Article Figures & Tables
Figures
- Figure 1:
Flow chart for participant recruitment. Note: PD = program director.
- Figure 2:
Current versus perceived fair salary for the program director (PD) position. Note: Other = remuneration by percentage of full-time equivalent, proportional remuneration by number of trainees, and compensation based on loss of clinical time and earnings.
- Figure 3:
Additional forms of compensation for performing the program director (PD) role (n = 81; 2 respondents provided other responses including teaching funding from the ministry and respect from residents/students).
- Figure 4:
Satisfaction with program director (PD) role compared with satisfaction with compensation for the PD role (n = 80 for satisfaction with PD role; n = 79 for satisfaction with compensation).
Tables
Characteristic No. (%) of respondents
n = 81Gender Male 59 (72.8) Female 20 (24.7) Prefer not to answer 2 (2.5) Years in practice before becoming a PD < 5 14 (17.3) 5–10 28 (34.6) 11–15 10 (12.3) 16–20 4 (4.9) > 20 3 (3.7) Educational training before becoming a PD Master of education 12 (14.8) Education scholars program* 4 (4.9) Royal College education program† 5 (6.2) Other 6 (7.4) None 55 (67.9) More than 1 of the above 1 (1.2) Program Cardiac surgery 7 (8.6) Colorectal surgery 2 (2.5) General surgery 12 (14.8) Neurosurgery 12 (14.8) Orthopedic surgery 8 (9.9) Otolaryngology 9 (11.1) Pediatric surgery 1 (1.2) Plastic surgery 9 (11.1) Surgical oncology 4 (4.9) Thoracic surgery 4 (4.9) Urology 8 (9.9) Vascular surgery 4 (4.9) No response 1 (1.2) Characteristic No. (%) of respondents
n = 81Average PGY-1 intake per year (over last 3 yr) 1 resident 21 (25.9) 2 residents 23 (28.4) 3 residents 15 (18.5) 4–6 residents 14 (17.3) 7–10 residents 4 (4.9) > 10 residents 3 (3.7) No response 1 (1.2) Current size of program Small (1–10 residents) 41 (50.6) Mid-size (11–20 residents) 24 (29.6) Large (> 20 residents) 15 (18.5) No response 1 (1.2) Resident option of dedicated research year Yes 55 (67.9) No 24 (29.6) No response 2 (2.5) Number of residents currently in formal remediation 0 60 (74.1) 1 resident 12 (14.8) > 1 resident 6 (7.4) No response 3 (3.7) Likelihood of program changing its number of residents in the next academic year Definitely will/likely to decrease 16 (19.8) Expected to keep the same number 54 (66.7) Definitely will/likely to increase 10 (12.3) No response 1 (1.2) Characteristic No. (%) of respondents Small program (1–10 residents)
n = 41Mid-size program (11–20 residents)
n = 24Large program (> 20 residents)
n = 15Overall
n = 80Hours per week devoted to the role of program director 1–5 17 (41.5) 6 (25.0) 2 (13.3) 25 (31.2) 6–10 16 (39.0) 12 (50.0) 3 (20.0) 31 (38.8) > 10 7 (17.1) 5 (20.8) 10 (66.7) 22 (27.5) Other or no response 1 (2.4) 1 (4.2) 0 (0) 2 (2.5) Protected academic time for program director responsibilities, h/wk < 1 22 (53.7) 10 (41.7) 1 (6.7) 33 (41.2) 1–5 14 (34.1) 11 (45.8) 7 (46.7) 32 (40.0) > 5 3 (7.3) 2 (8.3) 7 (46.7) 12 (15.0) Other or no response 2 (4.9) 1 (4.2) 0 (0) 3 (3.8) Proportion of time spent on administrative duties related to the PD role and activities, % 0–30 8 (19.5) 1 (4.2) 5 (33.3) 14 (17.5) 30–50 11 (26.8) 7 (29.2) 5 (33.3) 23 (28.7) 50–70 14 (34.1) 9 (37.5) 2 (13.3) 25 (31.2) > 70 7 (17.1) 6 (25.0) 3 (20.0) 16 (20.0) Other or no response 1 (2.4) 1 (4.2) 0 (0) 2 (2.5) Duties requiring most time or effort* Program administration 24 (58.5) 11 (45.8) 8 (53.3) 43 (53.8) Resident support and counselling 15 (36.6) 9 (37.5) 6 (40.0) 30 (37.5) Promotions and remediation 6 (14.6) 7 (29.2) 3 (20.0) 16 (20.0) Educational and curriculum development 24 (58.5) 9 (37.5) 8 (53.3) 41 (51.2) Other or no response 6 (14.6) 2 (8.3) 2 (13.3) 9 (11.2) Administrative support for the program, FTE < 0.4 16 (39.0) 1 (4.2) 1 (6.7) 18 (22.5) 0.5–0.99 22 (53.7) 16 (66.7) 2 (13.3) 40 (50.0) ≥ 1 2 (4.9) 6 (25.0) 12 (80.0) 20 (25.0) Other or no response 1 (2.4) 1 (4.2) 0 (0) 2 (2.5) Availability of additional administrative supports during periods of increased work Yes, sufficient 11 (26.8) 6 (25.0) 3 (20.0) 20 (25.0) Yes, more needed 3 (7.3) 3 (12.5) 3 (20.0) 9 (11.2) No 25 (61.0) 14 (58.3) 9 (60.0) 48 (60.0) Other or no response 2 (4.9) 1 (4.2) 0 (0) 3 (3.8) Source of funding for administrative support† Hospital administration 10 (24.4) 4 (16.7) 1 (6.7) 15 (18.8) Hospital or university division 9 (22.0) 10 (41.7) 4 (26.7) 23 (28.7) Department 17 (41.5) 11 (45.8) 8 (53.3) 36 (45.0) Other 7 (17.1) 3 (12.5) 6 (40.0) 16 (20.0) Did not know or no response 4 (9.8) 0 (0) 0 (0) 4 (5.0) Role characteristic Representative comment Positive feature Resident relationships, support and success* Working with residents. They are generally engaged, enthusiastic and open to challenge. Watching them gain skills and transition into capable surgeons is immensely rewarding/gratifying. (P37)
