What influences medical students' choice of surgical careers

Factors That Affect Medical Students' Perception and Impression of a Plastic Surgery Program: The Role of Elective Rotations and Interviews

OBJECTIVE

Securing a residency training position in plastic surgery is highly competitive each year with a limited quota of positions and numerous qualified applicants. Although previous studies have highlighted the importance of residency programs and applicants seeking a "good fit," it remains poorly understood what influences a medical student's impression and desire to train at a certain program over others. The objective of this cross-sectional study was to identify which specific potentially modifiable factors during elective rotations and program interviews were most important to Canadian medical students when ranking plastic surgery programs.

METHODS

An electronic survey with 42 questions was administered to Canadian final year medical students who applied through the 2017 Canadian Residency Match Service to the plastic surgery training program at the University of Toronto. The survey consisted of 7-point Likert scale questions related to demographics, general factors affecting impression of a plastic surgery program, and specific factors related to the elective and interview experiences. Survey responses were collected anonymously for analysis.

RESULTS

Twenty-three of 46 applicants completed the survey (50% response rate). The most important general factors affecting a medical student's impression and desire to train at a residency program were mentors at a specific program (weighted average, 6.39) and geographic location of a program (weighted average, 5.65). During elective rotations, the most important factors identified were overall impression of resident and staff collegiality (weighted average, 6.57), overall impression of resident happiness (weighted average, 6.52), and having a formal rotation-end debrief evaluation with the supervising staff (weighted average, 6.04). At program interviews, perceiving an atmosphere of collegiality (weighted average, 6.45) and opportunities to interact with residents and faculty at an organized social event (weighted average, 5.95) were considered of greatest importance.

CONCLUSIONS

Current applicants to plastic surgery in Canada prioritize resident happiness, program collegiality, and meaningful faculty relationships, such as those with a mentor, when ranking residency programs. Although finding a mutually "good fit" between applicant and program will remain a major aim, these findings indicate the importance of certain tangible, potentially modifiable factors that affect how medical students ultimately perceive and rank plastic surgery programs.

Exploring Medical Students' Perceptions of Organ Procurement: Need for a Formalized Medical Student Curriculum

OBJECTIVE

We evaluated the medical student experience with a deceased-donor multiorgan procurement program at a single center. The program provided the opportunity to assist with organ procurement, but no formal curriculum was offered.

DESIGN, SETTING, PARTICIPANTS

In 2018, medical students who registered for the program between 2014 and 2017 completed a voluntary survey about the experience and its impact on surgery interest and organ donation knowledge and advocacy.

RESULTS

Of 139 respondents, 53.3% (N = 74) of students participated in at least one procurement. The experience was resoundingly positive: 81.7% (N = 58) believed it exceeded expectations, with less than one-third missing class and only 4.3% (N = 3) reporting a negative impact on academics. Although 60.6% (N = 43) students studied prior to procurement, 57.8% (N = 41) expressed the need for increased preparation. Preferred learning modalities included videos, discussion with the transplant fellows, and focused anatomy overview. Following participation, 53.5% (N = 38) of students had increased interest in pursuing an acting internship and career in surgery. However, participation was not associated with improved familiarity with organ donation concepts or advocacy.

CONCLUSIONS

Adding a structured curriculum may turn medical students from passive observers into active learners, maximizing the educational value of procurement and better equipping future providers to promote organ donation.

Perception, knowledge, and interest of urologic surgery: a medical student survey

BACKGROUND

Although only a limited number of medical schools require a formal educational rotation in urologic surgery, urology as a medical specialty continues to attract a large number of students into the match each year. The purpose of this study was to describe medical student awareness, perception, and knowledge of urology, to determine factors influencing students' consideration of urology as a career, and to determine if prior urology clerkship experience is associated with differences in these variables.

METHODS

In this cross-sectional study, medical students were electronically surveyed in 07/2016. Self-reported and question-based knowledge of urology were determined. A total of 25 factors were assessed with a five-point Likert scale to determine their influence on students' consideration of urology as a career. Data analysis was performed using R.

RESULTS

The survey was completed by 114 students (13.5% of all medical students). A total of 11(9.65%)students had previously participated in a urology clerkship. All students reported awareness of urology; however, only 74 students (64.9%) correctly identified the training pathway and job duties of urologists. Self-perceived knowledge of urology was poor but improved with increased medical school training. Question-based assessment also demonstrated increased knowledge with advanced medical school training (27% per year; p < 0.01). Prior urology clerkship experience appeared to be associated with increased urologic knowledge; however, this was confounded by year in medical school training. When assessing factors impacting students' consideration of a career in urology, 'combination of medicine and surgery' was the most positively influential and 'competitiveness of the specialty' was the most negatively influential.

CONCLUSIONS

Although medical students are aware of urology as a specialty, they perceive their knowledge of urology as poor. However, knowledge of urology increases throughout medical school training. Multiple factors influence students' consideration of urology as a career choice. Additional studies are needed to further explore how participation in a formal urology experience alters students' perceptions and influences their consideration of urology as a career choice.

TRIAL REGISTRATION

Retrospectively registered.

