Academic-vs community-based surgical residency programs: Impact on fellowship pursuit and attending practice location.

INTRODUCTION

The influence of residency training environment (academic-based versus community-based) on the geographic distribution of general surgeons and pursuit of fellowship has not been well studied. We aimed to evaluate how residency program type relates to fellowship pursuit and practice location.

METHODS

Data from 202 graduates over 20 years were collected from two general surgery residencies associated with one medical university: one community-based program (CBP) and one academic-based program (ABP).

RESULTS

Fellowship-trained surgeons from both locations were more likely to practice in urban settings (p < 0.001). ABP graduates were significantly more likely to pursue fellowship (77.6% vs. 34.5%, p < 0.001) and were more likely to practice in urban environments (89% vs 71%, p < 0.001).

CONCLUSION

ABP graduates more commonly pursue fellowship training and ultimately practice in urban settings. Despite completing residency in a rural community program, though, over half of CBP graduates practice in urban areas, underscoring the need for further study to expand surgical access.