Commentary: The Case for Expanding General Surgery Residencies

Russell, John C. MD; Nelson, M. Timothy MD; Fry, Donald E. MD

Academic Medicine:
doi: 10.1097/ACM.0b013e3181d7e056

Despite the significant growth in population in the United States since 1980 and societal and demographic factors such as an aging population, there has been no increase in the number of graduating general surgery residents each year, which has created a worsening shortage of general surgeons. Other factors, such as stricter duty hours requirements and an increase in the number and variety of procedures general surgeons must perform, have also contributed to this shortage. Yet, applicant demand for general surgery positions is currently strong and will increase as new medical schools are created and current medical schools expand class size. The authors of this commentary propose an expansion of the Accreditation Council for Graduate Medical Education-approved general surgery categorical resident positions as the necessary first step in addressing the current and projected shortage of general surgeons. Before this expansion of general surgery residencies can occur, impediments such as the availability of residency spots for both U.S. and international medical graduates, the availability of educational opportunities for residents in teaching hospitals, and inadequate financial resources, such as a lack of funding from the Centers for Medicare and Medicaid, must be overcome.

Author Information

Dr. Russell is professor and chairman, Department of Surgery, University of New Mexico, Albuquerque, New Mexico.

Dr. Nelson is associate professor, vice chairman for education, and general surgery residency program director, University of New Mexico, Albuquerque, New Mexico.

Dr. Fry is emeritus professor, Department of Surgery, University of New Mexico, Albuquerque, New Mexico, and adjunct professor, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Correspondence should be addressed to Dr. Russell, MSC 10–5610, 1 University of New Mexico, Albuquerque, NM 87131-0001; telephone: (505) 272-6869; fax: (505) 272-4165; email:

© 2010 Association of American Medical Colleges