We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Commentary |

General Surgeons A Dying Breed?

Kathryn Chu, MD, MSc
Arch Surg. 2009;144(6):498-499. doi:10.1001/archsurg.2009.73.
Text Size: A A A
Published online


The poor availability of surgery in developing countries is a long-neglected problem that has recently gained attention. Surgical services are now recognized as cost-effective public health interventions that aim to prevent death and disability; up to 15% of the world's disability-adjusted life-years are amenable to surgery.1 The inverse care law, which dictates that the availability of medical care is inversely proportional to need, is starkly apparent in surgery, with the poorest third of the world estimated to benefit from only 3.5% of surgical procedures.2 Most developing countries only have 1 to 2 medical schools and few doctors go on to specialize in surgery (by one estimation, Africa has approximately 1% of the number of surgeons of the United States1). Finally, because of economic and political factors, many African doctors immigrate to the United Kingdom, Europe, and the United States, creating an even larger vacuum of health care providers.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

6 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
[Transgress to progress]. Rev Prat 2015;65(3):299.
[Preserving fertility and future death]. J Int Bioethique 2015;26 Spec no():111-7.

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Evidence to Support the Update

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Original Article: Does This Patient Have an Instability of the Shoulder or a Labrum Lesion?