Factors Associated With Surgical Faculty's Desire to Leave or Stay at Their Jobs.

IMPORTANCE: Surgical faculty turnover in academic centers causes interruptions in continuity of patient care, trainee education, and loss of funding from research and clinical revenue, while burdening departments with new recruitment efforts. OBJECTIVE: To identify variables associated with surgical faculty's desire both to leave and to stay in their job. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional 67-item survey based on the job demands-resources model was administered to 452 surgical faculty at 10 medical centers across the US from February 2025 to September 2025. Demographics and factors related to attrition/intent to leave/retention were queried. Satisfaction was measured on a 5-point Likert scale. Reliability was high (Cronbach α > 0.70). χ2 testing and Mann-Whitney U tests were used for analysis. These data were analyzed from September 2025 through February 2026. EXPOSURES: Surgical faculty in full-time practice at 1 of 10 medical centers. MAIN OUTCOMES AND MEASURES: The primary outcome measure was surgical faculty seriously considering leaving (SCL) their current job. Secondary outcome was attrition from prior faculty position. RESULTS: There were 209 respondents (response rate, 46.2% [209 of 452]); 59.4% were in their first job (FJ) after training, with 36.7% serving as assistant professors, 29.4% as associate professors, and 29.4% as full professors. Overall, 41.1% (95% CI, 34.3%-48.1%) reported SCL. SCL was higher for FJ (47.2%; 95% CI, 38.1%-56.4% vs 32.1%; 95% CI, 22.4%-43.2% for non-FJ faculty [P = .03]), those working longer clinical hours (50; 95% CI, 40-58.75 vs 40; 95% CI, 40-50; P = .05), and the university-academic SCL rate (45.5% [55 of 121]) vs university-affiliated SCL (48% [24 of 50]) vs nonprofit independent SCL (16.7% [6 of 36]) (P = .004). The top reasons cited for SCL were unhappiness with current leadership/governance (60% strongly agreed/agreed), lacking work-life balance (51.8%), feeling burnout (51.8%), and seeking new leadership opportunities (48.2%). Age, gender, race and ethnicity, geographic region, and academic rank were not associated with SCL. The most cited reasons for why faculty stayed in their present position were enjoying teaching trainees, relationship with colleagues, and the variety of cases. CONCLUSIONS AND RELEVANCE: These results demonstrated that a significant number of surgical faculty reported seriously considering leaving their positions. The results provide actionable insights for improving retention, including greater engagement from departmental leadership and the creation of a nurturing, collaborative environment with career advancement opportunities.