Role Modeling for Female Surgeons in Japan

Japan is still a patriarchal society. There is an increasing number of female doctors who wish to follow a career path in surgery. This new generation of female surgeons need support not only in their career but also in work-life balance, especially after they have a family. We founded the Japan Association of Women Surgeons (JAWS) with the aims to advance females in surgery by providing networking and to develop leadership, mentorship, education, expertise and advocacy. This article describes our philosophy and activities, and our concept of role modeling. To find a single perfect role model is impossible in Japan, because lifestyle and family situations are quite different among individuals. Many young doctors in Japan find difficulties in identifying role models appropriate to their own situations. Our concept of remote role modeling is to identify multiple outstanding persons with excellent roles that one wishes to emulate; classify them by field of work, lifestyle, family situations, and others; then select the parts that one needs and assemble them to customize one's own ideal role model. This type of role modeling is probably the most practical approach. While modern technology is good for communication, meeting role models in person at meetings and social occasions is important in building an ideal role model.

Effect of Community and Academic Surgical Rotation Sites on Medical Student Performance Outcomes and Career Choices

OBJECTIVE

We hypothesize that students exposed to both academic and community surgery clerkship sites will have higher National Board of Medical Examiners Subject Exam in Surgery (NBME SES) scores and be more likely to pursue a career in a surgical specialty.

DESIGN

The NBME surgery subject exam scores and National Resident Matching Program (NRMP) results were collected for all medical students rotating through the surgery clerkship over 4 years. Permutations of sites were analyzed against exam scores and match rates into surgical and nonsurgical specialties.

SETTING

This study was performed at the Tulane University School of Medicine, in New Orleans, Louisiana, United States of America.

PARTICIPANTS

Data for a total of 910 students rotating through the surgery clerkship over a period of 4 years was collected and analyzed.

RESULTS

There was no statistical difference in NBME subject exam scores (p = 0.44) or match rates into a surgical specialty (p = 0.13) as stratified by site placement. Average NBME surgery subject exam scores were higher for those pursuing a surgical specialty (p < 0.001).

CONCLUSIONS

The combination of sites experienced during the surgery clerkship did not affect NBME surgery subject exam scores nor lead to a tendency to match into a surgical specialty.

Screening for Harassment, Abuse, and Discrimination among Surgery Residents: An EAST Multicenter Trial

Estimating the prevalence of harassment, verbal abuse, and discrimination among residents is difficult as events are often under-reported. The purpose of this study was to determine the prevalence of discrimination and abuse among surgical residents using the HITS (Hurt, Insulted, Threatened with harm or Screamed at) screening tool. A multicenter, cross-sectional, survey-based study was conducted at five academic teaching hospitals. Of 310 residents, 76 (24.5%) completed the survey. The HITS screening tool was positive in 3.9 per cent. The most common forms of abuse included sexual harassment (28.9%), discrimination based on gender (15.7%), and discrimination based on ethnicity (7.9%). There was a positive correlation between individuals who reported gender discrimination and racial discrimination (r = 0.778, n = 13, P = 0.002). Individuals who experienced insults were more likely to experience physical threats (r = 0.437, n = 79, P < 0.001) or verbal abuse (r = 0.690, n = 79, P < 0.001). Discrimination and harassment among surgical residents in academic teaching hospitals across the United States is not uncommon. Further research is needed to determine the impact of these findings on resident attrition.

The effect of an organ procurement experience on preclinical medical student perceptions of transplant surgery

Transplant surgery is a predominantly male specialty with high burnout rates. There are currently limited data regarding how programs can attract a diverse applicant pool to the field of transplant surgery. This study evaluated the effect of an Organ Procurement Experience elective on preclinical medical students' perceptions of transplant surgery in a prospective, longitudinal study. Preclinical medical students were anonymously surveyed before and after attending a deceased donor organ procurement. Questions focused on the following themes: Personal Beliefs, Personal/Professional Life, Diversity, and Gender Equality. Responses were rated on a five-point Likert scale. Ninety-nine and 45 students completed pre/post-procurement survey, respectively. Post-procurement responses demonstrated increased education about the field (2.1/5 vs 3.89/5, P < 0.001) and perceptions of the personalities and collegiality between surgeons (3.06/5 vs 3.73/5, P = 0.005). Post-procurement, women were less likely to feel that female transplant surgeons are treated differently (3.98/5 vs. 3.45/5, P < 0.017). Post-procurement, 19% agreed that transplant surgeons have a high quality of life. One percent of respondents felt the current gender distribution in transplant surgery is satisfactory. The Organ Procurement Experience significantly improved preclinical students' perceptions of the field. However, there remains a strong concern about quality of life and gender diversity within the field.

Introduction of Suturing Skills Acquisition into Undergraduate Surgical Education: Early Experience from Ile-Ife, Nigeria

Background:

Undergraduate medical students of the Obafemi Awolowo University, Ile-Ife, Nigeria, had over the years acquired various skills informally without structured training in basic skills in wound closure. The Department of Surgery introduced suturing skills acquisition workshop into the curriculum of the Final-Year Medical Students in 2016. This study describes the preliminary experience and the perception of the participants.

Methods:

All students undergoing the senior rotations in surgery and surgical specialties were taken through a day suturing skills workshop at the surgical skills laboratory. Skills were demonstrated using validated narrative videos followed by practical sessions supervised by senior registrars and consultant surgeons. All participants were requested to complete a feedback form after the workshop.

Results:

One hundred and eighty students were trained in six workshop sessions per year over two academic sessions. There were 128 (71.1%) male and 52 (28.9%) female students trained by 9 consultants and 13 senior registrars with 15–17 students in each session. Self-assessment feedback after the workshop revealed that all but 3 (1.7%) students felt very confident in handling basic instruments, 102 (56.7%) were confident of their proficiency in basic suturing, 68 (37.8) were less confident, whereas 10 (5.6%) were not confident looking ahead and 82 students (46.1%) wanted additional skills to attain proficiency in some common surgical procedures prior to graduation.

