ACS Bulletin - April 2015

of which institution provides medical liability insurance also must be determined.

All of the previous details of the program must be included in the program letter of agreement and master contract between institutions before the program begins. The parent program must apply to the ACGME RRC for surgery in advance of any new program or rotation of six months or more in length. Shorter elective or required rotations do not necessitate advanced approval, although the rotation must still comply with all ACGME regulations.

The ACS intervenes

The American College of
Surgeons (ACS) offers several
resources to help establish rural
surgical programs, training, and
sites. One type of experience that
may have relevance for the future
of rural general surgery is the
ACS Transition to Practice (TTP)
Program, which is designed
to help better prepare new
graduates of surgical residency
for independent practice. These
programs may be customized
for a graduate who has a specific
type of future practice location in
mind and are ideal for preparing
a new graduate to enter a rural
practice. TTP fellows are best
placed in independent hospitals
without a general surgery
residency program, to avoid
any erosion of surgical resident
case volume or operative
experience. 5 Details about the
TTP Program are available
at www.facs.org/education/
program/ttp.

In addition, the members of the Education Committee of the ACS Advisory Council for Rural Surgery are available to consult with any institution interested in developing a rural site or track. Interested parties should contact Karen Deveney, MD, FACS, at deveneyk@ohsu. edu for further information.

Rural surgeons also are encouraged to contact the program director of the general surgery training program in their state to express their interest in serving as mentors to surgical trainees and helping to ensure the future of rural general surgery.

Finally, medical students with an interest in rural general surgery as a career can locate a list of general surgery residency programs that provide rural surgery experiences in residency at www.facs.org/ education/resources/residency-search/specialties/rural. ♦

Mercy Medical Center in Williston, ND, a rotation site for University of North Dakota’s rural surgery program

REFERENCES

1. Etzioni DA, Finlayson SR, Ricketts TC, Lynge DC, Dimick JB.

Getting the science right on the surgeon workforce issue. Arch Surg.

2011;146( 4):381-384.

2. Ritchie WP, Rhodes RS, Biester TW. General surgery workloads and practice patterns in the United States, 2007–2009. Ann Surg.

2011;254( 3):520-525.

3. Harris JD, Hosford CC, Sticca RP. A comprehensive analysis of surgical procedures in rural surgery practices.

Am J Surg. 2010;200( 6):820-825.

4. Sticca RP, Mullin BC, Harris JD, Hosford CC. Surgical specialty procedures in rural surgery practices: Implications for rural surgery training. Am J Surg.