Educating primary physicians in emergency surgical procedures

While federal agencies explore ways to encourage physicians to enter primary care practice in underserved areas, they largely avoid the question of how well current training programs prepare physicians for the role. No systematic study has been made of skills in emergency procedures that may be needed in areas where a surgeon is not readily available. A survey of the literature and of our own primary care residents gives cause of concern. Only a third of the residents were confident of their ability to perform a set of procedures essential for stabilizing injured patients. A greater reliance on training in ambulatory clinics, as recommended by the Graduate Medical Education National Advisory Committee (GMENAC), may further decrease opportunities for learning essential technics.