Ten-year reassessment of the shortage of general surgeons: Increases in graduation numbers of general surgery residents are insufficient to meet the future demand for general surgeons

Background: In 2008, we projected that a deficit in the general surgical workforce would grow to 19% by 2050. We reexamined population-based general surgical workforce projections to determine the impact of recent changes in population estimates and trends in certification and General Surgery Residency. Methods: We reviewed the Census Bureau data and the potential pool of general surgeons defined by American Board of Surgery certificates, residents completing Accreditation Council for Graduate Medical Education-approved General Surgery Residency and combined American Board of Surgery and osteopathic certificates averaged from 2007-2016. The model included removal of 150 surgeons/year who subspecialize and 729 retirements/year. Results: Updated census projections estimate a 2050 U.S. population of 439 million, a 19 million increase over prior census projections. From 2007-2016, the American Board of Surgery granted 10,173 certificates, averaging 1,017/year; General Surgery Residency graduations were 10,088, averaging 1,088/year; combined American Board of Surgery and osteopathic (American Osteopathic Association) certificates were 10,084, averaging 1,084/year. General surgical workforce shortage in 2050 is projected to be 7,047 (21%) based on American Board of Surgery certificates; 4,917(15%) based on General Surgery Residency completions; 5,037 (15%) based on combined American Board of Surgery and American Osteopathic Association certificates; and 57 (0%) based on hypothetical expansion of general surgeons training by 75 positions by 2021. Conclusions: Without increasing future general surgeons training numbers, the projected future general surgical workforce shortage will continue to grow. (C) 2018 Elsevier Inc. All rights reserved.