Findings of the Recent Graduate Employment Survey

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1 Findings of the Recent Graduate Employment Survey Ma; Strickland November 5 th, 2015 Associa?on canadienne des chirurgiens généraux

2 Outline 1. Background 2. Results of the Survey 3. Outstanding Ques>ons

3 Background The Canadian Associa>on of General Surgeons Represents ~2500 Canadian General Surgeons Founded in 1977 Promotes the training, educa>on, CPD, and research necessary to to provide exemplary surgical care to Canadians

4 Background Concerns with unemployment and underemployment ScaPered anecdotes but of increasing volume and subjec>ve frequency Changes in our tradi>onal prac>ce model (e.g. on- call- ogists )

5 Background In 2013, some members of OAGS concerned about unemployment brought sta>s>cs to our apen>on In Ontario, ~50 general surgery graduates/year vs 16 re>rements New surgeon billing paperns similar to older ones Called for dras>c cuts to training spots because of overtraining

6 Background Many of our subspecial>es were in the midst of studying their own workforces Canadian Associa?on of General Surgeons

7 CAGS s Approach to the Problem A mul>pronged approach: 1. The Recent Graduate Employment Survey 2. Crea>on of detailed General Surgeon census 3. Hiring of a CAGS HR officer 4. Studying how we can help match informa>on on pa>ent needs to correct graduate skillset

8 The Recent Grad Employment Survey As a first step, we wanted to see how true it was that nobody could find a job Chose to look at recent graduates 2-7 years ader they had become RC General Surgery fellows Cohort gradua>ng in 2009, 2010, 2011, 2012, and 2013 Distributed in both French and English

9 The Recent Grad Employment Survey

10 Who Are These? Mean Age: 37 years- old Age Range: years old 11% 81%

11 Who Are These? Training Program Other (please specify) Memorial University of Newfoundland Dalhousie University Université Laval Université de Sherbrooke Université de Montréal McGill University University of O;awa Queen's University University of Toronto University of Western Ontario McMaster University Northern Ontario School of Medicine University of Manitoba University of Saskatchewan University of Alberta University of Calgary University of Bri?sh Columbia 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% 20%

12 Who Are These? Mean length of post- graduate training period: 7.5 years Median length of post- graduate training period: 7.0 years

13 Who Are These? 36% 5.5% have a masters degree have a PhD 12% working on a master s Fellowship Training MIS 19% Surgical Oncology 14% Trauma 13%

14 Time Spent Working 80% Mean hours worked per week: , 2013 Mean weeks of vaca>on/year:

15 Salary Informa?on 80% Provided self- reported salary data. Average salary ader overhead but before taxes: $336,000 Average salary increases over >me: 2012, 2013 $277, , 2010, 2011 $386,000

16 Sa?sfac?on With Job and Salary How would you rate your current sa>sfac>on with your employment arrangement? How sa>sfied are you with the current income from your surgical prac>ce? 75% 14% 67% 16%

17 So, how much unemployment is there?

18 Work Characteris?cs Are you currently prac>cing General Surgery or one of its subspecial>es? NO 4 YES x Family Medicine 3 x Unemployed

19 Job Offers How many job offers for a permanent staff posi>on have you received since finishing your PG training?

20 Life as a locum surgeon 44 Recent grads surveyed were currently doing locums 68% Regular non- emergency OR >me 68% 71% Regular non- emergency endoscopy >me Regular follow- up clinic >me

21 Life as a locum surgeon Why do you do locums? 4% Desire to travel 4% I prefer this prac7ce style 14% To supplement my income 44 46% Awai7ng for job to open up at locum site Could not get the staff job I wanted 23%

22 Prac?ce Pa;ern Do you provide clinical care in more than one, unaffiliated centre? This group was more likely to be: Underemployed Dissa>sfied with their salary Dissa>sfied with their current employment arrangement

23 Mul?ple Centres and Job Sa?sfac?on Working in a single centre: Working in mul>ple centres:

24 Work Characteris?cs Do you consider yourself underemployed?

25 Underemployment and Job Sa?sfac?on In the underemployed: In those not underemployed:

26 Work Characteris?cs Are you currently in an arrangement that you would consider "job sharing"?

27 Under- Resourced Do you currently feel you have all the clinical resources that you want?

28 Under- Resourced Do you currently feel you have all the clinical resources that you want? 64% 52%

29 The Job Search While in training, how anxious were you about having to find a job? Not anxious Mildly anxious Moderately anxious 15% 20% 26% Extremely anxious 38%

30 How Difficult Finding a Job Was How many General Surgery staff jobs have you applied to since finishing your PG training? >10 59% 31% 4% 6%

31 The Job Search How did you find out about your current job?

32 How do new grads get jobs? When asked to rate the most important factors that resulted in them choosing their current loca>on: Most Important 1. Family or personal considera>ons 2. The opportunity to live in a specific city or province 3. Stability Least Important 1. Research support and resources 2. Joining a surgical group with less on call frequency 3. Reputa>on of the ins>tu>on or hospital

33 How do new grads get jobs? When asked to rate the most important factors for finding employment: Most Important 1. Contacts, networking 2. Need in the community in which I now work 3. Fellowship training Least Important 1. Work done prior to residency 2. Extra (non- fellowship) training

34 How do new grads get jobs? When asked to comment about other factors: You get the job depending who you know, it's a kind of Canadian" mafia Strong contacts and Internal selec7on- not fair Nepo7sm is the most important factor Knowing the right people

35 Feelings of Nepo?sm Was the job you currently hold publicly adver>sed?

36 Opinions on supply- side of HR The number of General Surgeons prac>cing in your geographic region is: The training programs in Canada are training too many residents for the number of posi>ons Currently available: 72% Agree Available in 5-10 years: 55% Agree

37 Themes in Comments 1. Senior surgeons are benefi>ng from the situa>on Older surgeons are NOT re>ring and there is no incen>ve for them to re>re because new grads are making their job easier by taking their call. In essence, the older surgeons are taking advantage of unemployed young grads. In my area, clinical associate posi>ons are mul>plica>ng [sic], without employment perspec>ve apached to them. Lots of gen Surg services seem to be taking advantage of the situa>on.

38 Themes in Comments 2. Frustra>on over resources hospital budgets cannot increase at a rate that matches popula>on need there will not be the necessary increase in OR >me/endo >me to facilitate the appropriate increase in general surgery posi>ons. Too many underemployed specialists while wait >mes for specialist services is the worst it has been in over a decade. Fiscal constraints (resource for elec>ve OR and endoscopy >me) is the MOST significant factor limi>ng job opportuni>es

39 Summary 1. Described this group of recently minted General Surgery fellows 2. Showed that although overt unemployment is rare, many are working part- >me, over mul>ple sites, and feel underemployed and dissa>sfied 3. There are frustra>ons over senior surgeons taking advantage of the situa>on and over the resources available

40 Remaining Ques?ons 1. This is what recent grads say, but what do they do? 2. How does this compare with the situa>on five years ago? Five years from now? 3. How can organiza>ons such as CAGS and the training programs help decrease the dissa>sfied, underemployed while helping to provide outstanding care for Canadians?

41 Ques?ons/Discussion

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