Article

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.

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    • "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. "
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