Conclusion:

The department achieved the aim of introducing suturing skills acquisition into undergraduate surgical education. In the future, other surgical skills acquisition workshops may be considered as desired by the students.

Factors influencing the choice of otolaryngology (ORL) head and neck surgery as a future specialty for Saudi medical students

Aim:

To find out the factors and causes that motivate medical students to choose ear, nose, and throat (ORL head and neck surgery) as a specialty in Saudi Arabian medical universities.

Materials and Methods:

A cross-sectional study was conducted at Kingdom of Saudi Arabia by distributing a self-administered questionnaire to 1,516 medical students across all medical universities. Chi-squared test and logistic regression analyses were used to examine the association between the participants’ choices and factors motivating their choice of specialty.

Results:

ORL head and neck surgery was chosen as a future specialty by 27% of the participants. Of these, 52% chose lifestyle as the most influential factor determining their choice of specialty. Further analysis of participant preferences revealed that 87.6% listed flexibility within medicine as their main reason for choosing a specialty, followed by reasonable hours of practice in 86%, while 15.9% considered a strong mentor relationship to be important. Students from King Abdulaziz University more frequently chose ORL head and neck, along with those from the eastern kingdom compared with other areas. Student preference for ORL head and neck did not vary significantly with gender, age, or duration of clinical rounds.

Conclusion:

Approximately 27% of students chose ORL head and neck, with lifestyle being the most influential factor, followed by flexibility within medicine. Among students who chose ORL head and neck, the highest percentage was from King Abdulaziz University.

Declining interest in general surgical training - Challenging misconceptions and improving access at undergraduate level

Background

In recent years, general surgery has faced a decline in applicants for postgraduate training. The St. George's Surgical Society hosted a national surgical conference with an aim to explore the reasons for the decline and to investigate the effectiveness of a one-day intervention on students' perceptions of general surgery and surgical skills.

Materials and methods

The conference took place on 20th January 2018 at St. George's, University of London. During the conference, medical students received lectures on "careers in surgery" and small-group workshops introducing students to simulation-based laparoscopic machines. Delegates were invited to complete before and after questionnaires looking at various domains; (1) Perceptions of general surgery, (2) Simulation skills, and (3) Usefulness of the day.

Results

There were significant impacts on student perceptions of the speciality such as increases in the views that "general surgery contained the opportunities for personal and professional development" (26%, p = 0.04), and of "general surgery as a rewarding speciality" (26%, p = 0.05). There were also negative changes such as an increase in the perception that "general surgery is female unfriendly" (+32%, p = 0.01). There were positive findings in all aspects relating to the use of laparoscopic simulation.

Discussion

The challenges faced in improving access to general surgery has been highlighted. More importantly the benefits of a one day intervention in addressing misconceptions and improving knowledge was seen. This study also shows the benefits of simulation teaching in the undergraduate curriculum.

Conclusion

The intervention has improved the perceptions on general surgery, surgical skills and knowledge and provided a platform for engaging students and clinicians.

Achieving gender equity in the radiation oncology physician workforce

There is currently much interest in identifying and mitigating gender inequity within medicine, the greater workforce and society as a whole. We provide an evidence-based review of current and historical trends in gender diversity in the RO physician workforce and identify potential barriers to diversity and inclusion in training, professional development, and career advancement. Next, we move to actionable items, addressing methods to mitigate bias, harassment, and other impediments to professional productivity and characterizing leadership lessons and imperatives for departmental, institutional, and organizational leaders.

Trauma Leagues-A Novel Option to Attract Medical Students to a Surgical Career

BACKGROUND

In Brazil, most medical schools do not offer trauma surgery in their undergraduate curriculum. The Trauma Leagues arose in Brazil as an important promoter of trauma education and stimulated activities related to surgical skills and practices. In recent decades, studies have demonstrated that the number of surgical residency applicants has decreased worldwide. Strategies to motivate medical students to choose surgery are needed.

OBJECTIVE

To evaluate the impact of participation in the Unicamp Trauma League (UTL) during a 20-year period in the choice for a surgical career.

METHODS

The study included 276 students in a Brazilian university hospital who were part of the Trauma League. Research of records in universities and medical societies about the specialties chosen during residency were evaluated. A Likert questionnaire was sent to participants to evaluate the impact of participating in the Trauma League in the student's professional career.

RESULTS

The questionnaire was answered by 76% of the participants. Of those, 38.4% chose general surgery. About 55.1% did not know what medical career to choose when joined the league. Participation in the league had an influence on specialty choice in 79.1% of the students. Of those choosing surgery, 93.2% believed that participating in the league had positively influenced their career choice. Overall, 93.1% believed that participating in the league provided knowledge and information that the medical school curriculum was not able to provide.

CONCLUSION

Participation in Trauma League has been an effective strategy to encourage medical students to choose a career in general surgery in Campinas, Brazil.

Doctors' career choices in health systems constrained by national medical exams: A discrete choice experiment

Previous studies that addressed factors influencing junior doctors' career decisions have failed to consider that the market for medical specialty is regulated and doctors are not always able to pursue their career of choice. There is the concern that the National Medical Exam that doctors have to take in many countries conditions their career choices and is behind the low efficacy of policies for retaining doctors in rural areas. In this paper, we use data from a Discrete Choice Experiment applied to a large sample of Portuguese junior doctors (N = 503) who had already taken their Medical Exam but had not chosen their medical specialty yet. We show that the exam score is de facto a strong predictor for (different) job preferences, but only for doctors who are amongst the highest and the lowest exam scores. For all others-almost half of our sample-geographical attachment (having lived or studied in rural areas or in metropolis) is more relevant in determining specialization decisions. Having a good work-life balance, specially amongst female physicians, is also an important determinant of specialty choice. Using latent-class analysis may help policymakers profiling different groups of doctors and tailoring incentive packages according to their characteristics.

