Şükran ÇAVDAR, Muhammed Salih SÜER, Faruk YAZICI, Deniz KÜTÜK, Bahattin BAYAR, Serkan DEMİR, Şener BALAS
Journal of Comprehensive Surgery - 2026;4(3):61-67
Aims: General surgery subspecialty training is influenced not only by individual career preferences but also by institutional capacity, regional inequalities, and changing professional expectations. Despite increasing quotas in recent years, declining occupancy rates suggest that subspecialty preferences may reflect broader professional and structural factors. This study aimed to evaluate temporal trends, occupancy rates, and regional/institutional distribution patterns of general surgery subspecialty placements in Turkiye. Methods: Placement data from general surgery subspecialty programs between 2015 and 2025 were retrospectively analyzed. Examination year, placement type, subspecialty branch, hospital category, geographic region, quotas, vacant positions, and occupancy rates were evaluated using descriptive statistics. Results: A total of 503 placement records comprising 757 quotas were analyzed, of which 68.4% were filled. Occupancy rates declined from 82.8% in 2015-2019 to 58.0% in 2020-2025 despite increasing quotas. Surgical oncology (80.6%) and gastrointestinal surgery (75.5%) had the highest occupancy rates, whereas intensive care (45.8%) and hand surgery (34.8%) showed substantially lower occupancy. Most quotas were concentrated in university hospitals and metropolitan cities. Additional placement quotas demonstrated markedly lower occupancy rates (34.9%) and accounted for a considerable proportion of vacant positions. Conclusion: Although general surgery subspecialty training in Turkiye has expanded quantitatively over the last decade, occupancy rates have declined significantly, particularly after 2020. These findings suggest that subspecialty preferences are shaped not only by numerical quota increases but also by factors such as workload, training environment, burnout, career sustainability, and quality of life. A more comprehensive workforce planning strategy considering surgeons' professional expectations may therefore be necessary.
