A longitudinal analysis of general surgery workforce in the United States, 1981–2005

Department of Surgery, University of Washington, Seattle, USA.
Archives of surgery (Chicago, Ill.: 1960) (Impact Factor: 4.3). 05/2008; 143(4):345-50; discussion 351. DOI: 10.1001/archsurg.143.4.345
Source: PubMed

ABSTRACT The overall supply of general surgeons per 100 000 population has declined in the past 2 decades, and small and isolated rural areas of the United States continue to have relatively fewer general surgeons per 100 000 population than urban areas.
Retrospective longitudinal analysis.
Clinically active general surgeons in the United States.
The American Medical Association's Physician Masterfiles from 1981, 1991, 2001, and 2005 were used to identify all clinically active general surgeons in the United States.
Number of general surgeons per 100 000 population and the age, sex, and locale of these surgeons.
General surgeon to population ratios declined steadily across the study period, from 7.68 per 100 000 in 1981 to 5.69 per 100 000 in 2005. The overall urban ratio dropped from 8.04 to 5.85 (-27.24%) across the study period, and the overall rural ratio dropped from 6.36 to 5.02 (-21.07%). The average age of rural surgeons increased compared with their urban counterparts, and women were disproportionately concentrated in urban areas.
The overall number of general surgeons per 100 000 population has declined by 25.91% during the past 25 years. The decline has been most marked in urban areas. However, more remote rural areas continue to have significantly fewer general surgeons per 100 000 population. These findings have implications for training, recruiting, and retaining general surgeons.

  • Source
    • "At 7.8 per 100,000 population, the number of trained surgeons per capita is more than 10 times higher in Santa Cruz than in many sub-Saharan African and central Asian nations [8] [11] [25] for which data have been published. In fact, the US has only 5.7 general surgeons per 100,000 population, although this number does not include obstetricians and specialists [26]. The relative robustness of surgical systems in Santa Cruz is especially evident compared with data from Sierra Leone and Nigeria, the other countries for which PIPES data have been published [16] [23]. "
    Journal of Surgical Research 02/2013; 179(2):340. DOI:10.1016/j.jss.2012.10.780 · 2.12 Impact Factor
  • Source
    • "Surgery continues to have one of the highest attrition rates of all graduate medical education programs, which is of particular concern since it is predicted that there will be a substantial shortage of general surgeons. Data reported through 2005 show the population of general surgeons across the country has already decreased from 7.68 per 100,000 population in 1981 to 5.69 per 100,000 population in 2005—a decline of almost 26% [6]. Furthermore , it appears implementation of work hour restrictions has paradoxically exacerbated the attrition problem. "
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: Attrition in surgical residency programs continues to be a significant challenge. Ap-proximately 20% of residents who begin a categorical surgery residency fail to complete it. A number of studies speculated reasons for this including work hours, life style, family pressures, and resident feelings of inadequacy including fear of termination. To date no research has been conducted investigating the relation-ship between resident morale and attrition. This study sought to determine if this linkage exists in surgery residents. METHODS: The Morale Assessment in General Practice Index (MAGPI) was administered to 21 PGY 1, 2, 3, and 5 surgical residents to assess level of morale. Non-parametric methods were carried out to assess if there were differences in morale among the four PGY groups. Additionally, analyses of the four factors comprising the MAGPI were also conducted. RESULTS: Although differences did not reach statis-tical significance, analysis of the data reveals that residents demonstrate different trends in their levels of morale based on the amount of time they spend in a residency and in a way that approximates the morale curve described by W. Walter Menninger, M.D. Additionally, two of the four factors comprising the MAGPI also indicate trends similar to that described by the Menninger morale curve. CONCLUSIONS: Although no statistically significant results were achieved, the data reveal trends that approximate shifts in morale similar to those described by the Menninger morale curve, with residents at the PGY 2 and 3 levels present-ing lower morale levels than at the PGY 1 and 5 levels. This may be due in part to the size of the population studied. Future research should be continued in this area with a larger sample size.
    Surgical Science 01/2011; 02(07). DOI:10.4236/ss.2011.27087
  • Advances in protein chemistry 02/1998; 51:355-432. DOI:10.1016/S0065-3233(08)60656-7 · 0.75 Impact Factor
Show more