Hello, cwbrd!
Thank you for your patience while I compiled my answer. I found some
good information for most of the specialties, but statistics were
especially scarce for colorectal surgeons. It is surprising how few
numbers and projections are available for most of these physician
specialties, overall. Even digging deep within various search
parameters brings up only a few relevant articles.
If you would like to follow up with further questions, please feel
free. This line of research is actually quite interesting! I will be
fairly busy through next Tuesday, and should then have some time free
to work more intensively. However, if you should decide to post
another question soon, I can always pick away at the research in any
spare time I have available. I will keep my eyes open just in case.
*********************
EMERGENCY PHYSICIANS
*********************
Some results from a 1997 study of Emergency Medicine:
* "32,026 physicians fill 24,548 full time equivalent (FTE) positions
in the nation's 4,945 hospitals with emergency departments."
* "There are 4.96 FTEs per emergency department, with a ratio of 1.5
physicians for each FTE."
* "The average number of emergency physicians per hospital was 7.48."
* "99% (or 933) reported their emergency departments operate 24 hours
a day, and 86% (810) reported that physicians staff the department
during all hours of operations.
* "47% of responding hospitals reported the use of physician
assistants, nurse practitioners or both to supplement physicians."
* "58% of emergency physicians are residency trained and/or board
certified in emergency medicine (53% were board certified)."
* "Academic medical centers have the largest percentage of
residency-trained or board-certified emergency physicians (65%)."
* "The highest percentage of non-residency-trained and/or board
certified physicians are in rural locations and federal facilities."
* "Of those who are board certified, 48% were certified with the
American Board of Emergency Medicine (ABEM); 3% with the Board of
Certification in Emergency Medicine (BCEM); and 4% with the American
Osteopathic Board of Emergency Medicine (AOBEM)."
* "31% of emergency physicians have additional medical specialty
training or are certified in other specialties, the dominant ones
being internal medicine (14%) and family practice (9%)."
* "The average age of emergency physicians was found to be 42."
* "Emergency physicians are predominantly white (81%) and male (83%)."
* "The highest percentage of female emergency physicians practice in
academic medical centers."
* "Public facilities, both federal and nonfederal, employ the highest
percentage of ethnic minority physicians, and younger emergency
physicians on average practice in urban hospitals."
See "ACEP Begins Phase Two of Workforce Study." American College of
Emergency Physicians. Summe 1999. http://www.acep.org/1,483,0.html
==
1998 statistics:
Number (nationwide): 32,000 (1998 est. by ACEP).
"Entries to and exits from field per year: 500 new board-certified ER
physicians per year. About 40% of ER physicians now certified, still a
shortage situation but much less dramatic than 10 years ago. Other
physician enter ER practice through variety of paths."
From "Emergency Medicine at a Glance." (included in article: Emergency
MDs' Pay Heads Upward as Shortage Looms.) Physician Compensation
Report, Jan 31, 2001.
http://www.findarticles.com/p/articles/mi_m0FBW/is_3_2/ai_70204915/pg_2
==
The excerpt that follows is from an "undated" article, but the
projections for shortages are footnoted to a 1997 article:
"Today there are more than 30,000 practicing emergency physicians with
over 14,500 certified by the American Board of Emergency Medicine.
With approximately 100 million annual emergency department visits in
over 4900 hospitals, it is easy to calculate the severe shortage of
qualified emergency physicians. Current projections are that this
shortage will extend at least for the next 2-3 decades." (2,3)
From "Emergency Medicine as a Career Choice," by V. Gail Ray, MD and
Richard C. Lotsch, DO. Society for Academic Emergency Medicine.
http://www.saem.org/inform/career.htm
==
(1997 statistics)
"The survey was conducted of Emergency Departments drawn from a
representative sample of all hospitals with Emergency Departments
identified in the 1995 American Hospital Association database. The
study was guided by the Lewin Group, a nationally recognized research
firm with extensive experience in workforce studies.
