What is the future for General Surgery in Model 3 Hospitals?

Area of Science:

• Health Services Research
• Surgical Workforce Planning
• Hospital Management

Background:

• General Surgery consultant recruitment is a significant challenge in Ireland's Model 3 Hospitals.
• These hospitals play a crucial role in delivering surgical services within the Irish healthcare system.

Purpose of the Study:

• To analyze General Surgery activity and consultant staffing in Model 3 Hospitals.
• To provide data-driven insights for future manpower and service planning.
• To identify factors contributing to recruitment and retention challenges.

Main Methods:

• Utilized the 2014 Hospital Inpatient Enquiry (HIPE) dataset to assess surgical activity.
• Collected current consultant staffing data from hospital personnel departments.
• Surveyed trainees on the National Surgical Training Programme regarding career intentions.

Main Results:

• Model 3 Hospitals handle 50% of General Surgery discharges, with many procedures being low acuity (e.g., minor lesion excision, appendectomy).
• A substantial portion of General Surgeons in these hospitals are locums (25%) or trained internationally (54%), with 22% nearing retirement.
• Surgical trainees expressed a strong preference for Model 4 Hospitals, citing issues with rotas, skill enhancement, complex case exposure, research opportunities, and support.

Conclusions:

• An impending General Surgery consultant manpower crisis in Model 3 Hospitals is evident.
• Averting this crisis requires substantial changes to surgical training emphasis or a significant reorganization of surgical services.
• Addressing trainee concerns regarding career development and work environment is critical for future recruitment.