Evidence map›Paper›PMID 40590999›Full record

ArticleSurgery today2025

Decline in the surgical workforce in urban and rural Japan and the regional quota system as a potential solution to surgeon shortages.

Nozomi Karakuchi, Masatoshi Matsumoto, Yoshihiro Saeki, Kazuaki Tanabe, Hideki Ohdan

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Article in Surgery today, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Nozomi KarakuchiDepartment of Gastroenterological and Transplant Surgery, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan. karanozo0119@gmail.com.
Masatoshi MatsumotoDepartment of Community-Based Medical System, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-Ku, Hiroshima, 734-8551, Japan.
Yoshihiro SaekiDepartment of Gastroenterological and Transplant Surgery, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
Kazuaki TanabeDepartment of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi Minami-Ku, Hiroshima, 734-8551, Japan.
Hideki OhdanDepartment of Gastroenterological and Transplant Surgery, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study examined the decline in the number of surgeons in Japan compared with other specialists in urban and rural areas using a secondary analysis of government-owned census data. Furthermore, it evaluated the impact of the regional quota system in addressing the shortage of surgeons by comparing their proportion among the graduates of this system with that of the overall physician population.

methodsWe analyzed national census data (2012-2022) to evaluate trends in the numbers of physicians and surgeons in 47 prefectures from urban and rural groups. Data on regional quota graduates were obtained from an open-source study.

resultsThe number of physicians increased by 13.4%, whereas the number of surgeons decreased by 2.1%. The change in the number of surgeons per 100,000 population did not differ between the rural (+ 0.6%) and urban (+ 0.7%; p = 0.997) prefectures. Regional quota graduates had a higher likelihood of being surgeons (9.5%) than all (8.2%; p < 0.01) or young (age 26-39 years) physicians (7.8%; p < 0.01), although female representation was highest among regional quotas (38.7%) relative to all (22.8%; p < 0.01) and young (32.8%; p < 0.01) physicians.

conclusionThe regional quota demonstrates the potential of addressing surgeon shortages.

Indexed as

Health WorkforceRural PopulationSurgeonsUrban PopulationAdultCensusesFemaleHumansJapanMaleMiddle AgedRural Health ServicesWorkforceRegional medical programsSupply and distributionSurgeons

Identifiers

PMID40590999

What OpenQuestion holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.