Gates Robert L, Walker John T, Denning David A
Department of Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia 25701, USA.
Am Surg. 2003 May;69(5):367-71.
Rural general surgeons perform a wide variety of procedures and have practices different from those of surgeons in larger communities. Because of this residents completing a classical general surgery training program may not be prepared for the rural setting. The 219 licensed physicians in West Virginia who list general surgery as their practice specialty with the State Board were surveyed to determine the nature of the rural surgery workforce and to examine the caseload of these surgeons. The majority of rural surgeons were satisfied with their current situation; however, 22 per cent stated that they would leave the practice of medicine if financially able. One-third of these surgeons regarded the rural setting as having an adverse impact on their practice. More than half of those surveyed stated that they would not encourage a young person to pursue a career in medicine. For one-third of rural surgeons general medicine was part of daily practice. The caseload varied by community size. Surgeons in communities of fewer than 10,000 people performed a lower percentage of general surgical procedures than surgeons in urban areas. They listed obstetric and gynecologic (9%), urologic (5%), otolaryngologic (9%), and orthopedic (4%) procedures as part of their regular cases. Endoscopic procedures comprise 17 to 24 per cent of total procedures regardless of community size. We conclude that resident surgeons planning to pursue a career in rural general surgery should broaden their operative and general medicine experiences to meet the needs of the communities in which they will serve.
乡村普通外科医生开展各种各样的手术，其业务与大城市的外科医生不同。因此，完成传统普通外科培训项目的住院医生可能并未为乡村工作环境做好准备。对西弗吉尼亚州219名向州委员会登记将普通外科作为其执业专业的执业医生进行了调查，以确定乡村外科医生队伍的性质，并考察这些外科医生的工作量。大多数乡村外科医生对他们目前的状况感到满意；然而，22%的人表示，如果经济条件允许，他们会放弃行医。这些外科医生中有三分之一认为乡村环境对他们的业务有不利影响。超过一半的受访者表示，他们不会鼓励年轻人从事医学职业。三分之一的乡村外科医生日常业务中包含普通内科。工作量因社区规模而异。人口少于10000人的社区的外科医生进行的普通外科手术比例低于城市地区的外科医生。他们将妇产科手术（9%）、泌尿外科手术（5%）、耳鼻喉科手术（9%）和骨科手术（4%）列为其常规病例的一部分。无论社区规模如何，内镜手术占总手术量的17%至24%。我们得出结论，计划从事乡村普通外科工作的住院外科医生应拓宽其手术和普通内科经验，以满足他们将要服务的社区的需求。
