The Modern Medical School Graduate and General Surgical Training

Abstract

In the August 1987 issue of the New England Journal of Medicine, Dr McCarty referred to the soaring number of unmatched internal medicine residency spots as "Black Tuesday."¹ Now, nearly 15 years later, general surgery is facing the same dilemma, as the number of unmatched categorical positions has increased 10-fold in the last 4 years, and more than 100 vacant positions are anticipated in the 2002 match (Figure 1).² A multitude of changes in the demographics and desires of graduating medical students, coupled with a relative lack of change in surgical training programs, have forever changed the applicant pool from which general surgery departments recruit their trainees. As a result, the number of applicants to general surgery programs has decreased by 30% in the last 9 years, and there are no data to suggest that this trend will stop (Figure 2).² The decreasing number of applicants to general surgery training programs may reach critical proportions unless corrective action is taken.