Future demand for visceral surgeons in Switzerland: an empirical study.

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Conclusions: 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.