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Opportunities to Create New General Surgery Residency Programs to Alleviate the Shortage of General Surgeons
Ashley D Meagher1, Christopher A Beadles, George F Sheldon
1A.D. Meagher is a surgical resident, Loyola University Medical Center, Maywood, Illinois. C.A. Beadles is senior public health research analyst, RTI International, Raleigh, North Carolina. G.F. Sheldon (deceased) was professor and chair emeritus, Department of Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina. A.G. Charles is associate professor of surgery and research fellow, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina.
Purpose:
To estimate the capacity for supporting new general surgery residency programs among U.S. hospitals that currently do not have such programs.
Method:
The authors compiled 2011 American Hospital Association data regarding the characteristics of hospitals with and without a general surgery residency program and 2012 Accreditation Council for Graduate Medical Education data regarding existing general surgery residencies. They performed an ordinary least squares regression to model the number of residents who could be trained at existing programs on the basis of residency program-level variables. They identified candidate hospitals on the basis of a priori defined criteria for new general surgery residency programs and an out-of-sample prediction of resident capacity among the candidate hospitals.
Results:
The authors found that 153 hospitals in 39 states could support a general surgery residency program. The characteristics of these hospitals closely resembled the characteristics of hospitals with existing programs. They identified 435 new residency positions: 40 hospitals could support 2 residents per year, 99 hospitals could support 3 residents, 12 hospitals could support 4 residents, and 2 hospitals could support 5 residents. Accounting for progressive specialization, new residency programs could add 287 additional general surgeons to the workforce annually (after an initial five- to seven-year lead time).
Conclusions:
By creating new general surgery residency programs, hospitals could increase the number of general surgeons entering the workforce each year by 25%. A challenge to achieving this growth remains finding new funding mechanisms within and outside Medicare. Such changes are needed to mitigate projected workforce shortages.
