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. 2005 Jun;48(3):219-24.

Training of Canadian general surgeons: are they really prepared? CAGS questionnaire on surgical training

William G Pollett  1 , Elizabeth Dicks
Affiliations

Training of Canadian general surgeons: are they really prepared? CAGS questionnaire on surgical training

William G Pollett et al. Can J Surg. 2005 Jun.

Abstract
in English, French

Background: General surgery in Canada varies from single system subspecialty practice in large centres to multisystem broad-based practice in smaller communities. We have attempted to determine whether Canadian training programs in general surgery are appropriate for these varied practices.

Methods: A questionnaire was circulated to members of the Canadian Association of General Surgeons to collect demographic data and information about community size and patterns of practice. We also sought the source of training for general surgical subspecialties and other surgical specialties if applicable.

Results: Surgeons in smaller communities performed significantly more subspecialty and other specialty surgical practice than do surgeons in larger communities. Much of the training for this practice comes not from the primary fellowship but from senior colleagues in the community. Surgeons in smaller communities feel less well prepared than their colleagues in larger communities and are less likely to take additional fellowship training.

Conclusion: These results have important implications for surgical educators and manpower planners.

Contexte: Le contexte de la chirurgie générale au Canada varie d'une pratique de surspécialité à système unique dans les grands centres à une pratique générale à systèmes multiples dans les petites collectivités. Nous avons tenté de déterminer si les programmes de formation au Canada en chirurgie générale conviennent à la variation de la pratique.

Méthodes: Un questionnaire a été transmis aux membres de l'Association canadienne des chirurgiens généraux afin de recueillir des renseignements et données démographiques sur la taille des collectivités et les tendances de la pratique. Nous avons également cherché la source de formation des surspécialités en chirurgie générale et des autres spécialités chirurgicales, au besoin.

Résultats: Les chirurgiens des petites collectivités pratiquent beaucoup plus d'interventions de surspécialités et autres spécialités que les chirurgiens des grands centres. La plus grande partie de la formation relative à cette pratique ne provient pas du fellowship de premier niveau mais bien des collègues plus expérimentés au sein de la collectivité. Les chirurgiens des petites collectivités se sentent moins bien préparés que leurs collègues des grands centres et sont moins susceptibles de suivre un autre fellowship pour approfondir leur formation.

Conclusion: Ces résultats comportent des répercussions importantes pour les formateurs en chirurgie et les planificateurs de la main-d'œuvre.

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Figures

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FIG. 2. Years in practice.
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FIG. 1. Age distribution.
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FIG. 3. Size of community in which those who had post-fellowship training practised (n = 240).
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FIG. 5. Size of community according to surgical specialties other than general surgery. p < 0.001 for all specialties. Black = plastic surgery, dark grey = obstetrics and gynecology, white = orthopedic surgery, light grey = urology.
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FIG. 4. Rate of other specialty practice.
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FIG. 7. Size of community according to general surgery subspecialty practice. p values for subspecialties are as follows: head and neck surgery (black bars) <0.001, vascular surgery (white bars) <0.007, thoracic surgery (grey bars) <0.009.
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FIG. 6. Rates of general surgery subspecialty practice.
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FIG. 8. Sources of training for other specialties. Black = fellowship training, diagonal lines = senior colleague training, white = self trained, light grey = course or preceptor training, dark grey = other training.
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FIG. 9. Sources of training in the subspecialties of head and neck surgery, vascular surgery and thoracic surgery. Black = fellowship training, diagonal lines = senior colleague training, white = self trained, light grey = course or preceptor training, dark grey = other training.
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FIG. 11. Preparedness for practice according to community size. Black = <50 000, white = >50 000–100 000, grey = >100 000.
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FIG. 10. Opinions of respondents with respect to how the primary fellowship prepared them for practice.
See this image and copyright information in PMC

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