Dissecting a department of surgery: Exploring organizational culture and competency expectations

Introduction: In order to recruit high-potential trainees, surgery residency and fellowship programs must first understand what competencies and attributes are required for success in their respective programs. This study performed a systematic analysis to define organizational culture and competency expectations across training programs within one academic surgery department. Methods: Subject matter experts rated the importance and frequency of 22 competencies and completed a 44-item organizational culture inventory along 1 to 5 Likert-type scales. Results: Importance and frequency attributions of competencies varied significantly among programs (p < .05 by ANOVA), but there was substantial agreement on organizational culture; self-directed (x̄ = 3.8), perfectionist (x̄ = 3.7) and social (x̄ = 3.7) attributes were most representative of the program, while oppositional (x̄ = 1.8), competitive (x̄ = 2.5) and hierarchical (x̄ = 2.7) characteristics were least representative. Conclusions: Residency and fellowship programs within the same department have shared perceptions of the culture and values of their institution, but seek different competencies among entering trainees.