"The results indicate that in 1997 there were approximately 32,000
physicians working in Emergency Departments and that only 52% were
certified by the American Board of Emergency Medicine or the American
Osteopathic Board of Emergency Medicine."
From "Shortage of Board-Certified Emergency Physicians - A Study of
the Workforce in Emergency Medicine," by John C. Moorhead, M.D.,
Michael E. Gallery,....Ann Emerg Med. 1998; 5:595-607.
http://www.aaem.org/boardcertification/shortage.shtml
==
Concerning the shortage of ER specialists (not the same as an ER physician):
"In an election year, healthcare is a big issue. For emergency room
patients with life threatening injuries, a new study by the American
College of Emergency Physicians finds there is a nationwide shortage
of emergency room specialists. The study reveals two thirds of
emergency departments are having trouble with on-call specialist
coverage. That's nearly 1,000 hospitals in the country. Experts say
shortages can cause delays in treatment, which can lead to serious
complications."
"According to the study, one reason for the shortage of specialists is
recent changes to a federal law that oversees how hospitals schedule
on-call specialists. The American College of Emergency Physicians also
says the ongoing medical liability crisis is another factor. Liability
premiums are skyrocketing in many states, and many doctors can't find
malpractice insurance to cover them when they treat patients in the
ER. There also are 45 million uninsured patients in the U.S. who get
healthcare in the ER because they have nowhere else to go."
From "NEW STUDY FINDS SEVERE LACK OF EMERGENCY ROOM SPECIALISTS
AFFECTS PATIENTS DAILY.
http://www.prnewswire.com/broadcast/20182/consumer.shtml
==
Shortage of ER specialists
"The American College of Emergency Physicians (ACEP) today said the
new EMTALA [Emergency Medical Treatment and Labor Act] regulation from
the Centers for Medicare & Medicaid Services (CMS) creates uncertainty
that could potentially increase the shortage of on-call medical
specialists available to provide backup support to emergency
departments and multiply the number of patients transferred to
hospitals able to provide this coverage."
"Without a hospital or on-call physician obligation to provide
emergency specialist backup, some hospitals may choose not to provide
emergency coverage at all. Therefore, the new rule could potentially
leave only a few hospitals left with medical specialists, which means
those hospitals may be flooded with emergency patients..."
From "New EMTALA Regulation Could Increase Shortage of On-Call
Specialists in Emergency Departments. Press Release. American College
of Emergency Physicians. September 3, 2003.
http://www.acep.org/1,33022,0.html
==
Additional articles:
"Shortage of on-call specialists alarms emergency room chiefs," by
Angela Stewart. Star Ledger. October 08, 2004
http://www.nj.com/news/ledger/jersey/index.ssf?/base/news-7/1097215980126760.xml
*************
INTENSIVISTS
*************
"In 1995, less than 30 percent of ICUs were staffed by full-time
intensivists. By 1999, they provided care to only one-third of all ICU
patients (Angus et al., 2000). Today there are 6,000 to 7,000 actively
practicing intensivists in the United States. They spend, on average,
only about a quarter of their time providing ICU care (Rosenfeld et
al., 2000). It is estimated that four times as many full-time
intensivists would be needed to provide around-the-clock staffing for
the more than 7,000 ICUs in this country. Experts project that as the
U.S. population ages this shortage of intensivists will become
increasingly acute. Angus and colleagues (2000) predict that by 2020
the supply of intensivists
will meet only 22 percent of the demand for their services."
Read "Intensivist Staffing in Intensive Care Unites (ICUs)," by Jason
S. Lee, Ph.D. AcademyHealth
http://www.academyhealth.org/syntheses/icu.htm
==
"According to the Leapfrog Group, an association of Fortune 500
companies leading the reform movement, "Intensivists, physicians
specially trained to care for critically ill patients, should staff
intensive care units (ICUs). Almost 5 million patients are admitted to
ICUs each year in the U.S., and more than 500,000 of these patients
die. Studies reveal that at least one in ten patients who die in ICUs
every day would survive if dedicated intensivists were present in the
ICU and managing their care."
