title: General surgery in crisis--the critical shortage.
abstract: BACKGROUND
  General surgery is facing a serious crisis. There has been a significant decline in the number of applicants for registrar posts and an inability to attract and retain general surgical specialists in the state sector. The Association of Surgeons of South Africa (ASSA) undertook this study to determine the extent and cause of the problem.
  
  
  METHODS
  The study involved a combination of desk research and structured interviews. In addition, the Health Professions Council of South Africa (HPCSA) database was reviewed and compared with the South African Medical Association (SAMA) and ASSA databases. The medical schools provided information about student numbers and demographics, and the National Department of Health pro vided information about the status of medical practitioner and specialist posts in the state sector.
  
  
  RESULTS
  Overall, 26.1% of the specialist posts were vacant. The situation was particularly critical in Mpumalanga and the Eastern Cape, where 84% and 58% of the specialist posts were vacant. Using a predictive model, a conservative estimate of the need for general surgeons was found to be at least 50 per year. Currently the eight medical schools graduate about 25 general surgeons per year. The changing demographics of medical students may be partly responsible for the decline in registrar applicants.
  
  
  CONCLUSIONS
  The findings from this study have revealed that the shortage of general surgeons in the state sector has reached critical levels.
authors.affiliation: Association of Surgeons of South Africa and Department of Surgery, University of Cape Town.
authors.forename: D
authors.initials: D
authors.lastname: Kahn
authors.forename: S
authors.initials: S
authors.lastname: Pillay
authors.forename: M G
authors.initials: MG
authors.lastname: Veller
authors.forename: E
authors.initials: E
authors.lastname: Panieri
authors.forename: M J R
authors.initials: MJ
authors.lastname: Westcott
mesh_terms: D002321:Career Choice; D004503:Education, Medical, Graduate / Q000639:trends*; D004641:Emigration and Immigration; D005194:Family Practice / Q000193:education; D005260:Female; D013502:General Surgery / Q000193:education; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D011057:Politics; D017149:Private Sector; D017150:Public Sector; D012570:School Admission Criteria; D012577:Schools, Medical; D013019:South Africa; D013038:Specialization; D013337:Students, Medical; D000078329:Workforce