So You Want to be a Rural General Surgeon: Optimizing Surgical Training to Support the Needs of Rural Hospitals

Area of Science:

• Rural Surgery
• Surgical Workforce Analysis
• Medical Education

Background:

• A significant shortage of general surgeons is projected, with rural areas facing disproportionate impacts.
• Northern New England states (Vermont, New Hampshire, Maine) are particularly affected by this impending surgeon deficit.

Purpose of the Study:

• To assess the required skill set and scope of practice for general surgeons in rural regions.
• To guide general surgery residents in prioritizing skills development for rural practice.

Main Methods:

• A survey-based needs assessment was conducted in Northern New England.
• Surveys were electronically distributed to hospital chief medical officers, gathering data on demographics, scope of practice, call burden, future needs, fellowship requirements, and desired skills.

Main Results:

• 37 surveys were completed, with a 57% response rate across New Hampshire, Vermont, and Maine.
• The majority of responding hospitals (54.3%) were critical access hospitals, and 51% of current surgeons are over 50.
• Minimally invasive and endoscopic skills are in high demand, though no hospitals require fellowship training.

Conclusions:

• The aging surgeon population and increasing surgical disease volume necessitate strategies for rural surgeon recruitment.
• General surgeons in rural New England commonly perform endoscopy, breast, colorectal, and acute care surgery.
• Future rural surgeons require comprehensive training with a focus on essential skills before graduation.