Needs of Volunteer Surgical Faculty in a Climate of Surgical Education Change

Volunteer surgical faculty (VSF), unlike preceptors in primary care, have not been well studied. Despite significant historic contributions to surgery resident training and medical student teaching, little is known about their characteristics or needs. There may not be enough full-time academic surgeons to provide the supervision and opportunities for patient care sufficient to train the number of future surgeons needed. We sought to determine the demographic characteristics of a sample of VSF, including practice patterns, teaching responsibilities, their relationships to the departments they volunteer in, their knowledge of changes in surgical education, including duty hours and the ACGME competencies and their need for faculty development as educators. 1,602 VSF were identified through surgery department chairs and program directors; 566 responded to a survey delivered electronically and via paper copies where necessary. Analysis of closed-ended questions was performed using descriptive statistics; open-ended responses were coded line-by-line and iteratively analyzed to identify themes using constant comparison associated with grounded theory. Demographically, these VSF were similar to the overall demographics of surgeons in the same time period, representing many surgical specialties. Most received no remuneration for teaching; over half characterized support from their university or medical school as “fair”, “poor” or “nonexistent”. Most had received no training in teaching methods. Over half were not familiar with, or had only a general knowledge of, the ACGME competencies. A majority were interested in learning about teaching methods and the competencies. Three themes emerged in analyzing the open-ended comments: 1) Motivations/incentives to teach, including joys and rewards, obligation to give back and benefits to trainees, patients and the community; 2) Disincentives to teach, including duty hours, perceived loss of trainee professionalism and perception that VSF are not valued as highly as academic faculty; and 3) Needs in the area of training and education, and for recognition with remuneration or perquisites. VSF can be a valuable, and enthusiastic, source of supervision and patients for surgical resident training and medical student teaching. The VSF characteristics and needs identified here can serve as a tool in the recruitment, retention and recognition of VSF by departments of surgery.