Abstract
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.
Original language | English (US) |
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Pages (from-to) | 1022-1027 |
Number of pages | 6 |
Journal | American journal of surgery |
Volume | 218 |
Issue number | 5 |
DOIs | |
State | Published - Nov 2019 |
Keywords
- General surgery
- Rural surgery
- Surgery fellowship
- Surgical education
ASJC Scopus subject areas
- Surgery