The U.S. has “remained inherently dependent” on international medical school graduates to sustain its ranks of general surgeons, but the number of graduates from foreign programs practicing here is declining and this could create “a crisis of urgency” and exacerbate a projected general surgeon shortage, concluded a report in the Journal of the American College of Surgeons.
Report notes U.S. dependence on international graduates to provide general surgeons
Although the report's authors calculated that the number of general surgeons has risen slightly—from 17,394 in 1981 up almost 2% to a current level of 17,727—it has not kept pace with U.S. population growth. The report cited a study that notes how there were 7.68 general surgeons per 100,000 U.S. residents in 1981, compared with 5.69 per 100,000 in 2005—a decline of almost 26%.
The number of general surgeon training positions has only increased 1.3% in five years, from 1,051 residency slots to 1,065 in 2009, the report stated, adding that five slots went unfilled at the time of the 2009 residency match--though 1,079 U.S. senior medical students had applied for general surgery training. They also predict that resident work hour limits could lead to requiring a 30% increase in the resident workforce to meet the same work output.
The report noted that the percentage of foreign medical school graduates in general surgery has decreased from 17.4% of general surgeons in 2005, to only 14.8% now; and that the overall number of general surgeons working in small, rural practices has fallen almost 39% since 2005.
Until domestic production of general surgeons increases, the nation is dependent on graduates of foreign medical schools, the report concluded, but those graduates are now facing resistance to their applications, potential political and bureaucratic barriers, and uncertainty in their ability to travel.
“This might jeopardize resident workforce, create resentment among fellow residents, and risk an individual's required training time,” the report said. “We are now at a critical point where we cannot provide for our own citizens through our medical education system.”
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