I love teaching, program development, making a difference, and changing their culture — ensuring that residents get proper training and are not taken advantage of. (P78)Educational influence {I enjoy} the ability to shape the education of the next generation of specialists. (P42)
{The ability to} share ideas, projects and problems with the other directors, and to actively participate in setting national goals and standards for the specialty. (P69)Personal fulfillment I love working with the fellows. They have great ideas and have so much energy and I feel like I am doing something positive to keep {our specialty} as a profession going, which means a lot to me. (P43)
I take pride in seeing residents finish their program and knowing I have participated in their success. (P50)Overall satisfaction The residents — everything about it. The guidance, mentoring, teaching, watching them grow. Extremely rewarding and satisfying. (P65)
{I enjoy the} ability to improve our profession by improving resident education, and to improve our residents’ lives, well-being and future. (P52)Stressor Resident support and remediation Dealing with residents in difficulty makes it next to impossible to devote time to program improvement and enhancing the skill development of the majority. (P19) Administrative demands Without administrative support all the mails and communications are my responsibility. (P48)
Accreditation documentation {leads to} time commitment and extra work that needs to be done after regular work hours, on evenings, weekends and sometimes when on vacation. (P5)Educational programming {I am} dealing with the constant pressure to add content for residents … while balancing service and education expectations. (P63) Faculty engagement At [the] faculty level, being a “change leader” and getting colleagues to put the work into changing their teaching style, filling in CBD evaluations, etc. {is challenging}. (P52)
{It can be challenging to} motivate faculty to get involved in the program over and above providing clinical teaching during direct patient care. (P33)Compensation In our system, with no true university promotion system or support, apart from the innate, visceral benefit one receives from being a part of exceptional, young colleagues/residents’ lives, there really isn’t any other significant benefit one receives. I commit between 1 to 1.5 clinical days for the position, and thoroughly enjoy it, but despite the amount I receive in salary support, I end up losing 3× as much income. (P44)
This is one of the most difficult jobs in an academic centre and is often very much underappreciated. (P22)Note: CBD = competency by design, P = participant.
↵* Mentioned in narrative comments by 60 participants.
- Table 5:
Factors associated with thoughts of resignation (responses to “I have considered giving up the program director position before the end of my term”)
Program director characteristic No. (%) of participants who responded Agree/strongly agree
n = 30Neutral
n = 17Disagree/strongly disagree
n = 31Gender Female 5 (27.8) 5 (27.8) 8 (44.4) Male 25 (43.1) 11 (19.0) 22 (37.9) No response 0 (0) 1 (50.0) 1 (50.0) Years spent as a PD < 5 16 (34.8) 12 (26.1) 18 (39.1) ≥ 5 14 (45.2) 5 (16.1) 12 (38.7) No response 0 (0) 0 (0) 1 (100.0) Program size Small (1–10 residents) 14 (36.8) 12 (31.6) 12 (31.6) Mid-size (11–20 residents) 10 (40.0) 5 (20.0) 10 (40.0) Large (> 20 residents) 6 (42.9) 0 (0) 8 (57.1) Protected academic time for PD responsibilities per week < 1 h 17 (48.6) 8 (22.9) 10 (28.6) 1–5 h 10 (31.2) 8 (25.0) 14 (43.8) > 5 h 3 (27.3) 1 (9.1) 7 (63.6) Hours per week devoted to PD role 1–5 8 (30.8) 7 (26.9) 11 (42.3) 6–10 11 (35.5) 7 (22.6) 13 (41.9) > 10 11 (52.4) 3 (14.3) 7 (33.3) Administrative support for the program, FTE < 0.4 6 (31.6) 5 (26.3) 8 (42.1) 0.5–0.99 16 (40.0) 8 (20.0) 16 (40.0) ≥ 1 8 (42.1) 4 (21.1) 7 (36.8) Availability of additional administrative supports during periods of increased work Yes 10 (33.3) 4 (13.3) 16 (53.3) No 20 (42.6) 13 (27.7) 14 (29.8) Do not know 0 (0) 0 (0) 1 (100.0) Satisfaction with compensation Very/somewhat satisfied 5 (17.9) 7 (25.0) 16 (57.1)* Neutral 2 (13.3) 4 (26.7) 9 (60.0) Very/somewhat dissatisfied 23 (65.7) 6 (17.1) 6 (17.1) Have enjoyed role of PD Agree/strongly agree 19 (30.6) 12 (19.4) 31 (50.0) Neutral 10 (71.4) 4 (28.6) 0 (0) Disagree/strongly disagree 1 (50.0) 1 (50.0) 0 (0) Role is more work than expected Agree/strongly agree 24 (43.6) 11 (20.0) 20 (36.4) Neutral 4 (20.0) 6 (30.0) 10 (50.0) Disagree/strongly disagree 2 (66.7) 0 (0) 1 (33.3) Note: FTE = full-time equivalent, PD = program director. Category of “no response” not shown, therefore, column totals may not sum to 100%.
↵* Statistically significant (p < 0.001).
In this issue
Article tools
Respond to this article
Related Articles
Cited By...
- No citing articles found.