D. R. Heller1, V. Kurbatov1, M. R. Freedman-Weiss1, G. Chao1, R. A. Jean1, P. S. Yoo1 1Yale University School Of Medicine,Surgery,New Haven, CT, USA
Introduction: Surgeons function as team leaders on the wards, in the operating room, and at all levels of training and practice. Yet leadership skills are not an ACGME core competency, nor is leadership training a standard curricular requirement for residents. We explored resident perceptions and experiences with leadership to assess for unmet educational needs.
Methods: An anonymous survey was electronically distributed to all General Surgery residents at a university-affiliated hospital (Qualtrics Survey Software). Questions centered on perceptions and experiences around physician leadership in healthcare and formal leadership training. Leadership experiences were defined as participation in healthcare-related administrative roles or committees. Leadership training was defined as participation in symposia or conferences teaching leadership theory and skill-building.
Results: Of 70 residents, 56 (80.0%) responded to the survey. Males comprised 57.1% and each post-graduate year 1–5 had majority representation, ranging from 68.8% – 100%. Almost all respondents, 98.2%, ranked physician leadership in healthcare as somewhat or very important vs. neutral or unimportant. A large majority, 87.3%, ranked leadership training during residency as somewhat or very important. Far less reported exposure to leadership experiences (37.0%), and less still reported receiving leadership training during residency (24.1%). Senior residents had significantly more exposure to leadership experiences (p=0.01) and training (p=0.01), and married residents with higher incomes saw a trend toward association with leadership experiences. Among those who received formal education, roughly half were trained by the hospital/university or external healthcare organizations; only 14.3% reported training by the residency program. When polled about the leadership style most often employed by surgical residents, a majority reported “pacesetting” (31.2%) and “commanding” (22.2%); the “visionary” and “affiliative” styles were least-often employed (7.4% and 9.3%, respectively).
Conclusion: At a large academic surgical residency, nearly all residents perceive physician leadership in healthcare systems and formal leadership training as important. Yet roughly a third are exposed to leadership roles and a quarter to leadership training at a given point in residency. Since leadership development is not an ACGME requirement, opportunities for experience and education during residency may be lacking, and trainees may preferentially acquire a narrow band of skills rather than the balanced spectrum requisite for effective leadership. Hospitals and training programs should mind this educational gap and aim to expand opportunities for residents during the critical years of professional development.
