Attrition of Surgical Faculty in an Academic Medical Center

Importance: With a shortage of surgeons, attrition of academic surgery faculty, especially junior faculty represents an organizational challenge. Objective: To profile surgical faculty attrition at one academic medical center and investigate whether differences in attrition exist over time between faculty ranks, genders or ethnic groups. Design, Setting, and Participants: The population included surgical faculty members who were employed in our academic medical center as of July 1, 1996, or were subsequently hired at least half-time through June 30, 2011. The primary analyses involved length of time to faculty departure during the study period. We applied Kaplan-Meier survival analysis methods, Cox Proportional Hazard Regression, and incidence rates of departure per 100 person-years. Main Outcomes and Measures: Using faculty rank as a time-varying covariate, we examined the association between time to departure and the following: faculty rank, gender, and race. Results: Among 302 members of the surgical faculty, almost 70% of whom entered the study period as assistant professors, the rate of departure was significantly higher for assistant professors compared to senior faculty ranks. Departure rates were not found to be different between gender or race groups. Conclusions and Relevance: The rate of departure over several decades was significantly higher for assistant professors compared to senior faculty ranks. Although estimates of surgeon shortages may vary, to remain competitive and establish a pipeline of future leaders, academic medical centers will not only have to recruit new surgeons to replace retirees, but will also have to work to retain surgeons at the earlier stages of their careers.