title: Projecting surgeon supply using a dynamic model.
abstract: OBJECTIVE
  To develop a projection model to forecast the head count and full-time equivalent supply of surgeons by age, sex, and specialty in the United States from 2009 to 2028.
  
  
  BACKGROUND
  The search for the optimal number and specialty mix of surgeons to care for the United States population has taken on increased urgency under health care reform. Expanded insurance coverage and an aging population will increase demand for surgical and other medical services. Accurate forecasts of surgical service capacity are crucial to inform the federal government, training institutions, professional associations, and others charged with improving access to health care.
  
  
  METHODS
  The study uses a dynamic stock and flow model that simulates future changes in numbers and specialty type by factoring in changes in surgeon demographics and policy factors.
  
  
  RESULTS
  : Forecasts show that overall surgeon supply will decrease 18% during the period form 2009 to 2028 with declines in all specialties except colorectal, pediatric, neurological surgery, and vascular surgery. Model simulations suggest that none of the proposed changes to increase graduate medical education currently under consideration will be sufficient to offset declines.
  
  
  CONCLUSIONS
  The length of time it takes to train surgeons, the anticipated decrease in hours worked by surgeons in younger generations, and the potential decreases in graduate medical education funding suggest that there may be an insufficient surgeon workforce to meet population needs. Existing maldistribution patterns are likely to be exacerbated, leading to delayed or lost access to time-sensitive surgical procedures, particularly in rural areas.
authors.affiliation: Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. erin_fraher@unc.edu
authors.forename: Erin P
authors.initials: EP
authors.lastname: Fraher
authors.forename: Andy
authors.initials: A
authors.lastname: Knapton
authors.forename: George F
authors.initials: GF
authors.lastname: Sheldon
authors.forename: Anthony
authors.initials: A
authors.lastname: Meyer
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Ricketts
mesh_terms: D004503:Education, Medical, Graduate; D005260:Female; D005544:Forecasting; D006280:Health Workforce / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010820:Physicians / Q000600:supply & distribution* / Q000639:trends; D012179:Retirement; D017678:Sex Distribution; D013043:Specialties, Surgical / Q000193:education / Q000639:trends; D014481:United States