Rural surgery and rural surgeons: Meeting the need

ANZ Journal of Surgery (Impact Factor: 1.12). 12/2007; 77(11):919-20. DOI: 10.1111/j.1445-2197.2007.04281.x
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    ANZ Journal of Surgery 08/2008; 78(7):619-20. DOI:10.1111/j.1445-2197.2008.04589.x · 1.12 Impact Factor
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    ABSTRACT: Background The Royal Australasian College of Surgeons' Rural Surgical Training Program (RSTP) ran from 1996 to 2007. As a formal review of the RSTP had never occurred, it remained unknown whether the RSTP had achieved its objectives of training surgeons for and retaining them in practice in rural Australia.Methods Sixty-six RSTP fellows and 67 general surgery fellows were asked to complete a survey evaluating factors influencing the decision to pursue a rural surgical career, the influence of the RSTP on subsequent career pathways and the adequacy of the RSTP in preparing its trainees for rural work.ResultsFifty-one out of 66 RSTP fellows were noted to be in practice in metropolitan Australia, with only 15 in rural Australia. Responses obtained revealed rural surgical rotations during training as a major influence in the decision to perform rural work. Thirty out of 35 RSTP participants stated that the RSTP did not influence their subsequent careers. Six out of 15 RSTP respondents responded positively when asked about the adequacy of the RSTP in preparing its trainees for rural work.Conclusion The RSTP largely succeeded in preparing its trainees for rural work, but did not succeed in retaining the majority of its trainees in practice in rural Australia. It appears that targeting doctors at the point of admission to surgical training, in the hope that this would translate into more rural surgeons, did not result in improved retention in rural areas.
    ANZ Journal of Surgery 11/2014; 85(3). DOI:10.1111/ans.12880 · 1.12 Impact Factor
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    ABSTRACT: Surgery is a crucial component of health systems, yet its contribution has been difficult to define. We linked national hospital service utilization with national epidemiologic data to describe the use of surgical procedures in the management of a broad spectrum of conditions. We compiled International Classification of Diseases-10-Australian Modification codes from the New Zealand National Minimum Dataset, 2008-2011. Using primary cause of admission, we aggregated hospitalizations into 119 disease states and 22 disease subcategories of the World Health Organization Global Health Estimate (GHE). We queried each hospitalization for any surgical procedure in a binary manner to determine the volume of surgery for each disease state. Surgical procedures were defined as requiring general or neuroaxial anesthesia. We then divided the volume of surgical cases by counts of disease prevalence from the Global Burden of Disease Study 2010 to determine annual surgical incidence. Between 2008 and 2011, there were 1,108,653 hospital admissions with 275,570 associated surgical procedures per year. Surgical procedures were associated with admissions for all 22 GHE disease subcategories and 116 of 119 GHE disease states. The sub-categories with the largest surgical case volumes were Unintentional Injuries (48,073), Musculoskeletal Diseases (38,030), and Digestive Diseases (27,640). Surgical incidence ranged widely by individual disease states with the highest in: Other Neurological Conditions, Abortion, Appendicitis, Obstructed Labor, and Maternal Sepsis. This study confirms that surgical care is required across the entire spectrum of GHE disease subcategories, illustrating a critical role in health systems. Surgical incidence might be useful as an index to estimate the need for surgical procedures in other populations. Copyright © 2015 Elsevier Inc. All rights reserved.
    The Lancet 04/2015; 385(1):S25. DOI:10.1016/S0140-6736(15)60820-0 · 45.22 Impact Factor