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When the job description no longer fits the job, it is time to reexamine the task and its purpose. The residency in general surgery is a good example. The description, as presented in the booklet of information of the American Board of Surgery (ABS), no longer fits the job.
The job, of course, is training "general surgeons" for the future, surgeons who can provide proficient care for patients with vascular disease, endocrine problems, cancer, and diseases of the alimentary tract and yet can be experts in transplantation, the management of trauma, and critical care.
It is a big order. There may still be a few master surgeons who can do it all, but for most of us the times of the "compleat" general surgeon are gone. General surgery has become too complex, and all indications are that this complexity and sophistication will continue to increase.
This expansion of general surgery
PORIES WJ, ASLAKSON HM. The Surgical Residency: The Job Description Does Not Fit the Job. Arch Surg. 1990;125(2):147–150. doi:https://doi.org/10.1001/archsurg.1990.01410140021003
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