A systematic review of the factors affecting choice of surgery as a career

BACKGROUND

Interest in surgical careers among medical students has declined over the past decade. Multiple explanations have been offered for why top students are deterred or rejected from surgical programs, though no consensus has emerged.

METHODS

We conducted a review of the literature to better characterize what factors affect the pursuit of a surgical career. We searched PubMed and EMBASE and performed additional reference checks. Agency for Healthcare Research and Quality (AHRQ) and Newcastle-Ottawa Education scores were used to evaluate the included data.

RESULTS

Our search identified 122 full-text, primary articles. Analysis of this evidence identified 3 core concepts that impact surgical career decision-making: gender, features of surgical education, and student "fit" in the culture of surgery.

CONCLUSION

Real and perceived gender discrimination has deterred female medical students from entering surgical careers. In addition, limited exposure to surgery during medical school and differences between student and surgeon personality traits and values may deter students from entering surgical careers. We suggest that deliberate and visible effort to include women and early-career medical students in surgical settings may enhance their interest in carreers in surgery.

Characteristics of role models who influenced medical residents to choose surgery as a specialty: exploratory study

CONTEXT AND OBJECTIVE

Choosing a medical specialty and making decisions concerning a career are difficult processes for medical students and newly graduated physicians.This exploratory study aimed to investigate the influence of role models on the choice of surgery as a career, and to determine the most influential model characteristics.

DESIGN AND SETTING

Qualitative analysis on responses to a self-administered questionnaire, in different teaching-learning settings.

METHODS

Residents from all years of various surgical subspecialties in a university hospital were included in a survey about the factors that determined their choice of surgery. The questions included items on whether a role model had influenced them in choosing surgery, and the personal or professional characteristics of the models that had been most influential. The responses were subjected to qualitative content analysis.

RESULTS

Sixty-four out of 96 medical residents participated. Fifty-three residents (82.8%) acknowledged the influence of role models. Sixteen model characteristics were indicated as important, with 136 mentions. Characteristics classified as technical skills (55%), such as"medical knowledge"and "manual dexterity" predominated over humanistic characteristics (35%), such as "patient-physician relationships" and "ethical behavior". However, this difference was not statistically significant (Fisher test, P = 0.11).There were no age differences regarding the proportions mentioning "technical" and "non-technical" attributes, but female residents mentioned significantly more technical skills than their male colleagues did.

CONCLUSIONS

The influence of role models seems to be an important factor determining the choice of surgery as a career. The influential characteristics of the models include not only technical but also humanistic qualities.

Evaluation of a technical and nontechnical skills curriculum for students entering surgery

BACKGROUND

Prior interventions to address declining interest in surgical careers have focused on creating early exposure and fostering mentorship at the preclinical medical student level. Navigating the surgical environment can be challenging, however, and preclinical students may be more likely to pursue a surgical career if they are given the tools to function optimally.

MATERIALS AND METHODS

We designed a 10-wk technical and nontechnical skills curriculum to provide preclinical students with knowledge and skills necessary to successfully navigate the surgical learning environment, followed by placement in high-fidelity surgical simulations and scrubbing in on operative cases with attending surgeons. We administered pre-post surveys to assess student confidence levels in operative skills, self-perceptions of having a mentor, overall course efficacy, and interest in a career in surgery.

RESULTS

The overall response rates presurvey and postsurvey were 100% (30 of 30) and 93.3% (28 of 30), respectively. Confidence levels across all operative skills increased significantly after completing the course. Faculty mentorship increased significantly from 30.0% before to 61.5% after the course. Overall effectiveness of the course was 4.00 of 5 (4 = "very effective"), and although insignificant, overall interest in a career in surgery increased at the completion of the course from 3.77 (standard deviation = 1.01) to 4.17 (standard deviation = 0.94).

CONCLUSIONS

Our curriculum was effective in teaching the skills necessary to enjoy positive experiences in planned early exposure and mentorship activities. Further study is warranted to determine if this intervention leads to an increase in students who formally commit to a career in surgery.

Choosing Surgery: Identifying Factors Leading to Increased General Surgery Matriculation Rate

Tulane graduates have, over the past six years, chosen general surgical residency at a rate above the national average (mean 9.6% vs 6.6%). With much of the recent career choice research focusing on disincentives and declining general surgery applicants, we sought to identify factors that positively influenced our students’ decision to pursue general surgery. A 50-question survey was developed and distributed to graduates who matched into a general surgery between the years 2006 and 2014. The survey evaluated demographics, exposure to surgery, and factors affecting interest in a surgical career. We achieved a 54 per cent (61/112) response rate. Only 43 per cent considered a surgical career before medical school matriculation. Fifty-nine per cent had strongly considered a career other than surgery. Sixty-two per cent chose to pursue surgery during or immediately after their surgery clerkship. The most important factors cited for choosing general surgery were perceived career enjoyment of residents and faculty, resident/faculty relationship, and mentorship. Surgery residents and faculty were viewed as role models by 72 and 77 per cent of responders, respectively. This study demonstrated almost half of those choosing a surgical career did so as a direct result of the core rotation experience. We believe that structuring the medical student education experience to optimize the interaction of students, residents, and faculty produces a positive environment encouraging students to choose a general surgery career.

