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

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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.