** "Unfortunately, there is a severe shortage of intensivists. Less
than 6,000 are actively practicing in the United States, leaving less
than 15% of ICUs receiving dedicated intensivist care. With our aging
population we can expect to experience a greater shortage in the
future."
From "Solving the Critical Care Crisis." VISICU (no date)
http://www.visicu.com/solving/
==
From the GME Medical News:
"The shortage of physician intensivists is "unprecedented, and largely
unrecognized," and will lead to denial of standard critical care
services for large populations of patients with serious illnesses,
according to a recent white paper from the critical care professional
societies."
"If the current trend persists, shortages of these specialists,
combined with the current shortages of critical care nurses,
pharmacists, and respiratory therapists, will become severe by 2007
and will worsen through 2030," write the authors of The Critical Care
Medicine Crisis: A Call for Federal Action."
See "Coming soon: Intense shortage of intensivists?" GME News. June 2004
http://www.ama-assn.org/ama/pub/category/12590.html#12_data_info
==
From a 2002 article:
Section - "Intensivist Labor Shortage - Implications for Intensivists and Others":
"The best information about ICU staffing comes from the Committee on
Manpower for Pulmonary and Critical Care Societies (COMPACCS) survey
performed in 1999 by Abt Associates and sponsored by the Society of
Critical Care Medicine, the American Thoracic Society and the American
College of Chest Physicians.5
** "This workforce survey found that only 15 percent of U.S. hospitals
have dedicated intensivists, and half of all ICU patients are not seen
by an intensivist. The survey also highlighted the presence of a
severe shortage of intensivists. There are approximately 5,500
practicing intensivists in the United States, and most of these devote
only a fraction of their time to critical care. Probably less than 20
percent of these actually provide dedicated ICU care. Depending on
hours of coverage, between 10,000 and 25,000 full-time intensivists
would be required to implement dedicated intensivist coverage for all
U.S. ICUs. Moreover, the COMPACCS survey suggests that the number of
intensivists will likely not increase over the next decade. The
magnitude of the intensivist shortage will create difficulties for
hospitals trying to move to dedicated staffing models."
Read "A New Beginning for Anesthesia Critical Care: Changes and
Challenges for the Workforce." American Society of Anesthesiologists
Newsletter. August 2002, Volume 66.
http://www.asahq.org/Newsletters/2002/8_02/new_begin.htm
==
From an article concerning pulmonary care:
"In 1997 (the most recent year for which figures are available),
intensivists cared for 36.8% of all ICU patients, the study revealed."
"The supply and demand for intensivists will remain essentially
unchanged until 2007, the authors forecasted. The demand will then
rapidly increase, but the supply will remain about the same, producing
a shortfall of 22% by 2020 and 35% by 2030."
Read "PHYSICIAN SHORTAGE LOOMS IN PULMONARY AND CRITICAL CARE."
Pulmonary Reviews.com. Vol. 6, N0. 4 April 2001.
http://www.pulmonaryreviews.com/apr01/pr_apr01_shortage.html
************************
CARDIOTHORACIC SURGEONS
************************
"A new study done by the Society of Thoracic Surgeons shows that the
number of physicians entering training to become heart surgeons is too
low to replace the surgeons who will retire by 2010. That shortage
worries Kevin Accola, MD, and other cardiac surgeons, because the
number of people older than 60 expected to need heart surgery will
increase by 13 million in 10 years."
"The society analyzed data from the National Resident Matching
Program, which places medical school graduates. The study found that
the number of cardiothoracic surgical training positions has remained
steady in the last 10 years, at roughly 140. But applicants for those
positions have dropped from 197 in 1995 to 145 in 2002, with U.S.
medical school graduates interested in the residencies declining from
156 to 107 during that period."
"Data showed that 21 of 144 positions available for cardiothoracic
surgery have not been filled in residency programs that start in
2003."
