K. Laaman4, S. Jung3, J. Shim4 3University Of Wisconsin, Division Of Education, Department Of Surgery, Madison, WI, USA 4Bassett Healthcare, Department Of General Surgery, Cooperstown, NY, USA
Introduction:
Surgeons have a unique opportunity for leadership, leading teams within the operating room, trauma bay, or surgical intensive care unit. However, though leaderships skills are expected at the start of a surgeon’s practice, formal leadership training has not historically been included in residency curricula. Thus, a focus on the need for this training during residency has increased, and multiple approaches have been incorporated. However, rural surgeons face unique challenges, and no organized curriculum has been developed to address the specific leadership skills needed. With 60 million Americans living in rural areas and only 8% of the general surgeon workforce practicing in these communities, many of whom will soon retire, rural surgery leadership training may prove critical in providing care to these communities. The goal of this study was to characterize the leadership development experiences and perceived needs for skills development of residents in a rural general surgery program.
Methods:
A one-hour focus group was conducted, recorded and transcribed. Participants included 14 surgical residents ranging in PGY1 to PGY5 at a rural general surgery residency program. Topics included prior leadership training, skills and qualities specific to rural surgery leadership, and ways leadership can improve equality within rural surgery. A thematic analysis was then performed.
Results:
Three participants had attended the ACS Residents as Teachers and Leaders conference. No participants reported receiving any other formal leadership training during residency. Due to limited resources and personnel in rural settings as well as the often greater perceived role of physicians within rural communities, skills and qualities that the participants found important in rural leadership were emotional intelligence, empathy, an attitude of service, the ability to work strategically with care and creativity, developing capability, having a broad and flexible skill set, relationship building and community integration, patient advocacy, and engaging the team while inspiring a shared purpose. These skills are important because rural surgery is personal. Rural surgeons know their patients living in a community and their practice affords no anonymity or objectivity.
Conclusion:
Awareness has recently grown regarding the importance of leadership development in residency. In this focus group of rural surgical residents, the development of leadership skills was universally valued with a particular focus on those that confront the challenges practitioners in rural environments face. It also highlights the importance of leadership training in rural surgery programs. With this information, we can develop an interventional arm to create intentional curriculum to address this need. Further research should be completed to assess whether leadership training helps prepare residents for these unique challenges and helps lower attrition rates of rural surgeons.