Engagement, workplace satisfaction, and retention of surgical specialists in academic medicine in the United States.

BACKGROUND Academic medical centers strive for clinical excellence with operational efficiency and financial solvency, which requires institutions to retain productive and skillful surgical specialists. Faculty workplace perceptions, overall satisfaction, and intent to leave are relationships that have not been examined previously among US surgeons in academic medicine. We hypothesize that critical factors related to workplace satisfaction and engagement could be identified as important for enhancing institutional retention of academic surgeons. STUDY DESIGN The 2011-2012 Association of American Medical Colleges Faculty Forward Engagement Survey evaluated demographic variables, physician workplace satisfaction, and overall engagement among faculty subgroups, including comparison of surgical and nonsurgical clinicians. Multiple regression analysis (β = standard regression coefficient) was performed to identify critical factors most closely related to surgeon satisfaction and intent to leave their institutions. RESULTS A total of 1,356 of 1,949 (70%) surgeons from 14 medical schools responded across different faculty subgroups, and comparisons were made with 1,105 nonsurgical clinicians. Multiple regression indicated that the strongest predictors of surgeons' overall satisfaction with their department included department governance (β = 0.36; p < 0.001), collegiality and collaboration (β = 0.23; p < 0.001), and relationship with supervisor (β = 0.17; p < 0.001). Although compensation and benefits were important (β = 0.08; p < 0.001), these did not rank as the most important factors. Promotion equality (odds ratio = 0.62; p < 0.05), collegiality and collaboration (odds ratio = 0 .51; p < 0.05), and nature of their work (odds ratio = 0.52; p < 0.05) were most closely related to intent to leave the medical school within 1 to 2 years. CONCLUSIONS In the largest survey focusing on workplace factors affecting surgical faculty satisfaction and intent to leave, we conclude that institutional understanding of, and improvement in, specific work environment factors can enhance recruitment and retention of academic surgeons.