RURAL SURGERY TRAINING PROGRAMS IN THE UNITED STATES:
A REVIEW OF THE LITERATURE
Abstract: Rural surgery training programs have been developed to train general surgeons for community and rural service. There are 10 rural surgery training programs in the United States. Rural surgery training began in 1974 in LaCrosse, Wisconsin to prepare general surgery residents for rural service. There is a national shortage of general surgeons which translates into a deficit of surgeons in rural areas. The terms “general surgeon” and “rural surgeon” are not synonymous as rural surgery is more extensive, more broad-based and more subspecialty with more trauma, burn care and wound care and far more endoscopic and laparoscopic procedures. There are many advantages to rural general surgery training programs. A well-trained rural surgeon with OB/GYN experience can handle 66% of all inpatient operations in a rural hospital.
Rural surgery programs have been developed to address the above problems and attract graduating general surgeons to communities and rural areas. These programs have had high general surgery practice and high rural placement. Selection of appropriate campus, hospital and attending staff is critical for the educational experience to be maximal. Attending surgeons need to be general surgeons, rural surgeons and subspecialty surgeons. The American College of Surgeons (ACS) has developed the Advisory Council for Rural Surgery (ACRS). The ACRS has developed a repository of rural training experiences and training sites. There are five different types of training experience ranging from rotations to dedicated tracks to fellowships. Rural surgery training programs are a mechanism to attract more medical students to general surgery residencies, more graduating chief general surgery residents to private practice in community and rural areas, improve the case numbers and confidence of graduating surgery residents, and improve the quality of surgical care in this country.