General surgery in crisis - factors that impact on a career in general surgery

Introduction. The Association of Surgeons of South Africa (ASSA), because of a concern about the decline in the number of applicants for registrar posts, undertook this study into the various factors that may influence the choice of surgery as career option. Methods. The study involved a combination of desk research and structured interviews with heads of departments, specialists, and registrars in general surgery. Results. The reasons for choosing general surgery as a career included the immediately visible results of a surgeon's efforts and the practical and intellectual challenge of the specialty. General surgery continued to enjoy a high status in society. The greater focus on primary health care has affected facilities at tertiary and secondary institutions. General surgeons worked excessively long hours, which was associated with increased levels of stress and placed severe strains on family life. All respondents felt that their levels of remuneration were 'poor' in relation to other disciplines and professions. Conclusion. In this study we identified various factors that impacted either positively or negatively on the choice of general surgery as a career option.