title: Surgical specialty procedures in rural surgery practices: implications for rural surgery training.
abstract: BACKGROUND
  Specialty procedures constitute one eighth of rural surgery practice. Currently, general surgeons intending to practice in rural hospitals may not get adequate training for specialty procedures, which they will be expected to perform. Better definition of these procedures will help guide rural surgery training.
  
  
  METHODS
  Current Procedural Terminology codes for all surgical procedures for 81% of North Dakota and South Dakota rural surgeons were entered into the Dakota Database for Rural Surgery. Specialty procedures were analyzed and compared with the Surgical Council on Resident Education curriculum to determine whether general surgery training is adequate preparation for rural surgery practice.
  
  
  RESULTS
  The Dakota Database for Rural Surgery included 46,052 procedures, of which 5,666 (12.3%) were specialty procedures. Highest volume specialty categories included vascular, obstetrics and gynecology, orthopedics, cardiothoracic, urology, and otolaryngology. Common procedures in cardiothoracic and vascular surgery are taught in general surgical residency, while common procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology are usually not taught in general surgery training.
  
  
  CONCLUSIONS
  Optimal training for rural surgery practice should include experience in specialty procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology.
authors.affiliation: Department of Surgery, University of North Dakota, School of Medicine and Health Sciences, Grand Forks, ND 58203, USA. robert.sticca@med.und.edu
authors.forename: Robert P
authors.initials: RP
authors.lastname: Sticca
authors.forename: Brady C
authors.initials: BC
authors.lastname: Mullin
authors.forename: Joel D
authors.initials: JD
authors.lastname: Harris
authors.forename: Clint C
authors.initials: CC
authors.lastname: Hosford
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003479:Curriculum / Q000592:standards*; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000592:standards; D009658:North Dakota; D019035:Rural Health Services / Q000706:statistics & numerical data*; D013023:South Dakota; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*