Background Although operative report documentation (ORD) is an essential skill for surgeons and is evolving with electronic health records (EHRs), little is known about current ORD teaching in surgical training. Study Design An electronic survey was sent out in January 2012 to all 1,096 ACGME surgical program directors that assessed characteristics of training programs, EHR adoption, ORD education, synoptic or templated report usage for ORD, and attitudes and opinions about ORD education and electronic tools for ORD. Content thematic analysis of qualitative responses was performed iteratively until reaching saturation. Results Overall, 441 program directors (40%; 17.9 ± 8.8 years in practice) responded from university-affiliated (383 [87%]), community/private (44 [10%]), and military (14 [3%]) programs. Although most (n = 295 [67%]) consider ORD teaching a priority, only 76 (17%) programs provide ORD instruction. Program directors formally trained in ORD were more likely to offer ORD instruction (61% vs 11%; p < 0.0001), as were obstetrics/gynecology programs (obstetrics/gynecology 35% vs surgery 18%, neurosurgery 16%, ophthalmology 14%, orthopaedics 14%; p < 0.05 each). Although EHR adoption and electronically available operative reports were common (91%), besides ophthalmology (31%) and obstetrics/gynecology (30%) programs, ORD with synoptic reporting was used in only 18% of programs overall. Program directors perceived major barriers to ORD instruction and synoptic reporting for ORD. Conclusions Although most program directors consider ORD teaching an educational priority, incongruence exists between its perceived value and its adoption into surgical training. Operative report documentation with synoptic reporting is currently not common in most surgical subspecialties. © 2014 by the American College of Surgeons Published by Elsevier Inc.