What impact might general surgery practice patterns of colon and rectal surgeons have on future training?

Currently, surgeons specialize in colon and rectal surgery after a complete residency and certification in general surgery. The American Board of Surgery is proposing reorganization of surgical training; only two to four years of general surgery would be required followed by two to three years of specialization. The general surgery practice patterns of colon and rectal surgeons are unknown. The purposes of this study were to evaluate the current practice patterns of colon and rectal surgeons and to quantify the frequency and type of general surgical procedures performed. Active candidates, members, and fellows of The American Society of Colon and Rectal Surgeons were asked to complete an online survey. Results collected from November 18 to 26, 2004 were included. Data were self-reported. A total of 772 surgeons were included in the analysis; 7 percent were candidates, 29 percent were members, and 64 percent were fellows. Sixty-three percent had been practicing for 20 years or less and 64 percent were younger 50 years of age. Colon and rectal practice consisted of 28 percent abdominal surgery, 14 percent laparoscopic surgery, 28 percent anorectal surgery, and 30 percent endoscopy. Fifty-six percent of colon and rectal surgeons reported performing general surgery procedures with an average of 25 percent of their practice being general surgery. The most common procedures were herniorrhaphy (87 percent), cholecystectomy (76 percent), and appendectomy (33 percent). The most common reasons for general surgery practice were practice (52 percent) and emergency room requirements (43 percent). Currently, colon and rectal surgeons perform general surgery procedures in clinical practice. If general surgery residency of future trainees is shortened, the types of procedures colon and rectal surgeons will be competent to perform may need to be redefined. This will have profound implications on training programs, certification requirements, and future practice patterns.