"It used to be we had several applicants for one position. Now it's
one for one," said Douglas Behrendt, MD, chair of cardiothoracic
surgery at the University of Iowa Carver College of Medicine in Iowa
City."
"The problem is magnified, the study said, because a significant
number of cardiothoracic surgeons will retire by 2010. The thoracic
society estimates that 50% of surgeons will retire by that year."
Read further....
From "Cardiac surgeon shortage likely if low residency trend
continues," by Damon Adams, AMNews staff. Aug. 26, 2002.
http://www.ama-assn.org/amednews/2002/08/26/prsb0826.htm
==
"A distinct shortage of cardiothoracic surgeons could develop over the
next five to 15 years. Surgeons in the field have stuck with it
despite income declines, Philip says, but enrollment for fellowships
is way down in response to the declines. He adds that there probably
will be many retirements from the field over the next 10 years. "It's
a life-saving, end-of-line service," he notes."
"A recent academic piece forecasts a 42% jump in cardiothoracic
surgery procedures between now and 2020 based on aging of the
population and frequencies of various cardiothoracic procedures by
patient age. Ronald Evans, CMPE, executive director of South Texas
Cardiothoracic & Vascular Surgery Associates in San Antonio, predicts
that despite the loss of procedures to cardiology, there will be
plenty of demand for cardiothoracic surgery over the next 10 to 15
years unless a drug is developed that "wipes out atherosclerosis," the
disease syndrome that underlies most heart disease."
From "Heart surgeon pay plans range from production to equal shares."
Physician Compensation Report, Sept, 2003.
http://www.findarticles.com/p/articles/mi_m0FBW/is_9_4/ai_106954763
==
Predicted increase in Cardiothoracic Procedures:
"Cardiothoracic surgery--Up 18% by 2010 and 41% by 2020."
From "Demands on surgeon work force to grow rapidly through 2020."
Physician Compensation Report, Sept, 2003
http://www.findarticles.com/p/articles/mi_m0FBW/is_9_4/ai_106954764
**************
NEUROSURGEONS
**************
The nationwide shortage of neurosurgeons is highlighed in a recent
abstract of an oral presentation to the American Association of
Neurological Surgeons in May 2004:
Results: "Five hundred thirty-nine neurosurgery positions were
advertised in 1991, and this number decreased each year until 1995 to
297. After 1995, the number increased each year to a high of 786 in
2002. The number of neurosurgery residency positions did not change
during that time period (128 in 1991; 134 in 2002). The number of
residency applicants decreased from 425 in 1995 to 287 in 2002. Data
from the American College of surgeons indicate that all surgeons are
retiring at an earlier age, in part due to dissatisfaction with the
workplace environment, decreasing reimbursement, and the rising cost
of malpractice insurance."
Conclusion: "There is a shortage in the neurosurgery workforce. The
number of neurosurgery residency positions has not changed, resulting
in a stasis in the number of physicians entering neurosurgery. The
number of residency positions needs to be increased to meet the
increased demand, and an effort should be made to retain
neurosurgeons."
See "Trends in Neurosurgery Supply and Demand," by Oren N. Gottfried,
MD, Richard L. Rovit, MD and William T. couldwell, MD. American
Association of Neurological Surgeons. May 6, 2004.
http://www.aans.org/annual/770.pdf
==
The above statistics are fleshed out in a recent press release from the AANS:
"Data from the American Board of Neurological Surgeons indicate that
the total number of practicing neurosurgeons declined after 1998, and
by 2003 the number had dropped to 3,080, fewer than in 1991."
"It is important to note that while the demand for neurosurgeons has
steadily increased since 1996, the number of active neurosurgeons has
decreased, reflecting a relative shortage in the workforce," said
William Couldwell, MD, PhD, an author of the recent study. "To
summarize, the shortage in the neurosurgery workforce creates
significant new pressures on the specialty, and the factors
contributing to this shortage need to be immediately identified,
evaluated and addressed."
