Doty Brit, Zuckerman Randall, Borgstrom David
Mithoefer Center for Rural Surgery, Bassett Healthcare, Cooperstown, New York 13326, USA.
J Surg Educ. 2009 Mar-Apr;66(2):74-9. doi: 10.1016/j.jsurg.2008.11.005.
Too few surgeons practice in small rural areas of the United States. Many newly graduating surgeons choose not to practice rurally because they feel unprepared for rural practice. Family medicine residencies have a track record of placing graduates in rural settings. Their experience shows that having a stated interest in training rural physicians, a rural-focused curriculum, and rural practice exposure opportunities are successful elements for graduating physicians who practice rurally.
To describe the extent to which general surgery residency training is likely to prepare future rural surgeons using criteria cited in reviews of rural family medicine residency programs.
Three criteria were used to assess whether general surgery residency programs are positioned to produce rural surgeons: rural location, rural-focused curriculum, and self-identified interest in rural training. Several search strategies were employed to identify residency programs that meet the criteria. Additionally, data extracted from the American Medical Association's Physician Masterfile was used to determine demographic characteristics of residency programs that have trained surgeons who currently practice rurally.
Overall, 25 general surgery residency programs meet at least 1 of the 3 criteria. This finding represents approximately 10% of all residency programs in the United States. Residency programs located in the Midwest and the South have generally been more successful in graduating surgeons who are practicing rurally than those situated in the Northeast and West.
Although a few general surgery residency programs have been successful in graduating surgeons who practice rurally, there has not been a coordinated effort among programs to accomplish this goal. Our findings suggest a need for organization and coordination among those programs committed to training surgeons for rural practice. The creation of a consortium of general surgical residency programs with an interest in training rural surgeons could be a useful first step in this process.
在美国农村小地区执业的外科医生太少。许多刚毕业的外科医生选择不在农村执业,因为他们觉得自己对农村执业没有做好准备。家庭医学住院医师培训项目在将毕业生安置到农村地区方面有良好记录。他们的经验表明,对培养农村医生有明确兴趣、以农村为重点的课程以及农村执业接触机会,是农村执业毕业医生的成功要素。
根据农村家庭医学住院医师培训项目综述中引用的标准,描述普通外科住院医师培训在培养未来农村外科医生方面的可能性。
使用三个标准来评估普通外科住院医师培训项目是否有能力培养农村外科医生:农村地区位置、以农村为重点的课程以及对农村培训的自我认定兴趣。采用了几种搜索策略来识别符合标准的住院医师培训项目。此外,从美国医学协会的医师主文件中提取的数据用于确定培训过目前在农村执业外科医生的住院医师培训项目的人口统计学特征。
总体而言,25个普通外科住院医师培训项目至少符合三项标准中的一项。这一发现约占美国所有住院医师培训项目的10%。位于中西部和南部的住院医师培训项目在培养目前在农村执业的外科医生方面通常比位于东北部和西部的项目更成功。
虽然一些普通外科住院医师培训项目在培养农村执业外科医生方面取得了成功,但各项目之间尚未为实现这一目标做出协调一致的努力。我们的研究结果表明,致力于培训农村执业外科医生的项目之间需要组织和协调。创建一个对培训农村外科医生感兴趣的普通外科住院医师培训项目联盟可能是这一过程中有用的第一步。