The current State of the acute care surgery workforce: A boots on the ground perspective

UMMS Affiliation

Department of Surgery; Department of Quantitative Health Sciences

Publication Date


Document Type



Critical Care | Emergency Medicine | Health and Medical Administration | Health Services Research | Surgery


BACKGROUND: Acute care surgery (ACS) was proposed to address a general surgery workforce crisis; however, the ACS workforce composition is unknown. A national survey was conducted to determine the differences in the emergency general surgery (EGS) workforce between ACS and non-ACS hospitals.

METHODS: The American Hospital Association (AHA) Annual Survey of Hospitals database was queried to identify acute care general hospitals. A hybrid mail/electronic survey was sent to 2811 acute care hospitals that met the inclusion criteria of hospitals that care for adult patients ( > /=18 years old) with an emergency room (ER), > /= 1 operating room (OR), and 24-h ER access. Hospitals were queried on whether they utilized an ACS model. The workforce composition among ACS and non-ACS hospitals was evaluated using X(2) tests, t tests, and Wilcoxon rank-sum tests.

RESULTS: Survey response was 60% (N=1690). ACS hospitals had a higher proportion of emergency surgeons who were female (20% vs. 14%, p < 0.0001), newly-trained (17% vs 10%, p < 0.0001), critical care trained (78% vs. 31%, p < 0.0001), and who had an additional degree (35% vs. 13%, p < 0.0001). More ACS hospitals had 24/7 in-house OR nursing staff (72% vs. 15%, p < 0.0001) and ancillary staff.

CONCLUSIONS: ACS and non-ACS hospitals differ in their surgical workforce. It is clear that ACS hospitals have more human capital, which suggests that ACS hospitals may require more dedicated resources compared to non-ACS hospitals.

DOI of Published Version



Am J Surg. 2018 Sep 8. pii: S0002-9610(18)30132-6. doi: 10.1016/j.amjsurg.2018.08.023. [Epub ahead of print] Link to article on publisher's site

Journal/Book/Conference Title

American journal of surgery

PubMed ID


Related Resources

Link to Article in PubMed