A nationwide questionnaire survey to investigate facility-based disparities in satisfaction and working conditions of surgical trainees in Japan: university hospitals, community hospitals, and hybrid-type facilities

Purpose: To investigate disparities and problems within surgical training programs in Japan based on the type of host facility. Methods: A post hoc analysis of a nationwide questionnaire survey was performed to evaluate program outcomes and working conditions among university hospitals (Group U), a combination of university and community hospitals (Group UC), and community hospitals (Group C). Results: A total of 758 respondents were analyzed across Groups U (n = 199), UC (n = 299), and C (n = 260). Groups U and UC had lower satisfaction scores and smaller surgical volumes than Group C. Academic activity and nonsurgical training in Group U were not superior to those in the other groups. Although overtime work did not differ significantly among groups, poorer working conditions, including a lower rate of overtime allowance, more frequent night duties, and a lower annual income, were found in Group U than in the other groups. Conclusion: This study revealed disparities and problems in training programs based on the type of host facility. Further improvements in working conditions and educational contexts are expected to help increase satisfaction levels and recruitment of surgical residents in the future.