Is General Surgery on the Verge of Demise?

Abstract

Although general surgery remains one of the most respected residencies available to medical students today, it is facing terrible pressures, including less attraction to surgery as a profession, increasing interest in surgical sub specialization, and high attrition rates. In November 2007, Josef Fischer sounded an alarm among physicians in the US with the commentary: “The impending disappearance of the general surgeon,” published in the Journal of the American Medical association. He note that the reasons for the “disappearance” were multiple including fewer graduating surgical residents pursuing general surgery as well as less favourable working conditions and less lucrative reimbursement for general surgeons. In the U.S. the imminent demise of the general surgeon has been a growing concern for the medical community and the general public, both who fear an end to a once robust medical discipline and its consequences for patients with general surgical problems. There is an abundance of literature addressing the challenges facing general surgery. Longo3 in Yale University School of Medicine in the USA reported that 5% to 20% of residents leave general surgery training annually compared to roughly 3% to 5% of physicians who leave medicine voluntarily. The Association of Surgeons of South Africa has identified and was concerned about the decline in the number of applicants for registrar posts and the critical shortage of general surgeons in the state sector