Background: Training future rural surgeons is critical, but training needs are unclear. We hypothesize perspectives on necessity of subspecialty training differ among rural surgeons by generational cohort. Methods: An online survey was sent to ACS Rural Surgery Listserv subscribers. Closed-ended elements were analyzed using bivariate testing and logistic regression. Purposively-sampled respondents participated in qualitative interviews analyzed using principles of grounded theory. Results: Generation was irrelevant to respondents’ hiring preferences, but older surgeons were more likely to state subspecialty training was ideal for any future rural surgeon. Controlling for practice context, younger rural surgeons were less likely to favor hiring a subspecialty-trained surgeon (p = 0.019). Themes emerged from qualitative analysis emphasizing broad training and the importance of practice context. Conclusion: Across generations, rural surgeons’ perceptions about the training needed for rural surgery are largely stable. Considering practice context will allow educators to better prepare future rural surgeons for rural practices.
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