Rural Surgery Experiences in General Surgery Residency Training—The Current State an ACGME Sponsored Survey of General Surgery Program Directors

Abstract

OBJECTIVE

Nationwide there is a significant shortage of surgeons in rural communities, which has led to a growing interest in training more general surgeons specifically for entry into rural practice. Despite noble intentions, exactly how this training should be performed is unclear, and highly variable across programs. The Accreditation Council for Graduate Medical Education (ACGME) Surgery Residency Review Committee (RRC) sought to better understand the current state of rural focused training options in general surgery residencies.

DESIGN

The Surgery RRC surveyed all 314 ACGME accredited surgery programs about their rural surgery training options.

PARTICIPANTS

General surgery residency programs.

RESULTS

One hundred thirty programs responded to the survey, of which 37 (28%) included some type of rural experience (rural track, or a required or elective rotation). Three programs had fully dedicated tracks with separate match numbers, while other programs recruited from within, or simply offered elective rotations to interested residents. There was significant variability in the structure, duration, timing, and frequency of experiences across programs. Lack of funding was identified as the number one barrier to new or ongoing development of rural surgery programs.

CONCLUSION

Rural surgery training is highly variable across general surgery residency programs, ranging from dedicated rural tracks with deliberate recruitment, to short elective experiences. This mismatch of available training to current and future workforce needs is an opportunity for innovation.