title: Is a broadly based surgical residency program more likely to place graduates in rural practice?
abstract: BACKGROUND
  There is a shortage of general surgeons practicing in rural America. Rural surgical practices differ from those in urban settings encompassing a broader case mix with a larger percentage of time spent performing abdominal, alimentary, gynecological, genitourinary, and orthopedic procedures. Present graduates of many general surgical residencies do not obtain the range of experience necessary to practice effectively in this environment. We hypothesize that general surgical residents undergoing broadly based training are more likely to practice in a rural location.
  
  
  METHODS
  We conducted a survey of graduates from the Mary Imogene Bassett Hospital's (MIBH) broadly based surgical residency program in 2004. Additionally, the surgical resident logs from the Accreditation Council for Graduate Medical Education (ACGME) and the residency program were reviewed for years 2001-2004.
  
  
  RESULTS
  Of the 56 surveys sent out, 42 (75%) were completed and used in the analysis. A majority of the general surgeons who were raised in a rural environment reported that they are residing and practicing in a rural setting. Graduates of the MIBH residency program, on average, performed more cases as residents in the following subspecialty areas: genitourinary, plastics/hand, gynecology, neurosurgery, and orthopedics than national residency graduates.
  
  
  CONCLUSIONS
  Based on our findings, surgical residents graduating from a broadly based training program appear more likely to practice in a rural setting.
authors.affiliation: The Mithoefer Center for Rural Surgery, Bassett Healthcare, One Atwell Road, Cooperstown, New York 13326, USA. brit.doty@bassett.org
authors.forename: Brit
authors.initials: B
authors.lastname: Doty
authors.forename: Steven
authors.initials: S
authors.lastname: Heneghan
authors.forename: Michael
authors.initials: M
authors.lastname: Gold
authors.forename: James
authors.initials: J
authors.lastname: Bordley
authors.forename: Patrick
authors.initials: P
authors.lastname: Dietz
authors.forename: Samuel
authors.initials: S
authors.lastname: Finlayson
authors.forename: Randall
authors.initials: R
authors.lastname: Zuckerman
mesh_terms: D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D019035:Rural Health Services; D014481:United States