Surgery News - April 2008 - (Page 2)

NEWS SURGERY NEWS • A P R I L 2 0 0 8 Record Number of Surgeons Retiring Shortage • from page 1 ACS Fellow Dr. E. Christopher Ellison, relied on influenced partly by the fact that medical school enrollments did not increase during 1980-2005, six assumptions: The year 2000 ratio of 7.53 general surgeons even though the U.S. population rose by 55 million during 1980-2000. The number of postper 100,000 people remains constant. The number of postgraduate training posi- graduate positions in general surgery has been fixed by the Centers for Medicare and Medicaid tions remains constant. General surgeons have a 30-year career from Services since 1996, according to Dr. Williams. “We have to increase the number of surgeons board certification to retirement. There are 1,000 new board certifications in we’re training, and if we don’t, we cannot maingeneral surgery per year, of which 850 go on to tain [the current] level of access to services,” he said. practice general surgery. Since there are at least 1,000 unemployed surThere were 21,150 general surgeons in pracgeons in Western Europe, some of whom “have tice in 2005. Only allopathic training programs are in- no chance of finding a job” in their home countries, Dr. Polk suggested opening 1,000 new pocluded. The analysis predicted that the number of sitions over the next several years in training general surgeons would gradually rise until it programs with good passing rates on the board levels off at about 25,000 around 2035, when certification exam, sufficient operative volume, most if not all current general surgeons will have and a history of residents who become general retired, said Dr. Williams, an ACS Fellow with surgeons. “We’ve been committed to importing physithe department of surgery at Ohio State Unicians into America since World War II. There’s versity, Columbus. But by 2050, the number of existing general nothing new about this,” Dr. Polk said. A PGY-4 general surgery resident in the audisurgeons versus the number needed may fall ence suggested that teaching residents what to short by 6,000 (19%). For 2020, Dr. Williams predicted a 7% short- expect in general surgery practice might motiage of 1,875 general surgeons. This shortage vate them to consider staying in the field, bewould increase to almost 4,000 if 700 of the as- cause it might counteract the perception that sumed 1,000 surgeons who become board cer- some surgical specialties provide an easier tified in general surgery actually go on to prac- lifestyle than does general surgery, relative to tice it. The shortage would balloon to nearly their income. 7,000 in 2020 if only half of those who obtain board Predicted General Surgeon Shortage certification in general surgery go on to practice it. Projected Surgeons Even without any Year U.S. Population Needed Shortage changes in assumptions, 2010 309 million 23,175 1,300 (6%) however, 156 new general 2030 364 million 27,300 2,525 (9%) surgeons would have to be 2050 420 million 31,500 6,000 (19%) trained each year to fill the predicted shortage in 2020, Source: Dr. Williams Dr. Williams said. The shortage has been Heparin Contaminated by Chemical Compound BY HEIDI SPLETE Else vier Global Medical Ne ws sulfated chondroitin sulfate is The chemical compoundofoverthe contaminant in batches heparin that has been linked to 19 deaths and several hundred serious health problems in the United States, according to information presented by the Food and Drug Administration in a press conference on March 19. “At the moment we don’t know definitively whether the contaminant was introduced intentionally or by accident,” said Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research. Now that the heparinlike contaminant has been identified, the FDA intends to move forward to determine how and when it was introduced into the supply chain. The contaminant was first discovered in batches of product imported to the United States from a Chinese facility that derives heparin from pig intestines. “We are continuing to investigate how this got in, and it doesn’t appear to be from the pig,” Dr. Woodcock said. “And still to be determined is whether the oversulfated chondroitin sulfate, when combined with heparin, can produce the reactions of the sort reported to the FDA,” she added. Compendial tests will enable heparin manufacturers to detect ELSEVIER GLOBAL MEDICAL NEWS trace amounts of the oversulfated chondroitin sulfate, which should not be confused with natural chondroitin sulfate, a natural substance commonly used to manage joint pain. The oversulfated version can be made relatively cheaply and easily by chemically modifying natural chondroitin sulfate, said Mohab Nasr, Ph.D., director of the FDA’s Office of New Drug Quality and Assessment. China’s state food and drug administration has been briefed on the findings. Chinese regulators have agreed to assist the FDA with its ongoing investigation, Dr. Woodcock said. The FDA continues to identify, hold, and examine all shipments of heparin entering the United States and test those that raise concerns, she said. There have been no further reports of death associated with the contaminated product since the Feb. 28 recall. “We feel