Establishing a Rural General Surgery Residency Program: Identifying Community Stakeholder Perception and Obstacles of a de Novo Residency in Rural Appalachia.

Abstract

Rural healthcare has become more challenging over the past several years with increasingly limited access to surgical care in the rural setting. The Accreditation Council for Graduate Medical Education (ACGME) has recently introduced the Rural Track Program (RTP) initiative to combat physician shortage in rural areas. We intend to start the first Rural General Surgery Residency program under the RTP designation in rural Appalachia. 430 community stakeholders were surveyed regarding the anticipated impact of a new training program. Questions focused on the understanding of a Residency Program, the care provided by residents, impact on availability of local care, current geographical limitation of surgical care, and potential benefits/obstacles of the training program. Over 90% of all surveyed approved of training surgeons locally, with the local government believing that the program would be a good investment for the community. Several locals had been treated by resident physicians at other facilities and the majority were satisfied with the care they received. Several families frequently travel to larger cities for surgical care, with 96% of all respondents believing that the program would provide better access to care locally. Our study demonstrated that the community is familiar with healthcare in a training facility and welcoming to a local training program, while believing that trainees will have a positive impact on local surgical care in rural Appalachia. We will continue to work with the local community and healthcare personnel while developing the program and tailor our Residency to the rural setting as able.