Surgical Video in the Age of Big Data.

We believe major impediments to surgeon scientist development are created by compensation structures that tie personal compensation solely to relative value unit (RVU) targets. If RVU targets alone are linked to personal salary and/or monetary incentives, major disincentives are created to academic pursuits such as research, writing, and teaching. There are only so many hours in the day and commitments such as chart documentation, ward presence, and need to be in the operating room have increased in the last decade. Thus, research and teaching often take last place in priority. We believe that faculty salaries should be keyed to Association of American Medical Colleges benchmarks by specialty, with additional bonus or incentive payments related to academic achievements such as grant submissions or teaching awards, in addition to clinical productivity. Several institutions have published their systems related to this issue. To promote the development of young surgical scientists, prolonged duration salary guarantees, 7 to 10 per year commitments, should be considered. Within a 7 to 10-year period, independent funding should be obtainable for those who are on this path. At this point, the research laboratory is generally more autonomous, and increased clinical caseloads could then be accommodated. Such a system relies on a balanced clinical faculty where high volume surgical clinicians and clinician scientists are treated equally. Who would underwrite this? We believe the department, medical school, and hospital should embrace the investment. Surgery departments play a major role in economic bottom line of academic medical centers. A desire for work–life balance was also cited as a major impediment to becoming a surgeon scientist. Imbalance is now recognized as an important cause of burnout, and needs to be seriously considered. Thus, it is critical to be innovative in how junior faculty are supported. In our department, we have instituted several programs to enhance junior faculty academic life-balance. A focused faculty ‘‘launch’’ program in which a mixed faculty team is assembled to coach the new faculty, allows for protected time structure, and networking with other (at times) nonsurgical investigators. A mini sabbatical program has also been started, with up to 2 months of time without clinical duties to learn novel research or other skills, or to spend time with a researcher at another institution. During time away, faculty salaries are paid for by the Department to off-set potential clinical volume losses. A junior faculty exchange program has been created so young faculty can travel to other institutions to network with junior and senior faculty and to demonstrate early work and initial academic focus. A formal mentorship program, designed to train both mentors and mentees, is underway at the departmental level. The declining numbers of surgeon scientists documented by Keswani et al and emphasized by the accompanying editorial highlight a major issue going forward. Given potential changes in the medical funding climate, innovative strategies and diversified funding streams that ensure healthy faculty life are paramount.