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Cleve Trimble, MD

Arch Surg. 1997;132(5):498.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Landcasper et al conclude that selected procedural rotations will better prepare surgical residency graduates for rural practice. Not discussed, however, was the larger question of whether a young surgeon should choose such a setting in the first place. There are considerations beyond the idyllic notion that a surgeon can escape managed care by being versatile, to wit:

• Rural surgery is solo, almost by definition; if a place has enough clinical work for 2, it is simply not "rural." To voluntarily separate oneself from colleagues and mentors is dangerous at any stage of a profession, let alone the outset.
  
• Transition from the teaching institution's environment of technologic plenty (a dependency demanded by standards of care) to one of dearth puts inordinate pressure on a clinical acumen which is only developing. It requires a mature ego to realize that surgical capabilities are often determined not by one's training but by
  

Author Affiliations
Norfolk Surgical Norfolk, Neb

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