The developing crisis in the National General Surgery Workforce

BACKGROUND: The number of surgeons willing to practice general surgery in its traditional form is in decline. One becomes acutely aware of this shortage, as a residency program director, given the many requests for new general surgeons (GS). STUDY DESIGN: From the 7th of February 2007 through the 30th of April 2007, and from May 23, 2007 through August 10, 2007, one program director collected all solicitations and advertised openings sent to him for a new GS. These communications varied from email submissions to formal letters. To assess the economic impact of a GS on a hospital, data were collected from existing recruiting industry surveys, the chief financial officer of a large inner-city teaching hospital, and an individual rural surgeon. RESULTS: There were 140 openings nationally for GSs during the initial study period. During the second study period, there were 149 positions in 40 states. The annual economic worth of a GS was estimated to be between $1.05 million and $2.4 million. CONCLUSIONS: Currently, there is an imbalance in supply and demand for the field of general surgery. If GSs retire or leave small hospitals and cannot be replaced, those hospitals will be threatened with closing. This will strain the large, safety-net hospitals even more. Solutions should include a national workforce survey, allowing hospitals to supplement a surgeon's income, the Residency Review Committee for Surgery should consider an immediate 20% increase in the number of categorical spots in general surgery, and focused recruitment of medical graduates from other countries.