Table 4:

Positive features and stressors of the role of program director

Role characteristicRepresentative 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 fulfillmentI 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 satisfactionThe 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)
Resident support and remediationDealing 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 demandsWithout 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 engagementAt [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)
CompensationIn 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.