Outcomes and influences of rural-focused integrated clerkship programs in general surgery

Am J Surg. 2020 Feb;219(2):355-358. doi: 10.1016/j.amjsurg.2019.11.040. Epub 2019 Dec 25.


Background: A shortage of general surgeons is predicted in the future, with particular impact on rural surgery. This is an exploratory analysis on a rural-focused longitudinal integrated clerkship to determine if such clerkships can be used to increase interest and recruitment in rural general surgery.

Methods: An institutional database was reviewed to identify students who became general surgeons after completing a rural-focused longitudinal integrated clerkship. Telephone interviews were conducted on a portion of these surgeons.

Results: Fifty-seven students (3.6%) completing the rural-focused longitudinal integrated clerkship became general surgeons. Of those participating in phone interviews, most (90%) decided to become surgeons during their experience while all stated that preclinical years did not influence their specialty decision.

Conclusions: A substantial portion of these surgeons went on to practice in rural communities. Pre-existing rural and primary care-focused education could help to address the future projected shortage of rural general surgeons.

Keywords: General surgery; Longitudinal integrated clerkship; Medical student; Rural surgery.

MeSH terms

  • Career Choice*
  • Clinical Clerkship / organization & administration*
  • Databases, Factual
  • Education, Medical, Undergraduate / organization & administration*
  • Female
  • General Surgery / education*
  • Hospitals, Rural / organization & administration
  • Humans
  • Interviews as Topic
  • Male
  • Outcome Assessment, Health Care*
  • Primary Health Care / organization & administration
  • Primary Health Care / statistics & numerical data
  • Retrospective Studies
  • Rural Health Services / organization & administration
  • Students, Medical / statistics & numerical data
  • Surgeons / supply & distribution
  • United States
  • Young Adult