2023 | Volume 24 | Issue 6

Author: Professor Mark Ashton, Chair, Fellowship Services

The College conducts a Surgical Workforce Census every two years to guide workforce planning and advocacy. The census collects valuable data on work patterns, wellbeing, and future work intentions for Fellows.

Open to all active and retired Fellows who live in Australia and Aotearoa New Zealand, the 2022 Surgical Workforce Census achieved a response rate of 24 per cent (n=1608). Respondents were representative of the wider Fellowship when considering specialty, age range, gender and location.  

Key insights include the following:

Work hours and patterns
Full time Fellows worked an average of 45.9 hours per week in 2022 compared to 47.1 in 2020, 50 hours in 2018, and 51 hours in 2016. This is a small but consistent decrease in average hours worked per week reported over the past six years. Full time Fellows would prefer to work on average 2.1 hours less per week, with surgeons in the 50-59 years old age group reporting the most hours worked per week (Figure 1).

Public and private employment
Fifty two percent of respondents reported working in both public and private practice. During 2022 Fellows in private practice reported working longer hours in consulting work than their public counterparts. Time spent on procedural work and administration was similar for public and private Fellows. In the public sector, one in 10 Fellows worked more than the recommended emergency on-call period of 1:4—the same result recorded in 2020.

Private billing
Australian Fellows in private practice were asked what they consider to be a fair professional fee. Almost 32 per cent reported that the Australian Medical Association (AMA) fee is about right, with a further 13 per cent reporting that higher than the private health insurance amount, but less than the AMA fee was considered to be a fair professional fee. This is similar to the results recorded in 2020 and 2018.

Regional and rural practice
Almost 16 per cent of Australian Fellows and 14.3 per cent of Aotearoa New Zealand Fellows reported working exclusively in a regional, rural or remote location. Approximately 38 per cent of Australian and 35 per cent of Aotearoa New Zealand Fellows reported working in a regional or rural location, including those practising in both metropolitan and regional or rural areas. Fellows who worked full time in regional or rural locations only reported working on average 39.9 hours per week—slightly less than the overall census result of 45.9 hours per work for full time respondents. Most Fellows indicated no intention to change their future work hours in regional or rural settings.

Pro bono work
More than 65 per cent of Fellows reported they participated in pro bono work during 2022, with Fellows on average working 10.5 hours per month on these activities. The most frequently reported pro bono activities were contributions to RACS, including the Surgical Education and Training (SET) program, followed by clinical education not related to RACS. For RACS focused activities, contributing as an educational instructor/examiner, SET program supervisor, or surgical mortality assessor were the most frequently reported pro bono contributions made by Fellows.

Administrative regulation and processes continue to rate as a high to extreme source of stress for Fellows, rating higher than workplace culture and COVID-19. Fellows rated COVID-19 most frequently as a little to moderate source of stress (Figure 2). Surgeon wellbeing is a RACS priority and most participants (72 per cent) reported having a health check-up in the last two years—a similar result recorded for 2020. There continues to be a small number of Fellows who reported undertaking their own health checks (8.6 per cent). Almost 10 per cent of Fellows reported seeking professional assistance for stress or mental health issues in the last two years.

Future work intentions
Fellows aged 40–69 intend on reducing their preferred weekly work hours gradually over the next 10 years, with no major differences between female and male Fellows. More than 75 per cent of Fellows aged 50 years and over reported that they plan to retire from all forms of paid work within the next 10 years, a key issue that RACS needs to plan for to meet workforce needs.

Thank you to all Fellows who participated in the census. The 2022 Surgical Workforce Census Report is available on the Workforce and Activities Reports webpage.