"In the recent study from the University of Utah and Albany Medical
Center, neurosurgeons evaluated the total annual number of applicants
for neurosurgery residencies, the total annual number of residency
graduates choosing to enter neurosurgery, and the total annual number
of board-certified practicing neurosurgeons. In addition, the total
annual number of available academic and private neurosurgery staff
positions was determined by examining all relevant recruitment
advertisements in the Journal of Neurosurgeryand Neurosurgery for the
10-year period from 1994 through 2003. The numbers of board-certified
practicing neurosurgeons, graduating residents, and applicants to
neurosurgery residencies were acquired from the American Board of
Neurological Surgeons (ABNS) and the San Francisco Match."
"The authors found that the number of neurosurgical positions
advertised in the Journal of Neurosurgery and Neurosurgery increased
from an average of 141.6 per year for a five-year period from 1994
through 1998, to an average of 282.4 per year for the five-year period
from 1999 through 2003. It was noted that the total number of
positions nearly tripled from a low of 110 in 1995 to 297 in 2003.
There were more private practice than academic positions advertised in
all years. In addition, the number and percentages of advertisements
for subspecialists were higher for academic positions than for private
practice positions; the mean percentage of subspecialty positions per
year was 36.2 for academic and 6.7 for private positions.
From "Relative Shortage of Neurosurgeons in the U.S. Alarms the
Medical Specialty." AANS.org. May 2003.
http://www.aans.org/Library/Article.aspx?ArticleId=21791
==
From a 2002 article concerning the effects of the rising cost of
liability insurance:
"Neurosurgeons are moving to states where PLI costs are relatively
stable. Mississippi, for instance, has lost 30% of its neurosurgeons
in the past two years. Patients now must travel great distances, often
going out-of-state to get neurosurgical care."
* "Further exacerbating this problem is the looming manpower shortage
caused by a high retirement rate. According to the American Board of
Neurological Surgery, in 2001 alone, over 300 neurosurgeons retired.
This is 10 percent of our nation?s neurosurgical workforce and for the
first time in over a decade, there are now fewer than 3,000 board
certified neurosurgeons practicing in the United States."
Read "Neurosurgery in a State of Crisis - Report on the State of
Professional Liability Insurance Rates and the Impact on Neurosurgeons
and their Patients." American Association of Neurological Surgeons.
September 25, 2002. http://src.senate.gov/pdf/rpt_neuro092502.pdf
==
Several sections of the Fall 2004 newsletter, "Neurotrauma and
Critical Care News", highlight the increasing shortage.
In a section concerning neurosurgeons and the emergency room, Alex B.
Valadka, MD writes:
"The frustrations of practicing neurosurgery in this climate have
driven many of us to retire early. The Boston Globe reports that,
between 1998 and 2002, the number of practicing neurosurgeons in the
United States decreased by 11 percent. The result: Fewer hands to
divide the growing workload. And yet, the emergency rooms keep calling
us."
Read "The ER Calls How Will Neurosurgeons Answer? Neurotrauma &
Critical Care. Fall 2004.
http://www.neurosurgery.org/sections/tr/newsletter/trauma0904.pdf
==
Predicted increase in Neurosurgical procedures:
"Neurosurgery--Up 14% by 2010 and 27% by 2020."
From "Demands on surgeon work force to grow rapidly through 2020."
Physician Compensation Report, Sept, 2003
http://www.findarticles.com/p/articles/mi_m0FBW/is_9_4/ai_106954764
******************
VASCULAR SURGEONS
******************
I found very little data after an exhaustive search, but perhaps the
following references will provide a bit of help!
Some speculation on the future shortage of vascular surgeons:
"...Patients older than 65 years will exhibit a 73% increase from 2010
to 2030, with a subsequent greater need for more vascular operations,
which are predicted to be 1,020,067 in 2020, compared with 583,000 in
1992. A larger workforce will be required to meet this need. Although
innovative technology and changes in health care delivery may cause
unpredictable changes in these anticipated workforce needs, the
potential exists that there will be insufficient numbers of surgeons
available to provide adequate surgical care early in the next century,
unless changes occur in the training and practice of general and
vascular surgeons."
