You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Increasing the Number of Trainees in General Surgery Residencies: Is There Capacity?

Charles, Anthony G. MD, MPH; Walker, Elizabeth G. MSPH; Poley, Stephanie T.; Sheldon, George F. MD; Ricketts, Thomas C. PhD; Meyer, Anthony A. MD, PhD

Academic Medicine:
doi: 10.1097/ACM.0b013e318212eb17
Physician Supply
Abstract

Purpose: General surgeons have decreased as a proportion of the total U.S. surgical workforce. Given the likelihood of increasing shortages of general surgeons, the authors evaluated available expansion capacity of existing general surgery residency programs.

Method: In November 2009, the authors e-mailed a Web-based questionnaire to the program directors and coordinators of the 246 U.S. general surgery residency programs that were then certified by the Accreditation Council for Graduate Medical Education.

Results: Of the 246 programs the authors contacted, 123 (50%) completed the survey. Community hospital programs and academic programs had similar response rates (52% and 50%, respectively). Of the 115 program directors who responded to the relevant question, 92 (80%) reported sufficient existing case volume capacity to accommodate additional surgery residents. Both community and academic program directors reported modest expansion capacity: an average of 1.7 and 2.0 additional residents per year, respectively. Across all programs, the average additional capacity reported was 1.9 additional residents per year. An expansion of this size would increase the number of general surgery residency positions from 1,137 to 1,515 annually. After accounting for subspecialization, this increase of 378 residents would result in approximately 249 additional general surgeons entering the workforce per year after five years.

Conclusions: Expansion capacity within existing approved general surgery residency programs is insufficient to meet the expected demand for general surgeons in the United States. Strategies to alleviate shortages include developing new training programs, cultivating new medical education funding streams, and changing the surgical training paradigm.

Author Information

Dr. Charles is assistant professor of surgery, University of North Carolina at Chapel Hill School of Medicine, and investigator, American College of Surgeons Health Policy Research Institute, Chapel Hill, North Carolina.

Ms. Walker was, at the time of this study, research associate, American College of Surgeons Health Policy Research Institute, and research associate, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Ms. Poley is research coordinator, American College of Surgeons Health Policy Research Institute, and research associate, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Dr. Sheldon is director, American College of Surgeons Health Policy Research Institute, and professor of surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina.

Dr. Ricketts is managing director, American College of Surgeons Health Policy Research Institute, and deputy director, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Dr. Meyer is chair, Department of Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina.

Please see the end of this article for information about the authors.

Correspondence should be addressed to Dr. Charles, University of North Carolina, 4008 Burnett Womack Building, CB 7228, Chapel Hill, NC 27599; telephone: (919) 966-4389; fax: (919) 966-0369; e-mail: anthchar@med.unc.edu.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A49.

© 2011 Association of American Medical Colleges