Nontertiary surgery in Manitoba: comparison of provincial and teaching-hospital data

Do the teaching hospitals in Manitoba provide a suitable spectrum and sufficient numbers of operations to prepare surgeons for practice in Manitoban communities? To answer these questions, the author reviewed the types and frequencies of all operations performed in Manitoba during 1985 and 1986 and compared them with all operations performed in the two Manitoba teaching hospitals for the same years. The 189,380 operations studied were categorized according to the surgical specialist who usually performed each operation in the teaching hospitals. For some procedures commonly performed in the province as a whole, there were too few operations performed in the teaching hospitals to provide sufficient experience for the trainees. A breakdown of nontertiary operations performed in Manitoba revealed that 39% were in the category of general surgery, 29% were in gynecology and operative obstetrics, 17% were in orthopedics, 10% were in urology and 4% were in plastic surgery. The author concludes that a surgeon going to a smaller community as the only surgical specialist requires training of a broader scope than is provided currently in the standard general-surgery training programs in Manitoba.