title: Increasing the number of trainees in general surgery residencies: is there capacity?
abstract: OBJECTIVE
  General surgeons have decreased as a proportion of the total U.S. surgical workforce. Given the likelihood of increasing shortages of general surgeons, the authors evaluated available expansion capacity of existing general surgery residency programs.
  
  
  METHODS
  In November 2009, the authors e-mailed a Web-based questionnaire to the program directors and coordinators of the 246 U.S. general surgery residency programs that were then certified by the Accreditation Council for Graduate Medical Education.
  
  
  RESULTS
  Of the 246 programs the authors contacted, 123 (50%) completed the survey. Community hospital programs and academic programs had similar response rates (52% and 50%, respectively). Of the 115 program directors who responded to the relevant question, 92 (80%) reported sufficient existing case volume capacity to accommodate additional surgery residents. Both community and academic program directors reported modest expansion capacity: an average of 1.7 and 2.0 additional residents per year, respectively. Across all programs, the average additional capacity reported was 1.9 additional residents per year. An expansion of this size would increase the number of general surgery residency positions from 1,137 to 1,515 annually. After accounting for subspecialization, this increase of 378 residents would result in approximately 249 additional general surgeons entering the workforce per year after five years.
  
  
  CONCLUSIONS
  Expansion capacity within existing approved general surgery residency programs is insufficient to meet the expected demand for general surgeons in the United States. Strategies to alleviate shortages include developing new training programs, cultivating new medical education funding streams, and changing the surgical training paradigm.
authors: University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina 27599, USA. anthchar@med.unc.edu
authors: Anthony G
authors: AG
authors: Charles
authors: Elizabeth G
authors: EG
authors: Walker
authors: Stephanie T
authors: ST
authors: Poley
authors: George F
authors: GF
authors: Sheldon
authors: Thomas C
authors: TC
authors: Ricketts
authors: Anthony A
authors: AA
authors: Meyer
mesh_terms: D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate / Q000458:organization & administration; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D020380:Needs Assessment; D010820:Physicians / Q000600:supply & distribution*; D011795:Surveys and Questionnaires; D014481:United States; D000078329:Workforce; D016526:Workload