From "The changing vascular surgery workforce," by Stanley JC. Semin
Vasc Surg. 1997 Jun;10(2):65-71.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9203256
==
The following link is for a more recent, speculative abstract, but I
found it more confusing than helpful!
"Vascular surgery training in the United States, 1994 to 2003." Cronenwett JL.
J Vasc Surg. 2004 Oct;40(4):660-9; discussion 669.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15472592
==
The following data regarding the number of vascular surgeons is from the 1980's:
"Inherent in any analysis of vascular surgical manpower must be
accurate data on surgical rates and numbers of surgeons who perform
vascular operations. For in-depth analysis of age-sex standardized
vascular operative rates from 1979 to 1984 and a determination of
current manpower levels, data from the National Center for Health
Statistics (NCHS) and the American Board of Surgery (ABS) were
reviewed. During 1979 to 1984, total vascular surgical procedures
increased 50%. In 1983 such operations comprised 11% of all general
surgical procedures and 3% of all operations performed in this
country. In 1983, 95,000 carotid endarterectomies, 74,000 peripheral
bypasses, were performed. Through November 1984, among approximately
1600 surgeons who had applied to take the General Vascular Surgery
Examination, 676 took the examination and 545 passed. What percentage
of all vascular surgeons these 1600 represent is unknown.
Consequently, what percentage of the total vascular operative load
their own experiences represent is uncertain. As of May 1985, the
Residency Review Committee for General Surgery had approved 42
fellowship positions in 29 vascular training programs. How these
training figures will change to meet optimal manpower requirements
remains undefined. Although data concerning operative rates have
become more precise, forecasting manpower needs will be met with
skepticism because of unknown current and future numbers of vascular
surgeons and their average caseloads. Regardless of these
uncertainties, vascular surgeons, program directors, and health
analysts should be aware of such information because until we know how
many vascular surgeons are necessary to provide optimal care, training
and certification can not rationally evolve."
From "An analysis of vascular surgical manpower requirements and
vascular surgical rates in the United States." Rutkow IM, Ernst CB. J
Vasc Surg. 1986 Jan;3(1):74-83.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3941484
==
Manpower data from the 1970's and early 1980's:
See "Vascular surgical manpower. Too much? Enough? Too little?
Unknown?" Rutkow IM, Ernst CB. Arch Surg. 1982 Dec;117(12):1537-42.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7149973
==
Regarding vascular surgery operations:
"The Committee on Workforce Issues of the Society for Vascular Surgery
(SVS) and the North American Chapter, International Society for
Cardiovascular Surgery (NA-ISCVS) generated data on the numbers and
trends of operations performed and workforce requirements to provide
surgical care of patients with vascular disease. Data for analysis
were obtained from The National Center for Health Statistics-National
Hospital Discharge Survey and questionnaires sent to 2732 vascular
surgeons. The data showed that SVS/NA-ISCVS and regional vascular
society (RVS) surgeons performed 51% of 583,000 vascular procedures
undertaken in the United States in 1992. This represents a 24%
increase over the 41% reported in 1985 by similarly defined surgeons.
Analysis of 1992 index cases documented that SVS/NA-ISCVS and RVS
surgeons accounted for 80% of 31,000 aortoiliofemoral bypasses, 68% of
46,000 aortic aneurysmectomies, 64% of 91,000 carotid
endarterectomies, and 72% of 98,000 angioaccess procedures. The mean
numbers of vascular operations performed in 1992 by SVS/NA-ISCVS and
RVS surgeons were 144 and 100, respectively. These procedures
represented 64% and 39% of the total surgical caseload of SVS/NA-ISCVS
and RVS surgeons, respectively. American Board of Surgery
(ABS)-certified vascular surgeons performed a mean of 171 vascular
operations in 1992. Other surgeons, including ABS-certified general
surgeons, appear to be performing fewer vascular operations."
