Caseload in rural general surgical practice and implications for training.

Abstract

Despite increasing specialization within general surgery, many general surgeons, particularly in rural practice, continue to treat a wide range of conditions. The aim of the present paper was to provide accurate information on three rural surgeons' case-loads to illustrate the spectrum of surgery encountered and to assist in the planning of rural general surgical training. A review was conducted of a prospectively maintained database of operations performed by three rural general surgeons in different parts of Victoria, Australia over a 5-year period. A large volume and wide range of procedures was performed by each surgeon, who averaged more than 500 operations per year (excluding endoscopies). Although most were within the range of procedures covered in the Royal Australasian College of Surgeons (RACS) Fellowship in general surgery, some encroached upon other specialties such as orthopaedics, urology, paediatric surgery and obstetrics/gynaecology. Operations outside of 'general' surgery reflected individual training and local community needs. The current RACS Fellowship in general surgery, augmented by training in other specialties as required, will help prepare general surgeons for rural practice.