Career in vascular surgery – the medical student’s perspective

Aim: Under the supervision of the Department of General and Vascular Surgery of Poznan University of Medical Sciences, a questionnaire was distributed online or as a paper version to medical students (MSs) in order to better understand the attitudes towards surgery as a specialty and to determine the reasons why students do and do not choose vascular surgery as their career path. Materials and methods: The questionnaire was distributed online or as a paper version to MSs in the 3rd, 5th, and 6th year of the PUMS 6-year M.D. program. It provided the data on the year of study, grade point average (GPA), sex, age, respondent’s specialty choice, 33 questions with responses on a 1-5 Likert scale (1 was the least important reason and 5 was the most important reason), and 2 questions with socres between 0 and 4. A total of 136 Polish MSs of PUMS completed the survey. Results: For MSs who choose vascular surgery as their career path, “endovascular capabilities of vascular surgery” and “higher income possibilities than a general surgeon” were the most important reasons. The “poor availability of work in other places than the vascular surgery department of your choice, few such clinics in the region” was the most important reason not to choose vascular surgery. A role of gender was also noted - 13% of male MSs classified gender as an “important factor”, in contrast to 60% of female MSs. Conclusions: The findings of this study might help to develop better strategies to attract future trainees to surgical specialties, particularly vascular surgery, and improve work environment.

Securing an OTL-HNS residency: how competitive is it? Comparing medical student perceptions to actual Canadian statistics

BACKGROUND

The residency match is an important event in an aspiring physician's career. Otolaryngology - Head and Neck Surgery (OTL-HNS) is a surgical specialty that has enjoyed high numbers of applicants to its residency programs. However, recent trends in Canada show a decline in first-choice applicants to several surgical fields. Factors thought to influence a medical student's choice include role models, career opportunities and work-life balance. The notion of perceived competitiveness is a factor that has not yet been explored. This study sought to compare competitiveness of OTL-HNS, as perceived by Canadian medical students to residency match statistics published yearly by CaRMS (Canadian Residency Matching Service), with the hope of informing future decisions of surgical residency programs.

METHODS

An electronic survey was created and distributed to all medical students enrolled in the 17 Canadian medical schools. After gathering demographic information, students were asked to rank what they perceived to be the five most competitive disciplines offered by CaRMS. They were also asked to rank surgical specialties from most to least competitive. Publically available data from CaRMS was then collected and analyzed to determine actual competitiveness of admissions to Canadian OTL-HNS residency programs.

RESULTS

1194 students, from first to fourth year of medical school, completed the survey. CaRMS statistics over the period from 2008 to 2014 demonstrated that the five most competitive specialties were Plastic Surgery, Dermatology, Ophthalmology, Emergency Medicine and OTL-HNS. Among surgical disciplines, OTL-HNS was third most competitive, where on average 72% of students match to their first-choice discipline. When students were questioned, 35% ranked OTL-HNS amongst the top five most competitive. On the other hand 72%, 74% and 80% recognized Opthalmology, Dermatology and Plastic Surgery as being among the five most competitive, respectively. We found that fourth-year medical students were significantly more knowledgeable about the competitiveness of both OTL-HNS and Plastic Surgery compared to first-year students (p < 0.01).

CONCLUSION

Overall, Canadian medical students may underestimate the competitiveness of OTL-HNS. Furthermore, competitiveness would appear to be a concept that resonates with medical students during the match process.

Personal life and working conditions of trainees and young specialists in clinical microbiology and infectious diseases in Europe: a questionnaire survey

The purpose of this investigation was to assess the balance between the personal and professional lives of trainees and young European specialists in clinical microbiology (CM) and infectious diseases (ID), and determine differences according to gender, country of training, workplace and specialty. The Steering Committee of the Trainee Association of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) devised a questionnaire survey consisting, beyond the demographic questions, of nine yes/no questions, 11 Likert scale self-evaluations and one open-response item on parenthood, working conditions, quality of life, alcohol consumption and burnout. This anonymous survey in English was held between April and July 2015 among European CM/ID trainees and young specialists (<3 years after training completion). Responses from 416 participants with a mean age of 32 years [standard deviation (SD) 5 years] were analysed. Females and physicians from Northern/Western Europe (NWE) benefit more from paternity/maternity leaves even during training than their counterparts. Among all respondents, only half of breastfeeding mothers enjoyed the benefit of working hours flexibility. Only two-thirds of respondents found their working environment stimulating. In comparison to colleagues from other parts of Europe, trainees and young specialists from Southern/Eastern Europe (SEE) had less frequent regular meetings with mentors/supervisors and head of departments where trainees’ issues are discussed. Also, physicians from SEE were more frequently victims of workplace mobbing/bullying in comparison to those from other regions. Finally, multivariate analysis showed that female gender, SEE region and ID specialty were associated with burnout feelings. Female gender and country of work from SEE largely determine satisfactory working conditions, the possibility of parenthood leaves, amount of leisure time, mobbing experiences and burnout feelings among European CM/ID trainees and young specialists.

