When rural is no longer rural: Demand for subspecialty trained surgeons increases with increasing population of a non-metropolitan area

Mackenzie R. Cook, Dorothy Hughes, Shanley B. Deal, Michael D. Sarap, Tyler G. Hughes, Karen Deveney, Karen Brasel, Adnan A. Alseidi

Research output: Contribution to journalArticle

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 languageEnglish (US)
JournalAmerican journal of surgery
DOIs
StatePublished - Jan 1 2019

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Population
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Keywords

  • General surgery
  • Rural surgery
  • Surgery fellowship
  • Surgical education

ASJC Scopus subject areas

  • Surgery

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When rural is no longer rural : Demand for subspecialty trained surgeons increases with increasing population of a non-metropolitan area. / Cook, Mackenzie R.; Hughes, Dorothy; Deal, Shanley B.; Sarap, Michael D.; Hughes, Tyler G.; Deveney, Karen; Brasel, Karen; Alseidi, Adnan A.

In: American journal of surgery, 01.01.2019.

Research output: Contribution to journalArticle

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AU - Sarap, Michael D.

AU - Hughes, Tyler G.

AU - Deveney, Karen

AU - Brasel, Karen

AU - Alseidi, Adnan A.

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