen positive for depression.
The researchers proposed several interventions, including flexible scheduling to allow more predictable hours, expanded mental health services, and revised parental leave policies. They noted that in most institutions, maternity leave ranges from 6 to 8 weeks, whereas paternity leave varies from 1 to 8 weeks, with male surgeons often taking shorter leaves due to concerns about stigma.
Limitations include the self-reported nature of marital status, which may not reflect legal divorce status, and the absence of data on employment status, years in practice, or spouse occupation. The researchers acknowledged that using marital status as a proxy for marital satisfaction did not fully capture marriage quality. The ACS data were not designed specifically to assess marital outcomes.
The study researchers reported no relevant conflicts of interest. The data for this study were obtained from the Integrated Public Use Microdata Series, which is publicly available.