that doctors and patients can be confident that the product on the market for large volume uses of heparin has been tested and is safe,” Dr. Woodcock said. “But we do ask that if any adverse events are observed by doctors or health care professionals that they be reported to the FDA.” To report adverse events and for information on the timing of reports of adverse events and deaths related to heparin, visit www.fda.gov/cder/ drug/infopage/heparin/default.htm. SURGERY NEWS SURGERY NEWS Editor in Chief, SURGERY NEWS Lazar J. Greenfield, M.D., FACS ACS Director of Communications Linn Meyer EDITORIAL ADVISORY BOARD Anesthesiology: Robert Morell, M.D., Clinical Associate Professor of Anesthesia, Fort Walton Beach Medical Center Bariatric: Myriam J. Curet, M.D., FACS, Professor of Surgery, Stanford University Cardiothoracic: Mark S. Allen, M.D., FACS, Professor of Surgery, Mayo Clinic Cardiothoracic: Fred A. Crawford, Jr., M.D., FACS, Chairman, Department of Surgery, Medical University of South Carolina Colorectal: Robert Madoff, M.D., FACS, Professor of Surgery, University of Minnesota Endocrine Surgery: Robert Udelsman M.D., FACS, Chairman, Department of Surgery, Yale University Ethics: James W. Jones, M.D., Ph.D., FACS, Visiting Professor of Medicine and Medical Ethics, Baylor University Information Technology: Patricia L. Turner, M.D., FACS, Assistant Professor of Surgery, University of Maryland Minimally Invasive and Gastrointestinal: Gerald M. Fried, M.D., FACS, Professor of Surgery, McGill University Neurological: Hunt Batjer, M.D., FACS, Michael J. Marchese Professor, Northwestern University Obstetrics and Gynecology: William J. Hoskins, M.D., FACS, Executive Director of Surgical Activities, Memorial Sloan-Kettering Cancer Center Ophthalmology: Natalie C. Kerr, M.D., FACS, Chief, Pediatric Ophthalmology Service, University of Tennessee Orthopedic: Mark R. Belsky, M.D., FACS, Chief of Orthopedic Surgery, Newton-Wellesley Hospital Otolaryngology: Mark Weissler, M.D., FACS, J.P. Riddle Distinguished Professor, University of North Carolina Pediatric Surgery: Thomas F. Tracy, Jr., M.D., FACS, Pediatric Surgeon-in-Chief, Hasbro Children's Hospital Plastic Surgery: Linda Phillips, M.D., FACS, Truman G. Blocker Jr., M.D. Distinguished Professor, University of Texas Resident/Associate Society: Ted A. James, M.D., Assistant Professor of Surgery, University of Vermont Surgical Oncology: James P. Neifeld, M.D., FACS, Chairman, Department of Surgery, Virginia Commonwealth University Transplantation: Jeffrey Punch, M.D., FACS, Associate Professor of Surgery, University of Michigan Trauma (Burns and Mass Casualties): Steven E. Wolf, M.D., FACS, Professor of Surgery, University of Texas Trauma and Critical Care: Grace S. Rozycki, M.D., FACS, Professor of Surgery, Emory University Urology: Badrinath R. Konety, M.D., FACS, Vice Chair, Dept. of Urology, University of California at San Francisco Vascular: Linda Harris, M.D., FACS, Associate Professor of Surgery, Millard Fillmore Hospital SURGERY NEWS is the official newspaper of the American College of Surgeons and provides the practicing surgeon with timely and relevant news and commentary about clinical developments and about the impact of health care policy on the profession and on surgical practice today. Content for SURGERY NEWS is provided by International Medical News Group and Elsevier Global Medical News. Content for the NEWS FROM THE COLLEGE is provided by the American College of Surgeons. The ideas and opinions expressed in SURGERY NEWS do not necessarily reflect those of the College or the Publisher. The American College of Surgeons and Elsevier Society News Group, a division of Elsevier Inc., will not assume responsibility for damages, loss, or claims of any kind arising from or related to the information contained in this publication, including any claims related to the products, drugs, or services mentioned herein. POSTMASTER: Send changes of address (with old mailing label) to Circulation, SURGERY NEWS, 60 B Columbia Rd., 2nd flr., Morristown, NJ 07960. The American College of Surgeons’ headquarters is located at 633 N. Saint Clair St., Chicago, IL 60611-3211. SURGERY NEWS (ISSN 1553-6785) is published monthly for the American College of Surgeons by Elsevier Inc., 60 B Columbia Rd., 2nd flr., Morristown, NJ 07960; 973-290-8200; fax 973-290-8250. ELSEVIER SOCIETY NEWS GROUP, A DIVISION OF INTERNATIONAL MEDICAL NEWS GROUP President, IMNG Alan J. Imhoff Director, ESNG Mark Branca Executive Director, Editorial Mary Jo M. Dales Executive Editor, IMNG Denise Fulton Executive Editor, EGMN Kathy Scarbeck Publication Editor Elizabeth Wood Publication Associate Editor Jay C. Cherniak VP, Medical Education Sylvia H. Reitman Senior Director http://www.fda.gov/cder/drug/infopage/heparin/default.htm http://www.fda.gov/cder/drug/infopage/heparin/default.htm

Table of Contents Feed for the Digital Edition of Surgery News - April 2008

Surgery News - April 2008 Contents Comorbidities Sway Bariatric Outcomes Database Finds Gap in Dissection For Melanoma Future Surgeon Shortage Predicted Dexterity Demo Best for Bile? Health Policy Scan Plan

Surgery News - April 2008

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