From "Vascular surgery in the United States: workforce issues. Report
of the Society for Vascular Surgery and the International Society for
Cardiovascular Surgery, North American Chapter, Committee on Workforce
Issues." Stanley JC, Barnes RW, Ernst CB, Hertzer NR, Mannick JA,
Moore WS. J Vasc Surg. 1996 Jan;23(1):172-81.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8558735
==
You may view a more dated abstract below:
From "Vascular surgery in the United States. Report of the Joint
Society for Vascular Surgery--International Society for Cardiovascular
Surgery Committee on Vascular Surgical Manpower." Ernst CB; Rutkow IM;
Cleveland RJ; Folse JR; Johnson G Jr; Stanley JC. J Vasc Surg. 1987
Dec; 6 (6), pp. 611-21.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3694761
********************
COLORECTAL SURGEONS
********************
There is a nearly complete absence of information about the number,
job outlook and future prospects for colorectal surgeons. It may be
due to the fact that this seems to be a relatively new surgical
specialty. This first tiny article from the AAMC website is all I
could find that addressed the job outlook for this specialty.
"According to the American Society of Colon and Rectal Surgeons,
"there seem to be more than ample job opportunities for graduates of
colon and rectal training programs with the large majority of trainees
limiting their practices to colon and rectal surgery. An increasing
number of university surgical departments are now recruiting colon and
rectal surgeons for their facilities." The annual salary for surgeons
ranges from $158,000 to $318,000.
Source: The American Board of Medical Specialties, the American
Society of Colon and Rectal Surgeons and the Faculty Salary Survey,
2002, Association of American Medical Colleges
From "Careers in Medicine: Specialty Information - Colon and Rectal
Surgery." Association of American Medical Colleges.
http://www.aamc.org/students/cim/pub_colonrectal.htm
==
The following references might provide some helpful insight, but not much!
"From 1989 through 1996, 446,082 procedures have been listed by 417
colorectal residents, an average of 1,060 cases per resident. When
contrasted with the operative experience of a general surgery
resident, the colorectal resident performs substantially more
anorectal operations, more endoscopic procedures, and more index
abdominal operations in one year than the average general surgery
resident performs in five years
"Colon and rectal surgery: a true subspecialty." Schoetz DJ Jr. Dis
Colon Rectum. 1998 Jan;41(1):1-10.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9510304
==
Also see "The specialty of colon and rectal surgery: its impact on
patient care and role in academic medicine." Longo WE. Yale J Biol
Med. 2003 Mar 1;76(2):63-77.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15369633
==
"How much colorectal surgery do general surgeons do?" Hyman N. J Am
Coll Surg. 2002 Jan;194(1):37-9.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11800338
******************
GENERAL SURGEONS
******************
"The number of applicants to general surgery residency programs has
dropped 30% during the last nine years, according to studies in the
March issue of the Archives of Surgery. One of the studies projects
that by 2005 only 4.8% of U.S. graduating medical students will be
interested in general surgery."
From "Cardiac surgeon shortage likely if low residency trend
continues," by Damon Adams, AMNews staff. Aug. 26, 2002
http://www.ama-assn.org/amednews/2002/08/26/prsb0826.htm
==
"The general surgeon, made larger than life by TV medical dramas, is
becoming scarce as medical students increasingly choose less demanding
fields. Medical students are more likely to be married and female than
they were a generation ago. And unlike large numbers of their
predecessors, many actually want a life outside medicine, students and
doctors say."
The number of applicants to residency programs in general surgery has
dropped 30 percent in the last nine years, according to studies in the
March issue of the journal Archives of Surgery. The trend began in the
1980s, but last year was the first since then that the number of
general-surgery positions offered to U.S. medical-school graduates
exceeded the number of students interested, the studies say."
* "American Medical Association figures show the number of general
surgeons grew steadily in the 1970s and '80s but slipped from 38,376
in 1990 to 36,650 in 2000."
"Last year, 68 residency positions in general surgery were untaken.
They eventually were filled, many with foreign medical-school
graduates, a trend that is expected to continue, Bland said."
