General surgery in Canada: current scope of practice and future needs

Area of Science:

• Surgery
• Surgical Practice
• Health Workforce Analysis

Background:

• General surgery scope of practice in Canada exhibits significant variability.
• Demographic characteristics of Canadian general surgeons require examination.
• Surgical procedures performed by general surgeons differ across community sizes and specialties.

Purpose of the Study:

• To examine the demographic characteristics of general surgeons in Canada.
• To compare surgical procedures performed by general surgeons across different community sizes and specialties.

Main Methods:

• Utilized data from the Canadian Institute for Health Information's National Physician Database.
• Analyzed fee-for-service (FFS) care provided by general surgeons and other providers in Canada for the 2015/16 period.
• Included data from 8 Canadian provinces.

Main Results:

• 1669 general surgeons provided FFS care; most worked in larger communities (>100,000 residents) and were male, aged 35-54, and Canadian medical graduates.
• Only 7% of general surgeons practiced in rural areas; these areas were more likely to have international medical graduates or surgeons over 65.
• Common procedures included hernia repairs, gallbladder/biliary surgery, skin tumor excisions, colon/intestine resections, and breast surgery. Many performed procedures outside their Royal College of Physicians and Surgeons of Canada training objectives.

Conclusions:

• Canadian general surgeons offer diverse services, with practice patterns varying by community size.
• Surgeons in rural/small communities need skills beyond typical residency training.
• Surgical training should incorporate opportunities to acquire skills needed for diverse practice settings to meet patient care needs.