Patterson R H
Acta Neurochir Suppl. 1997;69:30-2. doi: 10.1007/978-3-7091-6860-8_8.
Over the past ten years, an average of 135 residents have entered neurosurgical training in the United States each year. These neurosurgeons-to-be come from about 250 applicants who annually enter the national matching program for neurosurgery. After completing training, they join a pool of practicing neurosurgeons that includes about 3,260 board certified neurosurgeons and an additional 390 practicing neurosurgeons who are still in the certification process. The pool of active neurosurgeons does not increase by 135 surgeons each year since the forces of retirement and death serve to decrease it. Judging by the experience of some large Health Maintenance Organizations, who employ no more neurosurgeons than are necessary to supply their enrolled members, the net result is that the USA has at present about the proper number of neurosurgeons necessary to meet the needs of the country. No one can predict future needs for neurosurgeons with accuracy, and it is safer not to set the number of neurosurgeons based on a guess. We do need to restrict the number of trainees to that number we can train properly. The quality of our neurosurgeons needs to be maintained. Beyond that, the market place, however imperfect, is a better long-term regulator of numbers than any governmental or privately-based committee.
在过去十年中，美国每年平均有135名住院医师开始接受神经外科培训。这些未来的神经外科医生来自约250名每年参加全国神经外科匹配计划的申请者。完成培训后，他们加入了执业神经外科医生群体，其中包括约3260名获得委员会认证的神经外科医生以及另外390名仍在认证过程中的执业神经外科医生。由于退休和死亡因素会使执业神经外科医生群体数量减少，所以每年活跃的神经外科医生数量并不会增加135名。从一些大型健康维护组织的经验来看，它们雇佣的神经外科医生数量仅满足注册会员的需求，结果是美国目前拥有的神经外科医生数量大致刚好能满足国家需求。没有人能准确预测未来对神经外科医生的需求，基于猜测来设定神经外科医生数量并不稳妥。我们确实需要将学员数量限制在我们能够妥善培训的数量范围内。我们需要保持神经外科医生的质量。除此之外，尽管市场并不完美，但从长远来看，它比任何政府或私人委员会更能调节医生数量。
