Understanding the Time Investment of Program Directors and Core Faculty in Surgical Specialties

Surgical training has evolved considerably over the past decade. Both program directors (PDs) and surgical faculty have had to adapt to novel training paradigms and innovations in surgical techniques, while balancing resident education with administrative duties. The purpose of this study is to examine the time allotment of PDs and core faculty to the educational mission of surgical residency programs.

Data was collected from publicly available Accreditation Council for Graduate Medical Education (ACGME) annual reports from academic years 2011-2012 to 2022-2023. Total weekly hours for PDs and core faculty were categorized into administrative time, clinical duties, research, and teaching or didactics. Nine different surgical specialties were examined. Only residency programs were included in analysis. Linear regression analysis was utilized to examine trends over time.

Over the twelve-year study period, PDs reported working a mean of 50.6 hrs/week and core faculty reported 36.2 hrs/week. Among PDs, the specialties with the highest weekly hours worked per week included cardiothoracic surgery (61.4 ± 6.0 hrs), neurosurgery (55.6 ± 3.9 hrs), and plastic surgery (53.7 ± 3.7 hrs). The majority of PD time (55.0%) was spent on clinical duties, with an additional 26.1% spent on administrative tasks, and 10.3% on teaching. On trend analysis, PDs in six of nine surgical specialties reported a significant increase in time spent on administrative tasks (p < 0.05 each), and eight of nine specialties reported a decline in teaching time (p < 0.05 each). For core faculty members, the specialties with the highest weekly hours worked per week included cardiothoracic surgery (42.6 ± 7.8 hrs), neurosurgery (41.7 ± 4.7 hrs), and vascular surgery (39.6 ± 6.4 hrs). Clinical duties occupied the majority of working time (67.8%) for core faculty, with an additional 10.9% spent on research, and 10.4% dedicated to administrative duties. Core faculty in seven of nine specialties reported an increase in time spent on clinical duties (p < 0.05 each) on trend analysis, and all nine specialties reported less time spent on administrative tasks (p < 0.05 each).

PDs and core faculty within different surgical specialties balance multiple responsibilities including clinical duties, administrative tasks, research, and resident education. Over the past decade, surgical PDs have reported a trend of increasing administrative duties while spending less time on resident education and didactics. Over that same period core surgical facultyhave dedicated more time to clinical duties and less time towards administrative tasks. These findings have important implications on surgical resident education, and further work is needed to understand the contributing factors and consequences of these trends.