There is very little wasted time on surgical rounds, namely because there cannot be. It generally takes me about 45-60 minutes to round on 10-15 patients, going up to about 1 hour 15 on the occasions when the census hits 20+. Add another 15 minutes on either end of rounds for me to review labs, radiology and consultant plans. Given that all of our patients are generally located on specific surgical units, little of that time is wasted. And I can usually shave time off if I'm not spending time to provide education to medical students. So far, I don't see any place where I've described "scut"...rather the activities which actually makes one a physician.
In your extensive surgical experience, how many surgical consults are actual BS? We like to highlight the ones that are because they entertain us. But do you know what proportion of my day-to-day consults these make up? (Hint: Not very many.) Do you think that any consult that ends in "This patient doesn't need surgery" is BS? If so, you should probably excuse yourself from this thread as it belies your understanding of surgery as a discipline.
Miscommunication is not a function of surgical residency. That's a function of (poor) residents, and isn't unique to surgical residency.
Specifically, which surgical patients are not educational? It's easy to throw around generalities and catch phrases, but that doesn't mean it can be translated to practice.
Ok, assume we get rid of documentation for residents. Going to be a rude awakening when you make it into practice, as I'm fairly certain my attendings do more documentation than I do. So if you're suggesting that we change medical practice to require less documentation, I doubt anyone will object. But this isn't a function of surgical education or training, it's a function of the way our medical system is built.
And there is no hierarchy in IR? Where is this magical land where you don't have a division chief, who doesn't have a department chair, who doesn't report to the dean or a hospital CEO? Hierarchy is a fact of life in medicine (and in most professions). Unless you're going to go out and build your own surgical center, that's the way it goes.
As for hierarchy within surgical training, I don't ask any of my junior residents to do anything I'm not willing to do. Intern is off one day? Guess who's picking up the slack: me. But the reality of any training program is that graduated responsibility and progression to more complex tasks is the way learning works. Saying that the intern should show up and get to do the laparoscopic colectomy sounds great in theory, but it's like expecting a 2nd grader to do algebra before they've mastered multiplication tables. Can an attending do the colectomy with the intern? Sure, but the intern is going to gain very little from the experience because they don't have the skills required to actually participate.
There are actually a number of people who are trying to make this better. People, who unlike yourself, are surgical educators. And the interesting thing is that the ones with whom I've had the opportunity to speak wouldn't agree with your ideas of cutting training to 40 hours a week or reducing responsibility. And as for the women who leave surgery, you know the one thing that surgeons can't control? Their support system outside of the hospital. Because what makes it possible for me to be a surgeon and have a family is that my wife is amazing and takes care of many of the things for which I cannot be available. The women residents I know who have struggled do so not only because surgery residency is challenging (as it is for everyone), but because of the expectations their spouses place on them when they return home. So we can change the surgical training paradigm all we want, but if women are still expected to be a full-time surgeon AND a full-time wife/mother in the "traditional" sense then we are doomed for failure.
The goal of (any) training program is to create competent practitioners of that skill, not to make it accessible to everyone. There will always be trade-offs between what is required and what is desirable, or what is required and what people are capable of doing. The goal of designing surgical training should be to create competent surgeons as efficiently as possible. At that point, people can choose whether the compromises required complete that training are worth it. And yes, I would agree these compromises should be agnostic to age, gender, race, etc.
If you are interested in a thoughtful discussion of this from someone who is a woman and a surgeon, I'd encourage you to check out Caprice Greenberg's
AAS Presidential Address from last year.