Summary of findings for rural surgical workforce characteristics
| Publication | Country | Context | Primary findings |
|---|---|---|---|
| Breon et al., 2003 (29) | United States | Assessment of need for rural surgeons in Iowa | 64% of rural surgeons were recruiting a partner compared with 50% of urban surgeons 77% of rural surgeons felt that there was a shortage in the rural workforce |
| Bruening and Maddern, 1998 (24) | Australia | Characterizing the rural Australian workforce | 134 male surgeons; 3 female surgeons; 41% of rural surgeons were raised in a rural setting |
| Decker et al., 2013 (83) | United States | Assessment of the available general surgery positions in Wisconsin and Oregon | 71 positions available; 46% were rural, and only 18% required fellowship training; 67% of graduates enter fellowships |
| Doty et al., 2006 (36) | United States | Survey to determine the characteristics of graduates from a New York general surgery program | Surgeons raised in a rural area were more likely to choose a career in rural surgery |
| Doty et al., 2009 (38) | United States | Survey of rural hospitals recruitment of general surgeons and use of locum tenens surgeons | 56% of surveyed hospitals recruited for a general surgeon; 30% have been unable to fill the position and 20% used locum tenens surgeons |
| Ellison et al., 2021 (39) | United States | Estimation of the American general surgeon work force needs | Population growth in the US will outpace the number of trained general surgeons; the increased need in urbanized areas will negatively affect rural recruitment |
| Gates et al., 2003 (41) | United States | Survey of West Virginia rural surgeons | Only 5 female rural surgeons Average age of rural surgeons was 57; rural surgeons were more likely to have been raised in a rural community |
| Germack et al., 2019 (43) | United States | Assessment of the impact from the closure of rural hospitals on local communities | In the years before a hospital closure, there is a loss of general surgery capability; at the time of closure there is a substantial loss of all specialties remaining in the community |
| Glenn et al., 1988 (84) | United States | Defining the community requirements to support a general surgeon | To support a general surgeon, a population base of 15 000 and 11 referring physicians is required |
| Ingraham et al., 2021 (85) | United States | Survey of all US acute care hospitals, outlining emergency general surgery coverage gaps | 2811 hospitals responded; 279 hospitals are unable to provide 24/7 emergency surgical services Rural hospitals and nonteaching hospitals were less likely to provide 24/7 emergency surgical coverage |
| Kwakwa and Jonasson, 1997 (50) | United States | Characteristics of the American general surgical workforce | 19 791 general surgeons were identified; only 6.9% of surgeons work in a rural area |
| Jarman et al., 2009 (48) | United States | Factors correlating to a resident’s choice of rural practice | Rural surgeons were more likely to be male Completing high school or university in a rural setting correlated to selecting a rural career Completion of a rural clerkship was also correlated to pursuing a career in rural general surgery |
| Lynge, 2008 (52) | United States | Defining the rural general surgery workforce | Rural surgeons were more likely to be male, female surgeons were less likely to work in a rural setting, and, on average, rural surgeons were older |
| Roos, 1983 (21) | Canada | Defining the impact of rural surgeons in local utilization of surgical services | Arrival of a surgeon in a rural area increased the utilization of surgical services in that area, and decreased the number of procedures completed outside of the home centre Departure of a surgeon increased the workload of their surgical colleagues but did not decrease the local utilization of surgical services |
| Roos et al., 1996 (86) | Canada | Determining optimal workforce planning in rural general surgery | Defined 3 methods of determining the number of surgeons The first model was based on an optimal ratio of surgeons to population The second assessed the number of procedures where patients travelled out of their home communities to receive care The third model analyzed recruitment needs based on an assessment of the proportion of the population requiring surgery compared with other areas |
| Rourke, 1998 (22) | Canada | Assessment of surgical services in small Ontario hospitals | Between the years 1988 and 1995 there was a decrease in 24/7 coverage for general surgery, but the number of procedures completed increased; there were fewer general surgeons practising in these smaller communities |
| Schroeder et al., 2020 (23) | Canada | Assessment of the scope of practice of all rural Canadian surgeons | Rural surgeons were older on average, there were fewer female surgeons, and rural surgeons were more likely to be international graduates |
| Shanmugakumar et al., 2017 (26) | Australia | Characterizing the rural general surgery workforce in Western Australia | 18 hospitals completed the survey; 89% were serviced by fly-in and fly-out surgical services, and 2 hospitals had a resident general surgeon |
| Stringer et al., 2020 (62) | United States | Description of the loss of surgical workforce at rural hospitals in Kansas | Most rural sites in Kansas did not have a permanent surgeon Lack of surgical services at rural and frontier hospitals leads to a higher amount of patient transfers |
| Thompson et al., 2005 (63) | United States | Characterizing the American general surgery workforce | Rural surgeons were more likely to be male and older, and were more likely to be international medical graduates |
| Zuckerman, 2007 (66) | United States | Telephone survey of rural and urban surgeons, assessing endoscopy volume and training needs | 51% of rural surgeons were from a rural background v. 38% of urban surgeons |