Rural general surgery in Western Australia: a diverse state of play

Area of Science:

• Surgical Practice
• Rural Health
• Surgical Education

Background:

• Rural general surgeons need diverse skills for regional practice.
• Access to surgical services is challenged by surgeon shortages and subspecialization.
• General surgeons in rural settings manage a wide array of procedures.

Purpose of the Study:

• To document the procedural caseload of rural general surgeons in Western Australia.
• To analyze the scope and variety of surgical procedures performed in regional centers.
• To inform surgical training programs for rural practice.

Main Methods:

• Retrospective multi-center study.
• Data extracted from theatre management systems (2019-2023).
• Analysis of procedures at Albany Health Campus and Bunbury Regional Hospital.

Main Results:

• Over 18,000 (AHC) and 21,000 (BRH) procedures performed.
• Endoscopic procedures constituted 56.5% of work.
• Significant subspecialty (colorectal, GI/HPB) and non-general surgical procedures (plastic, urology, vascular) were noted, with variations between sites (35% vs 14%).
• Approximately 5% of procedures involved pediatric patients at both sites.

Conclusions:

• Rural general surgeons in Western Australia manage a highly varied caseload.
• Broad procedural exposure is essential for rural general surgeons.
• Novel training programs are needed to equip surgeons for diverse rural demands.