title: A proposal for enhancing the general surgical workforce and access to surgical care.
abstract: OBJECTIVE
  The goals of this focused meeting were to verify and clarify the causes and extent of the general surgery (GS) workforce shortfalls. We also sought to define workable solutions within the existing framework of medical accreditation and certification.
  
  
  BACKGROUND
  Numerous peer-reviewed and lay reports describe a current and worsening availability of GS services, affecting rural areas as well as large cities, academia, and the military.
  
  
  METHODS
  Primary recommendations were broadly agreed upon by attendee surgeons who were selected from numerous different professional scenarios and included 2 nonmedical observers.
  
  
  RESULTS
  
  
  
  CONCLUSIONS
  (1) enhance the number of GS trainees and the breadth of training, (2) incorporate more flexibility and breadth in residency, (3) minimally invasive surgery should largely return to GS, (4) broader use of community hospitals in these efforts, (5) publicize loan forgiveness and improved visa status for international medical graduates going into GS, and (6) select candidates with a bias toward a general surgical career.
  
  
  CONCLUSIONS
  These methods are promising approaches to this serious deficiency but will require regular reporting and publicity for the recording of actual increases in GS output.
authors.affiliation: Department of Surgery, University of Louisville, Louisville, KY 40292, USA. hcpolk01@louisville.edu
authors.forename: Hiram C
authors.initials: HC
authors.lastname: Polk
authors.forename: Kirby I
authors.initials: KI
authors.lastname: Bland
authors.forename: E Christopher
authors.initials: EC
authors.lastname: Ellison
authors.forename: Jay
authors.initials: J
authors.lastname: Grosfeld
authors.forename: Donald D
authors.initials: DD
authors.lastname: Trunkey
authors.forename: Steven C
authors.initials: SC
authors.lastname: Stain
authors.forename: Courtney M
authors.initials: CM
authors.lastname: Townsend
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004501:Education, Medical / Q000191:economics / Q000379:methods / Q000639:trends; D005550:Foreign Medical Graduates / Q000191:economics; D013502:General Surgery / Q000191:economics / Q000193:education / Q000639:trends; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006764:Hospitals, Community; D006801:Humans; D008887:Military Medicine; D019060:Minimally Invasive Surgical Procedures / Q000193:education / Q000639:trends; D014146:Training Support; D014481:United States; D000078329:Workforce