Grossen Hans, Baechtold Matthias, Antony Pia, Renzulli Pietro, Hauswirth Fabian, Probst Pascal, Muller Markus K
Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Switzerland.
Department of Surgery, Cantonal Hospital Thurgau, Münsterlingen, Switzerland.
Langenbecks Arch Surg. 2025 Aug 16;410(1):248. doi: 10.1007/s00423-025-03833-2.
Switzerland's aging population and evolving healthcare demands are expected to increase the need for specialized surgeons. Meanwhile, ongoing discussions about reduced work hours for residents and a growing trend toward minimally invasive and outpatient procedures may influence training opportunities and inpatient procedural volumes. The aim of this study was to evaluate workforce, training, and procedural volumes in surgery to determine the future demand for visceral surgeons in Switzerland.
This study analysed national datasets from 2009 to 2023 to assess trends in medical school enrolments, recognised medical diplomas, residency positions, and the availability of general and visceral surgeons. Additionally, surgical procedure volumes were evaluated with a particular focus on pancreatic surgery as a proxy for complex cases and appendectomies for simple procedures. Linear regression models projected developments up to 2040, incorporating Swiss population growth forecasts.
The number of medical diplomas - both Swiss-issued and foreign-recognized - showed an increase from 2,725 in 2011 to 4,647 in 2023. Projections indicate a further rise, reaching over 6,000 by 2040. Although total surgical residency positions declined slightly, spots dedicated to general surgery candidates grew by 8.7%. The overall pool of general surgeons increased from 1'127 in 2009 to 1'557 in 2023, with the proportion of women rising from 10.6 to 24.9% within the same interval. From 2013 to 2023, annual appendectomies increased from 11,529 to 12,412 (7.7% growth), and forecasts project a further rise of approximately 14% by 2040, although the procedures per surgeon are expected to decrease due to ongoing workforce expansion. Visceral surgeons numbered 303 by 2023 (11% female), and forecasts suggest a 50% increase to approximately 462 by 2040. Pancreatic surgery cases grew by 14.5% between 2016 and 2023 and are projected to increase by an additional 25% by 2040. However, the number of complex surgeries per visceral surgeon is projected to decline steadily over the next years.
The expansion of the surgical workforce is projected to overcompensate for the growth of Switzerland's population. In combination with a shift towards outpatient care and reduced working hours, procedural exposure could become critical in general and visceral surgery. Ensuring that training pathways and practice models adapt to these evolving demands will be vital to maintaining high standards of surgical care.
瑞士人口老龄化以及医疗保健需求的不断演变，预计将增加对专科外科医生的需求。与此同时，关于减少住院医生工作时间的持续讨论以及微创和门诊手术日益增长的趋势，可能会影响培训机会和住院手术量。本研究的目的是评估外科领域的劳动力、培训和手术量，以确定瑞士未来对内脏外科医生的需求。
本研究分析了2009年至2023年的国家数据集，以评估医学院入学人数、认可的医学文凭、住院医师职位以及普通外科和内脏外科医生的可获得性趋势。此外，对手术量进行了评估，特别关注将胰腺手术作为复杂病例的代表，阑尾切除术作为简单手术的代表。线性回归模型预测了到2040年的发展情况，并纳入了瑞士人口增长预测。
瑞士颁发的以及外国认可的医学文凭数量从2011年的2725份增加到2023年的4647份。预测表明还会进一步增加，到2040年将超过6000份。尽管外科住院医师职位总数略有下降，但普通外科候选人的职位增加了8.7%。普通外科医生总数从2009年的1127人增加到2023年的1557人，在此期间女性比例从10.6%上升到24.9%。从2013年到2023年，每年的阑尾切除术从11529例增加到12412例（增长7.7%），预测到2040年还将进一步增长约14%，不过由于劳动力持续扩张，预计每位外科医生的手术量将会减少。到2023年，内脏外科医生有303人（女性占11%），预测到2040年将增加50%，达到约462人。2016年至2023年期间，胰腺手术病例增加了14.5%，预计到2040年还将再增加25%。然而，预计在未来几年，每位内脏外科医生的复杂手术数量将稳步下降。
预计外科劳动力的扩张将超过瑞士人口的增长。再加上向门诊护理的转变和工作时间的减少，手术操作机会在普通外科和内脏外科中可能变得至关重要。确保培训途径和实践模式适应这些不断变化的需求，对于维持高标准的外科护理至关重要。
