American Surgical Association
2009 Annual Meeting Abstracts

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The Estimated Cost of Training the Future Surgical Workforce
*Thomas E Williams, Jr., Jr., *Bhagwan Satiani, *Andrew Thomas, E. Christopher Ellison
Ohio State University, Columbus, OH

Objectives: To estimate the workforce needed by 2030 in seven surgical specialties to serve a population of 364 million people and to quantify the cost associated with training additional surgeons. Materials and Methods: A review of the certificates granted in otolaryngology, orthopedic surgery, thoracic surgery, obstetrics and gynecology, neurosurgery, urology, and general surgery was conducted. Using a population-based algorithm we extended the results of Richard Cooper’s pioneering work to these fields of surgery. The assumptions were: unchanged physician to population ratio, 30 years in practice from completion of residency to retirement, no revision of the Balanced Budget Act of 1997 and therefore no additional residency positions offered. Per resident expenses were estimated at $80,000 including salaries, benefits, and other direct medical education costs.
Results: We will have to train more than 100,000 surgeons by 2030 in order to maintain access for our citizens (see TOTAL, column 6) .
          
SPECIALTYYEARSCERTIFIC-TOTALSHORTAGETOTALNUMBERMANPERTOTAL
ANDTOATIONSTRAINED TO BEPERYEARSCLASSCOST
POPULATIONTRAINPER2011 TO TRAINEDCLASSPERCOST2011 TO
RATIO YEAR2030 2011 TO CLASSAT $80,0002030
     2030  MILLIONSMILLIONS
          
OB-GYN -27.241,20024,00013,63637,6361,8827,527$602$12,044
ENT- 3.253006,0002,5168,5164262,129$170$3,406
ORTHO - 6.5565013,0004,35517,3558684,339$347$6,942
GENERAL - 7.551,00020,0002,52522,5251,1265,631$451$9,010
UROLOGY - 3.3152605,2003,8849,0844542,271$182$3,634
NEURO - 1.0661252,5002282,728136818$65$1,309
THORACIC - 1.4221002,0001,9943,994200399$32$639
          
TOTAL 3,63572,70029,138101,8385,09223,115$1,849$36,984

Conclusions:
1.
There will not be enough surgeons in the seven specialties studied..
2.
We will have to train more than 100,000 surgeons by 2030 in order to maintain access for our citizens at an annual cost of almost $2,000,000,000.
3.
That will cost almost $37,000,000,000 - an extra cost of more than $10,000,000,000.
4.
To do this, the Balanced Budget Act of 1997 must be revised to permit more residents to be trained in the United States.


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