General surgery graduates may be ill prepared to enter rural or community surgical practice

BackgroundRural/community surgery presents unique challenges to general surgeons. Not only are they required to perform “classic” general surgery procedures, but they are also often expected to be competent in other surgical disciplines.MethodsFinal-year Canadian-trained residents in general surgery were asked to complete the survey. The survey explored chief residents' career plans for the following year and whether or not they would independently perform various procedures, some general surgical, and others now considered within the domain of the subspecialties.ResultsSixty-four residents (71%) completed the survey. Twenty percent planned to undertake a rural surgical practice, 17% an urban community practice, and 55% had confirmed fellowships. Most residents (>90%) expressed comfort with basic general surgical procedures. However, residents were less comfortable with subspecialty procedures that are still performed by general surgeons in many rural practices.ConclusionsMore than half of graduating general surgery residents are choosing subspecialty fellowship training over proceeding directly to practice. Those choosing a rural or community practice are likely to feel ill prepared to replace existing surgeons.