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Keywords

Rural Surgery, Rural Surgery Training, General Surgery

Abstract

RURAL SURGERY TRAINING PROGRAMS IN THE UNITED STATES:

A REVIEW OF THE LITERATURE

Abstract: Rural surgery training programs have been developed to train general surgeons for community and rural service. There are 10 rural surgery training programs in the United States. Rural surgery training began in 1974 in LaCrosse, Wisconsin to prepare general surgery residents for rural service. There is a national shortage of general surgeons which translates into a deficit of surgeons in rural areas. The terms “general surgeon” and “rural surgeon” are not synonymous as rural surgery is more extensive, more broad-based and more subspecialty with more trauma, burn care and wound care and far more endoscopic and laparoscopic procedures. There are many advantages to rural general surgery training programs. A well-trained rural surgeon with OB/GYN experience can handle 66% of all inpatient operations in a rural hospital.

Rural surgery programs have been developed to address the above problems and attract graduating general surgeons to communities and rural areas. These programs have had high general surgery practice and high rural placement. Selection of appropriate campus, hospital and attending staff is critical for the educational experience to be maximal. Attending surgeons need to be general surgeons, rural surgeons and subspecialty surgeons. The American College of Surgeons (ACS) has developed the Advisory Council for Rural Surgery (ACRS). The ACRS has developed a repository of rural training experiences and training sites. There are five different types of training experience ranging from rotations to dedicated tracks to fellowships. Rural surgery training programs are a mechanism to attract more medical students to general surgery residencies, more graduating chief general surgery residents to private practice in community and rural areas, improve the case numbers and confidence of graduating surgery residents, and improve the quality of surgical care in this country.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

References

REFERENCES

  1. Moesinger R, Hill B: Establishing a Rural Surgery Training Program: A Large Community Hospital, Expert Subspecialty Faculty, Specific Goals and Objectives in Each Subspecialty, and an Academic Environment Lay a Foundation. J Surg Ed 2009; 66:106-112.
  2. Cogbill TH, Cofer JB, Jarman BT: Contemporary Issues in Rural Surgery. Curr Probl Surg 2012; 49:263-318.
  3. Stain SC, Cogbill TH, Ellison EC, Britt LD, Ricotta JJ, Calhoun JH, Baumgartner WA: Surgical Training Models: A New Vision. Curr Probl Surg 2012: 49:565-623.
  4. Landercasper J, Bintz M, Cogbill TH, Bierman SL, Buan RR, Callaghan JP, Lottman JK, Martin WB, Andrew MH, Lambert PJ: Spectrum of General Surgery in Rural America. Arch Surg 1997; 132:494-497.
  5. Cogbill TH, Jarman BT: Rural General Surgery Training: The Gundersen Lutheran Approach. Surg Clin N Am 2009; 89:1309-1312.
  6. Antonenko DR: Rural Surgery: The North Dakota Experience. Surg Clin N Am 2009; 89: 1367-1372.
  7. Lockett H, Browder W: Back to the Future: General Surgery Training at East Tennessee State University. The American Surgeon 2009; 75(1):11-14.
  8. Milligan JL, Nelson HS, Mancini ML, Goldman MH: Rural Surgery Rotation during Surgical Residency. The American Surgeon 2009; 75(9):743-746.
  9. Giles WH, Arnold JD, Layman TS, Sunida MP, Brown PW, Burns RP, Cofer JB: Education of the Rural Surgeon: Experience from Tennessee. Surg Clin N Am 2009; 89:1313-1319.
  10. American College of Surgeons: Rural Surgery Program. Available at http://www.facs.org/residencysearch/specialties/rural.html. 6/6/14.
  11. Burkholder HC, Cofer JB: Rural Surgery Training: A Survey of Program Directors. J Am Coll Surg 2007; 204:416-421.
  12. Doty B, Heneghan S, Gold M, Bordley J, Dietz P, Finlayson S, Zuckerman R: Is a Broadly Based Surgical Residency Program More Likely to Place Graduates in Rural Practice? World J Surg 2006; 30:2089-2093.
  13. Deveney K, Hunter J: Education for Rural Surgical Practice: The Oregon Health & Science University Model. Surg Clin N Am 2009; 89:1303-1308.
  14. Fischer JE: How to Rescue General Surgery (Editorial Opinion). Am J Surg 2012; 204:541-542.
  15. Gillman LM, Vergis A: General Surgery Graduates May be Ill Prepared to Enter Rural or Community Surgical Practice. Am J Surg 2013; 205:752-757.
  16. Halverson AL, Hughes TG, Borgstrom DC, Sachdeva AK, DaRosa DA, Hoyt DB: What Skills Rural Surgeons Need to Master. J Am Coll Surg 2013; 217:919-923.
  17. Smoot RL, Farley DR: Minnesota General Surgeons—Where Do They Come From? Minnesota Medicine 2006 Dec., 46-48.
  18. Deveney K, Deatherage M, Oehling D, Hunter J: Association Between Dedicated Rural Training Year and the Likelihood of Becoming a General Surgeon in a Small Town. JAMA Surg 2013; 148(9):817-821.
  19. Campos-Outcalt D: A Case for Special Programs to Expand the Ranks of Rural Physicians. Virtual Mentor—American Medical Association Journal of Ethics 2011;13 (5):317-319.
  20. Doty B, Zuckerman R, Borgstrom D: Are General Surgery Programs Likely to Prepare Future Rural Surgeons? J Surg 2009; 66:74-79.
  21. Vickers SM: “UAB School of Medicine Update: Training the Next Generation of Physicians.” 2014 Annual Meeting, Medical Association of the State of Alabama, Sandestin, FL, May 23, 2014.
  22. Chen PW: Are Today’s New Surgeons Unprepared? NY Times.com/2013/12/12.
  23. Reynolds FD, Goudas L, Zuckerman RS, Gold MS, Heneghan S: A Rural, Community-based Program Can Train Surgical Residents in Advanced Laparocopy. J Am Coll Surg 2003; 197:620-623.
  24. Sticca RP, Mullin BC, Harris JD, HosfordCC: Surgical Specialty Procedues in Rural Surgery Practices: Implications for Rural Surgery Training. Am J Surg 2012: 204:1007-1013.
  25. Borgstrom DC: Rural Surgical Practice Requires New Training Model, Offers Great Opportunities. Bulletin American College of Surgeons 2013; 98(7):55-56.
  26. Borgstrom DC, Heneghan SJ: Bassett Healthcare Rural Surgery Experience. Surg Clin N Am 2009; 89:1321-1323.
  27. Farmer D: Rural Surgery is Global Surgery (Letter). JAMA Surg 2013; 148(9):821.
  28. Waddle BJ: Rural Surgery—Opportunity or Minefield. Arch Surg 2000; 135:121-122.

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