Developing expertise in gynecologic surgery: reflective perspectives of international experts on learning environments and processes

Research in medical education does not provide a clear understanding of how professional expertise develops among surgeons and what experiential factors contribute to that development. To address this gap, the researchers interviewed 16 international experts in female pelvic medicine and reconstructive surgery to assess their reflective perceptions of what specific opportunities and experiences initiated and supported their development toward expertise in their field. Characteristics and influences explaining the speed and quality of expertise development were sorted into the following themes: the dynamic process of expertise development, internal and personal characteristics, general aptitudes and preparatory skills, role modeling and interpersonal influences, opportunities to learn and practice, and roles and reference points. Across the narratives and perspectives of these expert surgeons, both individual characteristics and choices, and contextual activities and opportunities were necessary and important. Experiences with greatest impact on quality of expertise development included those provided by the environment and mentors, as well as those sought out by learners themselves, to elaborate and supplement existing opportunities. The ideal combination across experts was interaction and integration of individual characteristics with experiential opportunities. Grounded in theory and research in expertise development, these findings can support improvement of medical education, both for individual mentors and strategic program development. As surgery evolves at a continuously increasing pace, effective mentoring of promising surgical trainees will be critical to ensure that future generations of gynecologic surgeons will remain excellent. Effective, efficient surgical expertise development requires identifying trainees with the appropriate characteristics and providing them with the best development opportunities.

Medical Student Presyncope and Syncope in the Operating Room: A Mixed Methods Analysis

OBJECTIVE

Medical students often feel faint (presyncopal) in the operating room (OR). Despite mandatory surgical rotations in clerkship, there is little formal training and acclimatization to the operating suite in the first 2 years of medical school. This study aimed to assess presyncope and syncope in the OR in first, second, third, and fourth year medical students at a large Canadian academic center.

DESIGN

Following an extensive literature review, we developed a mixed methods survey de novo to assess medical students' experience in the OR and determine the frequency of presyncopal and syncopal events.

RESULTS

A total of 180 students (106 females, 59%), evenly distributed among all 4 years of medical school, responded to the survey (response rate 40%, n = 180/454). In total, 75 students (42%) had experienced presyncope, and 10 students (6%) had experienced syncope in the OR. Female medical students were more likely to experience both presyncope (p < 0.001) and syncope (p = 0.011) relative to their male colleagues. They were also more likely to report that these experiences had an effect on their attitude toward the OR (p < 0.001) and their career choice (p < 0.001). Half of respondents believed that the undergraduate medical preclerkship curriculum did not provide adequate exposure to the OR. Students consistently expressed the desire for more preclinical OR exposure and formal instruction concerning OR etiquette. Only 28% of students reported receiving information on how to avoid syncope, and their classmates were the number one source (59%) for this advice. The most commonly employed preventative measures were eating before the OR and staying well hydrated. Presyncope had a negative effect on attitudes toward the OR in 28% of students.

CONCLUSION

Although true loss of consciousness (syncope) among medical students in the OR is uncommon, presyncope is a highly prevalent phenomenon. It is most prevalent in female students, and may have a negative effect on overall student well-being. All students may benefit from normalization of this very common experience by staff surgeons or residents. Formal instruction regarding the common symptoms, triggers, and methods for preventing presyncope and syncope is an essential supplement to the current preclinical medical curriculum.

Students to Surgeons

Introduction. Our nation suffers from a shortage in surgeons. This deficiency must be addressed at the medical student level. Increasing faculty and resident interaction with junior students augments surgical interest. Our surgical interest group has recently redefined its role to address these concerns. Methods. A multifocal approach has been implemented to increase interest in the surgical specialties. Each academic year, senior students recruit first and second year students to our group to establish early exposure. Members receive didactic presentations from surgical faculty, addressing various topics, on a biweekly basis. In addition, scrubbing, knot-tying, and suturing workshops address technical skills throughout the semester. Membership and match data were collated and analyzed. Results. Over the past 5 years, the enrollment in the student interest group increased significantly from 112 to 150. Accordingly, we have observed a parallel increase in the number of students who have successfully matched into surgical residencies. A record number of students (37) from the class of 2013 matched into surgical specialties, representing an 85% increase over the last decade. After creating bylaws and electing societal officers, the group has been recognized by the school’s Student Council and given financial support. At present, the group is fiscally solvent with support from the institution, surgery department, and faculty. Conclusion. As the demand for surgeons increases so too does the need to increase student interest in surgery. Our school has been successful because of our surgical interest group, and we encourage other schools to adopt a similar approach.

Medical Student Selection of Otolaryngology-Head and Neck Surgery as a Specialty: Influences and Attitudes

OBJECTIVES: 1) To determine factors students perceive as influential in decision to pursue otolaryngology; 2) to determine perception of importance of factors used for resident selection and individual student commitment to the match; and 3) to identify exposure to various subspecialties within otolaryngology.

DESIGN: Population survey.

METHODS: A survey was administered to students applying for otolaryngology between 2000 and 2003 at a single institution.

RESULTS: Ninety-six students were interviewed. Seventy-eight percent believed that the main factor influencing their decision to pursue otolaryngology was their exposure to the residents. Board scores and one-on-one interviews were important factors in selection of interviewees and ranking process. Interestingly, over 20% of students believed that the match should not be early because they wanted more time to commit to ENT.

CONCLUSIONS: These data underscore the importance that residents have in directing future students to our specialty. Results of the match survey may indicate an attrition rate within residency programs that may be avoided if ENT were part of the “regular” match.

EBM RATING: C

How to train plastic surgeons of the future

INTRODUCTION

Plastic surgery is a competitive and over-subscribed career choice despite minimal medical school exposure. We quantify factors influencing career interest in plastic surgery, speciality appeal and workforce planning. These findings optimise and refine evidence-based plastic surgery training and postgraduate selection criteria.

METHODS

Medical students from two national plastic surgery courses complete a post-course questionnaire. Data categories included past experience and career interest in plastic surgery, sources of exposure, motivational factors, and sub-speciality interest. Data were recorded on modified Likert scales, with linear regression and t-test analyses performed.

