Department of Surgery, University of Alberta, Edmonton, Alta. (Ma, Verhoeff, Purich, Strickland); Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Skinner, Dhaliwal)
Department of Surgery, University of Alberta, Edmonton, Alta. (Ma, Verhoeff, Purich, Strickland); Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Skinner, Dhaliwal).
Can J Surg. 2023 Aug 29;66(4):E439-E447. doi: 10.1503/cjs.015122. Print 2023 Jul-Aug.
Recruiting residents to practise rurally begins with an accurate characterization of rural surgeons. We sought to identify and analyze demographic trends among rural surgeons in Canada and to predict the rural workforce requirements for the next decade.
In this retrospective observational study, we assessed the demographic and practice characteristics of rural general surgeons in Canada, defined as surgeons working in cities with a population of 100 000 or less. Surgeons were identified using the websites of provincial colleges of physicians and surgeons. Demographic characteristics included year and country of medical degree achievement, fellowship status and primary practice location. We developed a model predicting future rural workforce requirements based on the following assumptions: that the current ratio of rural surgeons to rural patients is adequate, that the rural population will increase by 1.1% annually, that a rural surgeon's career length is 36 years, and that 85 graduates will enter the workforce annually.
Our study sample included 760 rural general surgeons. The majority graduated after 1989 (75%), were Canadian medical graduates (73%) and did not complete a fellowship (82%). There was a significant shift toward rural surgeons being trained in Canada, from 37% of surgeons graduating before 1969 to 91% of those graduating after 2009 ( < 0.001). Modelling predicts 282 rural general surgeons will retire by 2031, with 88 new surgeons needed to account for the population growth. Therefore, we predict a demand for 370 rural surgeons over the next decade, meaning 43% of general surgery graduates will need to enter rural practice.
Rural general surgeons in Canada vary widely in their background demographic characteristics. Future opportunities in rural general surgery are projected to increase. Recruitment and training of general surgery graduates to serve Canada's rural communities remains essential.
招募居民到农村地区行医，首先要准确描述农村地区的外科医生。我们试图确定并分析加拿大农村外科医生的人口统计学趋势，并预测未来十年农村劳动力的需求。
在这项回顾性观察研究中，我们评估了加拿大农村普通外科医生的人口统计学和实践特征，这些医生定义为在人口 10 万或以下的城市工作的外科医生。外科医生的身份是通过省级医师学院的网站确定的。人口统计学特征包括获得医学学位的年份和国家、奖学金状况以及主要执业地点。我们根据以下假设建立了预测未来农村劳动力需求的模型：目前农村外科医生与农村患者的比例是合理的，农村人口将以每年 1.1%的速度增长，农村外科医生的职业生涯长度为 36 年，每年将有 85 名毕业生进入劳动力市场。
我们的研究样本包括 760 名农村普通外科医生。他们中的大多数（75%）是在 1989 年后毕业的，是加拿大医学毕业生（73%），没有完成奖学金培训（82%）。加拿大培训的农村外科医生的比例显著增加，从 1969 年前毕业的外科医生中占 37%，增加到 2009 年后毕业的外科医生中占 91%（<0.001）。模型预测，到 2031 年，将有 282 名农村普通外科医生退休，需要增加 88 名新外科医生来应对人口增长。因此，我们预计未来十年农村地区将需要 370 名农村外科医生，这意味着 43%的普通外科毕业生需要进入农村地区行医。
加拿大农村地区的普通外科医生在背景人口统计学特征方面差异很大。未来农村普通外科手术的机会预计会增加。招聘和培训普通外科毕业生到加拿大农村社区服务仍然至关重要。
