J.Jpn. Surg. Soc.. 126(2): 138-143, 2025

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Feature topic

CURRENT STATUS AND CHALLENGES OF GASTROINTESTINAL SURGEONS: ADDRESSING PHYSICIAN SHORTAGES AND FUTURE PERSPECTIVES

Gastrointestinal (GI) surgeons play a critical role in cancer surgery and the management of acute conditions, yet their numbers have been steadily declining in Japan over the past two decades, despite an overall increase in the total number of physicians. GI surgeons address complex procedures, including esophageal, gastric, colorectal, hepatic, biliary, and pancreatic tumors, alongside palliative care and acute abdominal emergencies. The decline in their numbers has led to increased workloads, exacerbated by dissatisfaction with remuneration, lack of clear career paths, and limited opportunities for work–life balance. Efforts by professional societies have focused on enhancing education, defining career pathways, and advocating for improved working conditions. A revision of remuneration structures and the introduction of incentives for high-risk surgeries and emergency procedures are deemed essential to attract and retain talent in the field. Moreover, reducing outpatient workload and streamlining participation in academic activities may allow surgeons more time for skill development and research. To sustain and improve GI surgical care, targeted strategies such as centralization of complex surgeries, equitable distribution of services, and collaborative efforts among stakeholders are critical. Addressing these challenges requires integrated action from both national bodies and academic societies to ensure high-quality, accessible care for patients across regions.

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