Are we producing general surgeons who are ready for community or rural practice?

Are we producing general surgeons who are ready for community or rural practice?

Can J Surg 2021;64(5):E467-E472 | PDF

Jake Hiebert, MD; Leo Chen, MSc; Hamish Hwang, MD


General surgery remains a broad and unclearly defined specialty in small and medium-sized communities, where general surgeons perform more subspecialty and non-core procedures than their urban counterparts. It is unclear what specific procedures are being performed or whether today’s residents are being trained to meet community needs. We surveyed the members of the British Columbia (BC) Surgical Society and found that only 3% of BC’s surgeons believe today’s graduates are “definitely prepared” for a broad-based community practice. We also identified several non-core procedures performed more frequently by general surgeons in small and medium-sized communities. General surgery residency is narrowing its focus despite the fact that community general surgeons are maintaining a broad-based practice. To meet the needs of smaller communities, residency programs need to address the discrepancies that exist between the emphasis within the current training structure and the practice of our community surgeons.

Accepted Sept. 12, 2020

Affiliations: From the Division of General Surgery, University of British Columbia, Vancouver, BC.

Competing interests: Hamish Hwang is an associate editor of CJS; he was not involved in the review or decision to accept this paper for publication. No other competing interests were declared.

Contributors: All authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication.

Content licence: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See:

Disclaimer: The views expressed in this article are those of the authors, and do not represent the views of the University of British Columbia nor the UBC general surgery residency program.

DOI: 10.1503/cjs.014119

Correspondence to: J. Hiebert, General Surgery Residency Program, University of British Columbia, 2775 Laurel St, Vancouver BC V5Z 1M9,