title: [Identifying ways to address the crisis facing a medical specialty: a case study of general surgery].
abstract: BACKGROUND
  In a previous study we defined criteria for a medical specialty in crisis' and measures to assess the scale of the problem, and possible resolutions suggested based on experience abroad. This study seeks to gain further knowledge by exploring how front-line Israeli surgeons envisage the problems and possible solutions.
  
  
  OBJECTIVE
  To identify ways to address the workforce crisis in general surgery (GS) white focusing on issues that can be dealt with at the department and the hospital levels.
  
  
  METHODS
  An action study of GS conducted in two stages: (1) Semi-structured interviews with 180 GS residents. (2) The use of the retrospective method of "Learning from success" in five general surgical departments recognized as "successful" in attracting residents and integrating them into the departments while providing high-level training.
  
  
  RESULTS
  The factors attracting medical students to specialize in GS are presented along with the problems perceived by residents during their residency. AdditionaLLy, 12 general principles identified in the study are presented, which can be transmitted to and implemented by other GS departments. They are related to three key topics: the mode and quality of residency training; work schedules, departmental organization of work and departmental atmosphere; and the comportment of senior physicians. The value of implementing these principles should be weighed in terms of being identified as constituting "leverage for change".
  
  
  CONCLUSIONS
  Study findings will facilitate recommendations on internal organizational/professional factors of attracting and integrating residents to the specialty and the department. The study can serve as a basis for similar action research in other medical specialties.
authors.affiliation: Smokler Center for Health Policy Research, Myers-JDC-Brookdale Institute. nuritn@jdc.org.il
authors.forename: Nurit
authors.initials: N
authors.lastname: Nirel
authors.forename: Ayala
authors.initials: A
authors.lastname: Hendin
authors.forename: Micha
authors.initials: M
authors.lastname: Rabau
mesh_terms: D002321:Career Choice; D003625:Data Collection; D013502:General Surgery; D006801:Humans; D007396:Internship and Residency; D007557:Israel; D012189:Retrospective Studies; D013038:Specialization; D013337:Students, Medical / Q000523:psychology*; D000078329:Workforce