Effectiveness of a Dedicated Rural General Surgery Residency Track: A 13-Year Analysis of the First ACGME Designated Rural Track.

Background: The shortage of general surgeons in rural America is well documented. The North Dakota community-based general surgery residency program initiated a unique approach to training for rural practice through a dedicated rural track. The rural track included 9 months of rotations in specialty rotations beneficial for rural practice. This study analyzed practice patterns and satisfaction of residents completing rural track training.

Methods: An anonymous voluntary survey was sent to rural track graduates between 2010 and 2022 via the Qualtrics Web site.

Data Collection Included: Specialty rotations completed, specialty procedures currently performing, satisfaction with rural track training, and recommended specialty rotations for future rural track graduates.

Results: Twelve of fifteen graduates (80%) responded. Eighty-three percent of respondents chose the rural track because they desired practice in rural areas and/or desired broad-spectrum surgical practice. One hundred percent of the graduates were satisfied with their training. Seventy-five percent of the graduates came from a rural background, and 75% either previously practiced or currently practice in a rural community. Procedural data demonstrated that 67% of the graduates performed endoscopy procedures, 42% performed hand procedures, and 47% performed C-sections. Rural track graduates desired more experience in urology (50%), ENT, OBGYN, and advanced endoscopy (33%). Experience in plastic surgery, GI, hand surgery, dermatology, and IR was cited as beneficial.

Conclusion: The rural track graduates found significant value in their rural track training that benefited them in practice. Three quarters of the graduates entered rural surgery practice, performing a broad spectrum of procedures.