title: Do plastic surgery division heads and program directors have the necessary tools to provide effective leadership?
abstract: BACKGROUND
  Effective leadership is imperative in a changing health care landscape driven by increasing expectations in a setting of rising fiscal pressures. Because evidence suggests that leadership abilities are not simply innate but, rather, effective leadership can be learned, it is prudent for plastic surgeons to evaluate the training and challenges of their leaders because there may be opportunities for further growth and support.
  
  
  OBJECTIVE
  To investigate the practice profiles, education/training, responsibilities and challenges of leaders within academic plastic surgery.
  
  
  METHODS
  Following research ethics board approval, an anonymous online survey was sent to division heads and program directors from all university-affiliated plastic surgery divisions in Canada. Survey themes included demographics, education/training, job responsibilities and challenges.
  
  
  RESULTS
  A response rate of 74% was achieved. The majority of respondents were male (94%), promoted to their current position at a mean age of 48 years, did not have a leadership-focused degree (88%), directly manage 30 people (14 staff, 16 faculty) and were not provided with a job description (65%). Respondents worked an average of 65 h per week, of which 18% was devoted to their leadership role, 59% clinically and the remainder on teaching and research. A discrepancy existed between time spent on their leadership role (18%) and related compensation (10%). Time management (47%) and managing conflict (24%) were described as the greatest leadership challenges by respondents.
  
  
  CONCLUSIONS
  Several gaps were identified among leaders in plastic surgery including predominance of male sex, limitations in formal leadership training and requisite skill set, as well as compensation and human resources management (emotional intelligence). Leadership and managerial skills are key core competencies, not only for trainees, but certainly for those in a position of leadership. The present study provides evidence that academic departments, universities and medical centres may benefit by re-evaluating how they train, promote and support their leaders in plastic surgery.
authors.affiliation: British Columbia Children's Hospital; ; Sauder School of Business, University of British Columbia, Vancouver, British Columbia;
authors.forename: Js
authors.initials: J
authors.lastname: Arneja
authors.affiliation: University of Manitoba, Winnipeg, Manitoba;
authors.forename: Cw
authors.initials: C
authors.lastname: McInnes
authors.affiliation: Vancouver General Hospital and University of British Columbia;
authors.forename: Nj
authors.initials: Nj
authors.lastname: Carr
authors.affiliation: Vancouver General Hospital and University of British Columbia;
authors.forename: P
authors.initials: P
authors.lastname: Lennox
authors.affiliation: Vancouver General Hospital and University of British Columbia;
authors.forename: M
authors.initials: M
authors.lastname: Hill
authors.affiliation: British Columbia Children's Hospital;
authors.forename: R
authors.initials: R
authors.lastname: Petersen
authors.affiliation: Vancouver Coastal Health, Vancouver, British Columbia.
authors.forename: K
authors.initials: K
authors.lastname: Woodward
authors.affiliation: Sauder School of Business, University of British Columbia, Vancouver, British Columbia;
authors.forename: D
authors.initials: D
authors.lastname: Skarlicki
keywords: Leadership; Management; Plastic surgery; Skill set