From "Shortage of general surgeons is seen," by Lindsey Tanner.
Philadelphia Inquirer. March 15, 2002.
http://www.philly.com/mld/inquirer/living/health_science/2864537.htm?1c
==
"The American College of Surgeons has acknowledged the looming general
surgeon shortage over the next decade. Simply, medical students are
not choosing general surgery as their career. With ever increasing
numbers of general surgeons retiring and fewer being trained, a crisis
will exist in which surgical care will be rationed as patients will
find serious delays with diagnosis and treatment."
"Why aren't medical students choosing general surgery? There are
multiple plausible explanations. One surely is that they have scant
exposure early in their medical school experience to what the career
of a general surgeon truly is. By the time they reach their third year
rotations, many have already been pre programed to not even consider
general surgery."
From "CT Chapter Continues Mentoring Program to Encourage Med Students
to Pursue Careers in General Surgery for 2004." Connecticut Chapter of
the American College of Surgeons. Spring 2004.
http://www.ctacs.org/whatsnew/whatsnew.html
==
Some general numbers on the projected need for general surgery:
"When you need a qualified surgeon in the coming years, will there be
one available? Maybe not, according to a new study by UCLA
researchers. Due to an aging population, demand for surgery will
increase nearly 50 percent for some specialties by the year 2020. The
new study, featured in the August 2003 issue of the Annals of Surgery,
predicts shortages for most surgical specialties."
"General surgery, which included vascular, abdominal,
gastrointestinal, hernia, breast and pediatric surgery, demonstrated a
13 percent growth by the year 2010, increasing to 31 percent by 2020."
Read "UCLA study reveals surgeon shortage." Press Release. July 23, 2003.
http://www.eurekalert.org/pub_releases/2003-07/uoc--usr072303.php
==
The impact of liability insurance on general surgeons:
"One of the hardest-hit specialties in the liability insurance crisis
is general surgery. While surgeons in some of the highest premium
states find greener pastures in other states, many general surgeons
can?t find places to go where they can comfortably afford to practice.
Alabama and Alaska are the only U.S. states where insurers did not
hike liability premiums by at least 10 percent over the last year.
Some experts fear that the developing shortage of general surgeons can
only be exacerbated by their sky-high premiums. "The nursing and
anesthesia shortages get the most press, but there is also an alarming
shortage of surgeons in many specialties. General surgery is one of
the most greatly affected specialties," says Hiram Polk Jr., MD,
senior professor and chairman of the department of surgery the
University of Louisville Health Sciences Center. "The number of
practicing general surgeons dwindles nationally and there are more
positions available in medical schools than there are aspiring general
surgeons to fill them."
From "Medical Malpractice Rates Hinder General Surgery Nationwide."
Outpatient Surgery Magazine. November 2002.
http://www.outpatientsurgery.net/2002/os11/news.shtml
==
Some older numbers:
RESULTS--"We found that approximately 600 graduates of general surgery
residency programs enter the practice of general surgery each year,
and we found a close correlation between maximum and minimum estimates
of the number of fully trained general surgeons engaged in active
patient care, certified general surgeons who are not retired, and
currently certified general surgeons. This number (17,289 to 23,502)
is approximately half that commonly used in calculations of the
general surgery workforce (38,239). The larger number includes
surgeons with subspecialty training beyond general surgery, surgical
residents, and surgeons not engaged in patient care."
From "Calculating the workforce in general surgery." Jonasson O,
Kwakwa F, Sheldon GF. JAMA. 1995 Sep 6;274(9):731-4.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7650827
==
Predicted increase in General Surgical Procedures:
"General surgery--Up 13% by 2010 and 28% by 2020."
From "Demands on surgeon work force to grow rapidly through 2020."
Physician Compensation Report, Sept, 2003
http://www.findarticles.com/p/articles/mi_m0FBW/is_9_4/ai_106954764
======
Once again, I hope this information is helpful!
Sincerely,
umiat
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