When rural is no longer rural: Demand for subspecialty trained surgeons increases with increasing population of a non-metropolitan area - 17/10/19
, Dorothy Hughes b, Shanley B. Deal c, Michael D. Sarap d, Tyler G. Hughes e, Karen E. Deveney f, Karen J. Brasel a, Adnan A. Alseidi cAbstract |
Background |
Surgery in larger, non-metropolitan, communities may be distinct from rural practice. Understanding these differences may help guide training. We hypothesize that increasing community size is associated with a desire for subspecialty surgeons.
Methods |
We designed a mixed methods study with the ACS Rural Advisory Council. Rural (<50,000 people), small non-metropolitan (50,000-100,000), and large non-metropolitan (>100,000) communities were compared. Quantitative and qualitative data were analyzed.
Results |
We received 237 responses, and desire to hire subspecialty-trained surgeons was associated with practice in a large non-metropolitan community, OR 4.5, (1.2–16.5). Qualitative themes demonstrated that rural surgeons limit practices to align with available hospital resources while large non-metropolitan surgeons specialize according to interest and market pressures.
Conclusions |
Surgery in rural versus large non-metropolitan communities may be more distinct than previously understood. Rural practice requires broad preparation while large non-metropolitan practice favors subspecialty training.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | Rural and small/large non-metropolitan areas have distinct practice environments. |
• | Necessary clinical skills for these different practice environments are unique. |
• | Larger non-metropolitan areas are increasingly looking to hire sub-specialists. |
• | Residency training for rural and non-metropolitan surgeons should reflect this. |
Keywords : Rural surgery, General surgery, Surgical education, Surgery fellowship
Abbreviations : ACS, RUCC, OR
Plan
Vol 218 - N° 5
P. 1022-1027 - novembre 2019 Retour au numéro
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