Progressive Specialization Within General Surgery: Adding to the Complexity of Workforce Planning - 21/08/11
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Résumé |
Background |
Although most general surgeons receive comparable training leading to Board certification, the services they provide in practice may be highly variable. Progressive specialization is the voluntary narrowing of scope of practice from the breadth of skills acquired during training; it occurs in response to patient demand, rapid growth of medical knowledge, and personal factors. Progressive specialization is increasingly linked to fellowship training, which generally abruptly narrows a surgeon’s scope of practice. This study examines progressive specialization by evaluating trends in fellowship training among general surgeons.
Study design |
Because no database exists that tracks trainees from medical school matriculation through entrance into the workforce, data from multiple sources were compiled to assess the impact of progressive specialization. Trends in overall number of trainees, match rates, and proportion of international medical graduates were analyzed.
Results |
The proportion of general surgeons pursuing fellowship training has increased from > 55% to > 70% since 1992. The introduction of fellowship opportunities in newer content areas, such as breast surgery and minimally invasive surgery, accounts for some of the increase. Meanwhile, interest in more traditional subspecialties (ie, thoracic and vascular surgery) is declining.
Conclusions |
Progressive specialization confounds workforce projections. Available databases provide only an estimate of the extent of progressive specialization. When surgeons complete fellowships, they narrow the spectrum of services provided. Consequently, as the phenomenon of progressive specialization evolves, a larger surgical workforce will be needed to provide the breadth of services encompassed by the primary components of general surgery.
Le texte complet de cet article est disponible en PDF.Abbreviations and Acronyms : ABMS, ABS, ACGME, IMG, SSO, USMG
Plan
Competing Interests Declared: None. Supported in part by a National Research Service Award Postdoctoral Traineeship from the Agency for Healthcare Research and Quality, sponsored by the Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill (T32 HS00032 to KBS). |
Vol 201 - N° 6
P. 925-932 - décembre 2005 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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