General surgeons play a crucial role in rural health care in the U.S. Rural general surgeons decrease the need for patients to travel for routine surgery, provide backup to rural primary care providers in emergency care, obstetrics, and orthopedics, and contribute substantially to the financial health of rural hospitals.

Between 2001 and 2019, the per capita supply of general surgeons in the U.S. decreased by 18.0% overall and by 29.1% in rural areas. Rural general surgeons are older than their urban counterparts. In 2019, 59.4% of the general surgeons in small/isolated rural areas were 50 years of age or older, compared to 48.8% in urban areas.

While the proportion of women in the general surgery workforce rose from 10.6% in 2001 to 26.1% in 2019, this proportion is smaller in rural areas, only 19.7% in 2019. Long-term preservation of rural surgical services will require concerted efforts by medical school educators, residency directors, and rural advocates to promote and sustain interest in rural general surgery among medical students and surgical residents, especially women.