2/100.000 inhabitants. Current scope of practice There are 5 medical schools built around university BIBW2992 in vitro hospitals in Finland. In the multi-layered public health care system, primary care is provided by the healthcare centers in each of the about 400 counties. For specialist care, Finland is divided into 21 hospital districts.

There are 5 university hospitals and 16 central hospitals that provide most of the specialist care including surgical emergency services in their respective areas. There are also some, smaller district hospitals where basic surgical services are provided. The 5 university hospitals have special responsibilities for the most demanding specialized care in their area, and in some cases, such as transplantation surgery or major burn care, the centralization goes even further to one or two centers in the whole country. Overall, about 400.000 surgical procedures are performed each year in the public hospitals. In addition, there are private hospitals mostly in larger cities providing elective surgical services with selleck chemicals varying degree of specialization. The majority of patients with emergency surgical problems are managed in the university and central hospitals, although certain specialist services, such as cardiothoracic and neurosurgery, are available almost exclusively in university hospitals. In most central hospitals, there are usually one or

two surgical residents on call in the hospital outside the working hours with more senior surgeons (one Resminostat general or “”visceral”", and one orthopedic surgeon) on call at home with a response time obligation of 30 minutes at the most. The university hospitals have usually in-house specialist surgeons from the large specialties (gastroenterological surgery, orthopedics and traumatology) available around the clock and on-call services from home of other specialties including urology, vascular surgery, pediatric surgery, plastic surgery etc. Most of the emergency general surgery (mainly acute

abdomen) is performed by gastroenterological surgeons or residents, but in smaller hospitals also other visceral surgeons (urologists or vascular surgeons, for example) participate in the on-call rosters. Same applies to abdominal trauma including damage control surgery, whereas vascular or thoracic trauma patients are usually referred to a center with vascular surgeons or thoracic surgeons on-call, respectively. BAY 11-7082 nmr intensive care is largely provided by anesthesiologists with special interest in intensive care. Intensive care is not part of the surgical training curriculum. Current training program In the past, all surgeons were trained as general surgeons (including orthopedic surgery) for 6 years. If desired, an additional two-year fellowship in some specialized field (gastroenterological surgery, urology, plastic surgery, orthopedic surgery etc.) could be taken leading to a subspecialty in that field.