RESULTS

175 students completed the questionnaire (81% response). Duration of medical student exposure to plastic surgery was significantly associated with career interest (Linear coefficient 0.12, 95% CI 0.08-0.17, P < 0.0001; r(2) = 0.15). 75 h experience is a significant cut-off to categorise students. Mean (95% CI) career interest is 31 percentage points higher in students with >75 h experience (89.2%, 83.2-95.2) compared to students with ≤75 h experience (58.1%, 52.9-63.3) (P < 0.0001). Influential sources included: (1) Operating Room (2) Consultant/Attending interaction (3) Resident interaction. Motivational factors towards a career in plastic surgery included operative satisfaction (91%), improving patient quality of life (89%), and reconstructive surgery (88%). Sub-speciality interests included: (1) Hand and Upper Limb (28%); (2) Cleft Lip and Palate (26%); (3) Burns (15%).

CONCLUSION

This study identified influential and motivational factors upon a career in plastic surgery. Medical student exposure can be tailored to maximise positive educational exposure to optimise evidence-based plastic surgery training and workforce planning.

Factors influencing US medical students' decision to pursue surgery

BACKGROUND

Interest and applications to surgery have steadily decreased over recent years in the United States. The goal of this review is to collect the current literature regarding US medical students' experience in surgery and factors influencing their intention to pursue surgery as a career. We hypothesize that multiple factors influence US medical students' career choice in surgery.

METHODS

Six electronic databases (PubMed, SCOPUS, Web of Science, Education Resources Information Center, Embase, and PsycINFO) were searched. The inclusion criteria were studies published after the new century related to factors influencing surgical career choice among US medical students. Factors influencing US medical student surgical career decision-making were recorded. A quality index score was given to each article selected to minimize risk of bias.

RESULTS

We identified 38 relevant articles of more than 1000 nonduplicated titles. The factors influencing medical student decision for a surgical career were categorized into five domains: mentorship and role model (n = 12), experience (clerkship n = 9, stereotype n = 4), timing of exposure (n = 9), personal (lifestyle n = 8, gender n = 6, finance n = 3), and others (n = 2).

CONCLUSIONS

This comprehensive systemic review identifies mentorship, experience in surgery, stereotypes, timing of exposure, and personal factors to be major determinants in medical students' decisions to pursue surgery. These represent areas that can be improved to attract applicants to general surgery residencies. Surgical faculty and residents can have a positive influence on medical students' decisions to pursue surgery as a career. Early introduction to the field of surgery, as well as recruitment strategies during the preclinical and clinical years of medical school can increase students' interest in a surgical career.

Reaching Our Successors: Millennial Generation Medical Students and Plastic Surgery as a Career Choice

BACKGROUND

Research shows that career choices are made as a result of preconceived ideas and exposure to a specialty. If plastic surgery is to continue to attract the best, factors that may dissuade the millennial generation medical students from pursuing plastic surgery as a career must be identified and addressed. We explored the determinants of interest in plastic surgery as a career choice amongst millennial generation medical students.

MATERIALS AND METHODS

A survey regarding factors considered important in choosing plastic surgery was conducted amongst final year medical students in September 2011. Participants were asked to rate their agreement or disagreement with 18 statements on a four-point Likert scale (1 = very unimportant; 4 = very important). Statistical analyses were performed using Chi-square test to compare categorical variables between male and female medical students. Values of P < 0.05 were considered significant.

RESULTS

The most important factors influencing the decision of medical students to choose plastic surgery as a career include; plastic surgeons appear happy in their work 93 (85%), Plastic surgeons have rewarding careers 78 (71%), and plastic surgeons provide good role models for medical students 96 (87%). An overall score of > 3.0 was seen in all the subscales except in gender equity and life style concerns. There were statistically significant differences between male and female students in opinions of a spouse, a significant other, or family members in choosing plastic surgery P < 0.5 and my choice of plastic surgery will be influenced by my decision to have a family P < 0.5.

CONCLUSION

Factors influencing the decision of medical students to choose plastic surgery were related to the perceived quality of life as a plastic surgeon and the ability of plastic surgeons to provide good role models for medical students. Female medical students were more concerned with gender equity and work-life balance in selecting plastic surgery compared to male medical students.

Growing the 'SEAD': Expansion of the Surgical Exploration and Discovery Program

BACKGROUND

The declining popularity of surgical specialties among North American medical students has been attributed partially to limited early exposure and minimal involvement of surgeons in preclerkship education; in response, the Surgical Exploration and Discovery (SEAD) program was developed at the University of Toronto in 2012. SEAD is a 2-week curriculum that provides first-year medical students comprehensive exposure to surgical specialties through operating room observerships, simulation workshops, and career discussions. This study is the first to examine implementation of the SEAD program at another site.

METHODS

This prospective cohort study evaluated the effectiveness of the SEAD program in improving surgical knowledge and facilitating career decision making when compared with a control group. In all, 18 students participated in the SEAD program, and 18 students from the same class read only the program's instructional manual; both the groups completed multiple-choice tests and questionnaires at baseline and at completion to assess knowledge acquisition and career-related learning.

RESULTS

Both the groups significantly improved their surgical knowledge, but there was no difference between groups. SEAD participants made significantly greater progress in refining their career decisions when compared with the control group; all but one SEAD participant either gained interest in or ruled out a surgical specialty as a potential career choice compared with only 10 of the participants reading the manual only.

CONCLUSIONS

The SEAD program provides a meaningful opportunity for medical students to explore surgical careers during preclerkship and to make better-informed career decisions. This expansion demonstrates that the program can be successfully reproduced at another institution.

