A National Survey of Contracts, Compensation, and Workplace Culture Among Junior Surgical Oncologists

The transition from surgical training to independent practice is challenging, and little quantitative data exist to guide junior surgeons on contracts and compensation. Qualitative evidence suggests compensation model type may influence workplace dynamics and attrition, but this has not been formally examined.

A cross-sectional survey of Society of Surgical Oncology members in their first 8 years of practice was conducted in October-November 2025 (n = 221; response rate = 20.2%). Outcomes included contract and compensation characteristics, attrition risk, and workplace collegiality.

Respondents were 53% female, 68% non-Hispanic white, and 65% academic; 40% were within their first 2 years of practice. Most (69%) attempted contract negotiation and 79% succeeded in at least one domain. Nearly all (79%) had a guaranteed salary period (median 3 years), after which most transitioned to work relative value unit (wRVU)-based compensation. One in four respondents (25%) were considering leaving within the year; this rose to nearly 80% among those who strongly disagreed their compensation was fair (p < 0.01). Greater productivity emphasis was inversely associated with workplace collegiality (odds ratio 1.8 per standard deviation [SD] increase, 95% confidence interval [CI] 1.1-3.0; p = 0.02).

This national survey provides contract and compensation data for junior surgical oncologists and demonstrates associations between perceived compensation fairness and attrition risk, and between productivity-based compensation emphasis and workplace hostility. These findings suggest that how surgeons perceive their compensation-not merely its structure-may be a target for institutional efforts to improve retention and culture.