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

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.