Table 1

Roles and key tasks for leadership services in an academic division of general surgery

Role; levelKey tasks
Division head
  • Provide overarching divisional leadership and direction

  • Be the face of the division: do activities that reflect the strength of the university nationally and internationally; do activities that are in the best interest of the division

  • Contribute to fundraising activities

  • Create a positive culture

  • Facilitate efforts to enhance/evolve the division

  • Liaise with hospital regarding union rules and issues

  • Recruit faculty

  • Represent the division at external meetings

  • Allocate resources or assign a designate (e.g., clinic time, operating room schedule, on-call schedules, outpatient resources)

  • Chair/coordinate/attend internal executive and operational meetings

  • Complete annual reporting requirements

  • Coordinate functioning of the division (maintain a broad overview of research and education activities within the division)

  • Deal with division-wide clinical service delivery issues

  • Ensure adequate administrative support

  • Ensure that quality-based metrics, volumes and targets are met (quality assurance/improvement)

  • Oversee budget assigned from hospital to services

  • Provide updates on provincial changes in policy

  • Adjudicate clinical and behavioural issues (e.g., disciplinary matters)

  • Appoint surgeons into nonclinical roles

  • Coach and assign mentors for junior surgeons

  • Deal with complaints

  • Facilitate/support surgeons’ academic careers (e.g., promotions, learning environment, Grand Rounds, annual update, other continuing medical education activity)

  • Lead/participate in faculty evaluation for hospital and university reappointment

  • Organize or delegate division Grand Rounds

Divisional director of finance
  • Oversee budgeting for all divisional activities

  • Division may have representation only at the departmental level

  • Allocate budget to each nonclinical pillar, including research, education and leadership

  • Fundraise for various initiatives

  • Consult on personnel and equipment negotiations relevant to the division

  • Present budget to and seek budget approval from division members/divisional executive

  • Supervise accounts

  • Prepare yearly accounting reports

  • Authorize disbursements

Section head
  • Responsible for clinical functioning and coordination of a section

  • Deal with offences and complaints

  • Coordinate clinical functioning and appropriate resource allocation of the section

  • Lead program-specific committee

  • Liaise with hospital or cross-organizational administration

  • Lead quality assurance/improvement responsibilities (e.g., meeting provincial standards for wait times, review and respond to disease site NSQIP data)

  • Lead specialty-specific rounds (e.g., tumour board)

Site chief
  • Extension of division head responsibilities dealing primarily with scheduling

  • Represent division head at departmental/hospital committees (e.g., hospital perioperative services committee, department of surgery executive committee) as needed

  • Manage site-specific issues including scheduling (operating room and on-call) and resource allocation

Quality assurance/improvement lead
  • Oversee adherence to relevant quality standards and develop quality-improvement initiatives

  • Develop division-wide quality-improvement activities

  • Represent division at departmental/hospital quality assurance/improvement committee

  • Monitor and report morbidity and mortality within division

  • Represent/lead division in quality initiatives

  • NSQIP = American College of Surgeons National Surgical Quality Improvement Program.

  • * These tasks describe the mandate for both the academic (university) and clinical (hospital) organization. If these roles are not occupied by the same person, there would be a need to clarify the allocation of responsibilities.

  • Sections refer to a subspecialty and could also be referred to as clinical services, units or programs. Examples include colorectal surgery, foregut/bariatric, general surgical oncology, breast surgical oncology and hepatobiliary surgery.