Colleges and universities are having a difficult time hiring, recruiting and retaining members of their athletic training staffs because of a number of below-market conditions, a survey shows.

The survey, by the National Athletics Trainers’ Association and the American College of Sports Medicine, of 1,120 athletic trainers at all collegiate levels identified four areas of most common concern: compensation, organizational culture, burnout and increased work responsibility, according to a joint statement released Wednesday.

Among the findings, more than 50% of athletic trainers were caring for more than 100 student-athletes and 65% had been given additional responsibilities without a pay increase.

“They vote with their feet,” said Dr. Bill Roberts, chief medical officer of the American College of Sports Medicine, by leaving the collegiate ranks for positions with occupational health, hospitals, the military and other positions that offer better pay and more regular hours.