Surgeons in Training Love Teaching but Lack Support, Survey Finds

Every teaching hospital runs on an invisible workforce of educators. When attending surgeons are scrubbed into the operating theatre and unavailable on the wards, it is typically the residents—doctors still in the middle of their own training—who stand beside medical students, demonstrating how to suture, how to present a case, and how to think through a differential diagnosis. A new survey of surgical and orthopedic residents at a university teaching hospital in Hong Kong has now captured how these trainee-teachers actually feel about that role, and the results paint a picture of genuine enthusiasm undermined by a familiar triad of institutional neglect: too little training, too little time, and too little recognition.

The study, published as an open-access short communication in Global Surgical Education, the journal of the Association for Surgical Education, was led by Marvin Man Ting Chung of the Department of Orthopaedics and Traumatology at the University of Hong Kong. Between April and July 2023, the team distributed a 28-item online questionnaire to resident and resident-specialist grade doctors in the surgical and orthopedic departments of a single public university teaching hospital. The specialties included general surgery, urology, otolaryngology, paediatric surgery, neurosurgery, cardiothoracic surgery, and orthopaedics. Only doctors with prior experience teaching medical students were invited to participate, and all responses were anonymized with informed consent obtained under ethics approval from the institutional review board.

The response rate was strikingly high: 40 of the 55 eligible doctors completed the survey, or 72.7 percent, a figure that lends considerable weight to the findings. The respondents spanned every training grade from postgraduate year 1 through 6 as well as resident specialists, and their gender and seniority distribution closely mirrored the full target population, which reduces the chance that the sample was demographically skewed. Every single respondent had themselves been taught by residents during medical school, and 65 percent rated that experience as good or very good—a detail that matters, because the authors found that residents who had positive experiences learning from residents were significantly more likely to enjoy teaching themselves.

The quantitative picture of teaching activity was equally revealing. Nearly all respondents, 97.5 percent, had delivered bedside teaching; 82.5 percent had acted as student supervisors when students attached to their teams as assistant interns; 60 percent had led small-group tutorials; and 30 percent had given seminars or lectures. The average annual teaching commitment was 23.9 hours, though the range stretched from zero to 80 hours, indicating highly uneven distribution of educational labor across the department. This volume of unpaid, often unstructured educational work is delivered on top of the demanding clinical and operative obligations of a surgical residency.

The attitudinal data told a story of qualified positivity. A majority of residents, 65 percent, said they enjoyed teaching medical students, and 80 percent believed their students benefited from it. Most strikingly, 75 percent agreed that teaching improved their own knowledge and learning, an endorsement of the old pedagogical maxim that to teach is to learn twice. Nearly half, 47.5 percent, actively wanted to be more involved in teaching, and 60 percent believed that formal training in medical education would advance their professional development. These numbers suggest that the appetite for educational engagement within surgical training is far larger than many program directors might assume.

Yet the structural supports for that appetite were almost entirely absent. Only 25 percent of respondents had ever received formal training in medical education or teaching technique. Just 12.5 percent had protected time carved out from clinical duties for teaching, and a mere 20 percent felt valued by their hospital or university for their teaching contributions. Feedback on teaching quality was similarly scarce, reported by only 25 percent. Perhaps most tellingly, a substantial minority voiced outright skepticism: 37.5 percent viewed teaching as a burden, and 40 percent believed that specialists and university staff, not residents, should shoulder the responsibility for undergraduate teaching.

The statistical associations uncovered in the survey add nuance to these headline figures. Male respondents rated their enjoyment of teaching significantly higher than female respondents, a difference that reached statistical significance, and men were also more likely to want greater involvement in teaching. Senior trainees and resident specialists reported feeling more comfortable and better prepared to teach than junior residents, suggesting that pedagogical confidence accumulates with experience over the course of training. Residents who logged more annual teaching hours were more likely to agree that teaching deepened their own learning, with a moderate positive correlation, implying that the reciprocal intellectual rewards of teaching compound with sustained practice. Age, place of primary medical qualification, possession of a higher degree, and success in passing the professional surgical examination on a single attempt showed no significant association with teaching attitudes.

The authors argue that these findings expose a systemic gap that residency programs cannot afford to ignore. The literature they cite shows that structured residents-as-teachers curricula, including workshops and even globally delivered virtual courses, measurably improve residents’ knowledge, confidence, and feedback skills. Peer observation offers a low-cost alternative that reduces the faculty time required for instruction, and distributing teaching materials electronically has proven feasible in busy surgical programs. On the time problem, the authors point to North American models of protected block teaching time, in which residents are freed from on-call and clinical duties during teaching sessions while colleagues cross-cover their service obligations—support that must, they caution, come from genuinely adjusted workloads rather than simply stretching the training day. They suggest practical, low-friction interventions such as brief case-based micro-teaching on ward rounds and distributing teaching duties across the whole team, including attending surgeons.

Recognition emerges as perhaps the most psychologically potent lever. While faculty surgeons can accumulate teaching awards and educational portfolios that advance their careers, residents perceive few direct professional benefits from excellence in teaching, which may explain why some see it as uncompensated labor competing with the operating room. The authors propose awards, formal evaluations, and career advancement tied to teaching quality as mechanisms to close that gap. Their finding that residents with more teaching hours wanted even more involvement hints that institutional acknowledgment could trigger a virtuous cycle. There is also a workforce pipeline argument: prior research shows that surgical residents who are effective educators strongly influence medical students to pursue surgical careers, and the Hong Kong survey’s finding that early positive exposure to resident teachers predicts later enjoyment of teaching underscores how teaching culture perpetuates itself across generations.

The authors are appropriately candid about the study’s limits. It captures a single academic institution whose local educational culture may not generalize, the modest sample size raises the risk of response bias, and social desirability—amplified in a small departmental cohort where anonymity may not feel complete—may have inflated reported enthusiasm. The questionnaire lacked formal validity testing and had no qualitative component. Future work, they write, should use mixed methods across multiple sites with focus groups and properly validated instruments. Even so, the core message travels well beyond Hong Kong: surgical and orthopedic residents already recognize that teaching sharpens their own clinical reasoning and benefits their students. What they need from institutions is not exhortation but infrastructure—formal pedagogical training, protected time, honest feedback, and tangible recognition—so that the residents-as-teachers model can deliver on its promise for the next generation of doctors.

Subject of Research: Perceptions and experiences of surgical and orthopedic residents teaching medical students in a residency training program

Article Title: “Residents-as-teachers”: a survey on perceptions and experiences of surgical and orthopedic residents in teaching medical students

Article References: Chung, M. M. T., Cheung, B. H. H., Co, M. T. H., & Wong, T. M. (2026). “Residents-as-teachers”: a survey on perceptions and experiences of surgical and orthopedic residents in teaching medical students. Global Surgical Education – Journal of the Association for Surgical Education, 5(1), Article 155. https://doi.org/10.1007/s44186-026-00564-w

Image Credits: AI Generated

DOI: 10.1007/s44186-026-00564-w

Keywords: residents as teachers, medical education, surgical residency, orthopedics, clinical teaching, teaching hospital, undergraduate medical education, survey research, protected teaching time, faculty development, Hong Kong, surgical education