From the Division of General Surgery, University of British Columbia, Vancouver, BC.
Can J Surg. 2021 Sep 1;64(5):E467-E472. doi: 10.1503/cjs.014119.
General surgery remains a broad and unclearly defined specialty in small and medium-sized communities, where general surgeons perform more subspecialty and non-core procedures than their urban counterparts. It is unclear what specific procedures are being performed or whether today's residents are being trained to meet community needs. We surveyed the members of the British Columbia (BC) Surgical Society and found that only 3% of BC's surgeons believe today's graduates are "definitely prepared" for a broad-based community practice. We also identified several non-core procedures performed more frequently by general surgeons in small and medium-sized communities. General surgery residency is narrowing its focus despite the fact that community general surgeons are maintaining a broad-based practice. To meet the needs of smaller communities, residency programs need to address the discrepancies that exist between the emphasis within the current training structure and the practice of our community surgeons.
普通外科在小型和中型社区仍然是一个广泛而定义不明确的专业，普通外科医生在这些社区中执行的亚专业和非核心手术比城市同行更多。目前尚不清楚正在执行哪些具体程序，或者今天的住院医师是否正在接受培训以满足社区的需求。我们调查了不列颠哥伦比亚省（BC）外科学会的成员，发现只有 3％的 BC 外科医生认为当今的毕业生“绝对有准备”从事基础广泛的社区实践。我们还确定了一些中小型社区的普通外科医生更频繁地进行的非核心手术。尽管社区普通外科医生在维持基础广泛的实践，但普通外科住院医师的重点正在缩小。为了满足较小社区的需求，住院医师培训计划需要解决当前培训结构内的重点与我们社区外科医生的实践之间存在的差异。
