O1098: The Current Pediatric Surgery Job Market: A Perspective of Recent Fellowship Graduates

Background: There is ongoing debate regarding the optimal size and structure of the pediatric surgery workforce. It is imperative to train enough pediatric surgeons to provide high-quality surgical care for children while not training so many that the market is oversaturated, diminishing the potential of new graduates to acquire high quality jobs. Herein, we describe the landscape of the present job market from the perspective of recent fellowship graduates.

Methods: An anonymous, IRB approved survey was circulated electronically to the 137 pediatric surgeons who graduated from US or Canadian fellowships between 2019-2021.

Results: Of the survey recipients 67 (50%) responded, with similar representation from each fellowship year. The majority were women (52%), Caucasian (72%), US citizens (93%) and carried a median student debt burden of $140,000 (IQR 0, 250,000). In considering job opportunities, respondents placed strong emphasis on camaraderie (93%), mentorship (93%), facility reputation (67%), compensation (61%), spousal employment opportunities (57%), case mix (51%), call frequency (45%), and geography (42%). Additionally, 49% wanted protected research time, and 13% desired seed money for research. All respondents were able to secure jobs, 58 (87%) did so prior to completing fellowship and 7 (10%) within 6 months after graduation. 55 (82%) respondents reported that they would definitely choose pediatric surgery again. The majority 55 (88%) opportunities were in an urban setting, covering a median of 2 hospitals (range 2-9). Majority of the jobs were at a university-based hospital 47 (70%), 12(18%) were hospital employed positions and 6 (9%) respondents joined private practice. Only 13% respondents were offered substantial (>25%) protected research time. The median compensation for university-based jobs was $445,000 which on average was $7,538 below the median AAMC benchmark for assistant professors for the corresponding year of graduation. Overall, 51(76%) survey participants reported that they were satisfied with their compensation. Upon reflection, just 43% felt strongly prepared to search and negotiate their first job. 51% did not know how their salary was benchmarked, and 60% did not negotiate their salary or sign-on bonus. Overall, only 25.4% felt satisfied with the number of employment opportunities available (Figure 1).

Conclusion: Majority of pediatric surgery graduates were not satisfied with the number and type of job opportunities available. Available jobs often involved coverage of multiple hospitals. While almost half of the respondents wanted dedicated research time, only 13% were able to secure >25% protected time. A large number of pediatric surgery fellowship graduates did not feel strongly prepared to search and negotiate their first job. These data highlight an important opportunity for policymakers to re-evaluate the workforce needs and for pediatric surgery professional organizations and training programs to further assist graduating fellows so that they are better prepared to negotiate their first job.