Grasset Eugenio, Obaíd Miguel
Departamento Cirugía, General Hospital del Salvador, Universidad de Chile, Santiago, Chile.
Rev Med Chil. 2018 Nov;146(11):1325-1333. doi: 10.4067/S0034-98872018001101325.
The fragmentation of a general specialty in subspecialties or derived specialties is a widely spread reality. Chilean health care system is becoming more complex, requiring more specialists. On the other hand, doctors in specialty training increasingly choose a subspecialty to continue their training and professional development. This contrasts with the growing need for well-trained general surgeons. We aimed to compare the evidence about the needs for general surgeons and the perspectives of Chilean physicians about their specialty training. A literature review about the intention of specialization in Chilean general surgery residents and the gaps in the Chilean health system, was performed. As of December 2016, there were 2,103 general surgeons in Chile, of whom 598 (28%) also have a subspecialty. Among the latter, 49% are plastic or vascular surgeons, which are also the specialties with the greatest demand in the public system. According to estimates of the Chilean Ministry of Health, on that year there was a deficit of 285 general surgeons and 142 subspecialists. These figures correspond to 18.5% and 23.8% of the existing resources. A survey published in 2009 reported that 78% of trainees in general surgery would prefer to continue studying a subspecialty, following the trend observed in the USA and Europe. Therefore, there is a disproportion between the intentions of general surgery trainees and the needs for these professionals in Chile.
一个普通专科细分为亚专科或衍生专科的现象是广泛存在的现实。智利的医疗保健系统正变得越来越复杂，需要更多的专科医生。另一方面，接受专科培训的医生越来越多地选择一个亚专科来继续他们的培训和职业发展。这与对训练有素的普通外科医生日益增长的需求形成了对比。我们旨在比较有关普通外科医生需求的证据以及智利医生对其专科培训的看法。对智利普通外科住院医师的专科化意向和智利卫生系统中的差距进行了文献综述。截至2016年12月，智利有2103名普通外科医生，其中598名（28%）也拥有一个亚专科。在后者中，49%是整形外科或血管外科医生，这也是公共系统中需求最大的专科。根据智利卫生部的估计，当年普通外科医生短缺285名，亚专科医生短缺142名。这些数字分别相当于现有资源的18.5%和23.8%。2009年发表的一项调查报道，普通外科培训学员中有78%会倾向于继续学习一个亚专科，这遵循了在美国和欧洲观察到的趋势。因此，在智利，普通外科培训学员的意向与这些专业人员的需求之间存在不均衡。