Encouraging Subspecialty Practice by Constructively Influencing Trainees Early in their Careers Will Improve Advocacy for Neuro-Ophthalmology among Nigerian Ophthalmologists

This study was conducted to assess the current knowledge, attitude, and perception of Nigerian ophthalmologists toward neuro-ophthalmology; identify barriers to the uptake of neuro-ophthalmology as a desired subspecialty; and make recommendations to improve interest in neuro-ophthalmology training. This was a cross-sectional survey of ophthalmology consultants and trainees from the six geopolitical zones of Nigeria, who were attending a national ophthalmology conference. All consenting respondents voluntarily completed a validated self-administered questionnaire. There were 107 respondents comprising 56 males and 51 females. Majority (54.2%) of respondents were aged 40 years and younger. Almost half (47.8%) worked at tertiary level, public health institutions. Only 10.3% worked in private practice. Neuro-ophthalmology exposure was short and occurred mainly during residency (65.7%), while 15% had no exposure at all. Most (80.4%) indicated only nominal interest in neuro-ophthalmology, while only 4.6% indicated a desire to specialize in the field. Financial constraint was the main obstacle to the pursuit of subspecialty training. A total of 86% of respondents admitted that full (34%) or partial (52%) Funding would motivate them to pursue the training. Among respondents desiring part sponsorship, more than half were willing to augment such sponsorship with personal funds. In conclusion, career interest in neuro-ophthalmology is very low among Nigerian ophthalmologists. Late and limited exposure to neuro-ophthalmology during medical training may be contributing factors. Early exposure to neuro-ophthalmology during medical school rotations, coupled with the provision of sponsored subspecialty training opportunities, will serve to increase enrollment in the field.

The Impact of Early Medical School Surgical Exposure on Interest in Neurosurgery

BACKGROUND

Medical student interest in neurosurgery is decreasing and resident attrition is trending upwards in favor of more lifestyle-friendly specialties that receive greater exposure during medical school. The University of Toronto began offering an annual two week comprehensive, focused surgical experience (Surgical Exploration and Discovery (SEAD) program) to 20 first year medical students increasing exposure to surgical careers. This study determines how SEAD affects students' views of a career in neurosurgery.

METHODS

Surveys were administered to 38 SEAD participants over two program cycles. Information was obtained regarding demographics, impacts of SEAD, and factors affecting career decision making. Subgroup analyses assessed for factors predicting pre- and post-intervention interest in neurosurgery.

RESULTS

Ninety-seven percent (n=37) of students completed the survey. Before SEAD, 25% were interested in neurosurgery but this decreased to 10% post-SEAD (p=0.001). However, post-SEAD interest increased from 10% to 38% if lifestyle factors were theoretically controlled across surgical specialties (p<0.005). A majority (81%) felt SEAD improved their understanding of neurosurgery, 62.2% felt that exposure to other surgical specialties reduced their interest in neurosurgery, and 21% felt SEAD increased their interest in neurosurgery. Nineteen percent intended to explore neurosurgery further with observerships and one student planned to organize neurosurgical research.

CONCLUSIONS

This surgical exposure intervention increased understanding about neurosurgery and reduced overall interest in neurosurgery as a career. However, those remaining interested were motivated to plan further neurosurgical clinical experiences. The SEAD program may, therefore, aid in early selection of students motivated to satisfy the demands of a neurosurgical career.

Basic Cardiac Surgery Skills on Sale for $22.50: An Aortic Anastomosis Simulation Curriculum

BACKGROUND

Current resident and student duty-hour restrictions necessitate efficient training, which may be aided by simulation. Data on the utility of low-cost simulation in cardiothoracic surgery are scant. We evaluated the effect and value of a low-cost, low-fidelity aortic anastomosis simulation curriculum.

METHODS

Twenty participants (11 medical students, 9 residents) completed an aortic anastomosis on a porcine heart as a pretest. Participants were then provided access to a 14-minute online video created by a cardiac surgeon and given a low-cost task trainer for self-directed practice. Five weeks later, participants performed another aortic anastomosis on a porcine heart as a posttest. Pretest and posttest performances were filmed, deidentified, and graded blindly and independently by two cardiac surgeons using a standardized assessment tool (perfect score, 110; passing score, 58 or higher). Participants were surveyed anonymously after the posttest.

RESULTS

The mean (SD) aortic anastomosis performance score improved significantly from pretest (53.3 [25.3]) to posttest (83.6 [15.3]; p < 0.001). Pass rates also improved significantly (35% versus 95%, p < 0.001). Medical students' scores improved most (p = 0.01). All 20 participants reported improved confidence in performing the task, and 18 believed that the online video was essential to better performance. The cost of the curriculum totaled $22.50 per participant, with 6 hours of total staff time required for assessment.

CONCLUSIONS

An aortic anastomosis training and simulation curriculum improves the skills of student and resident trainees with minimal expense and staff time commitment. Such a curriculum may be of great value to both cardiothoracic training programs and their trainees.

Reconstruction of facial defects with local flaps--a training model for medical students?

Introduction

The lack of surgeons will be a future major problem in patient care for multifaceted reasons. Niche specialties such as OMFS face an additional drawback because of the need for dual qualification. Special surgical training that gives students the opportunity to gain experience in the techniques of plastic-reconstructive surgery (PRS) has therefore been established to promote interest in OMFS.

Methods

Two hands-on courses with 8 modules of 2 h for 10 students were established. Course modules included surgical techniques of PRS, such as local flaps in a complex facial defect on pig heads, and were supervised by two OMFS surgeons. The identical initial and final tests examined theoretical knowledge and practical skills. Questionnaires concerning basic demographic data, future career goals, and perception of surgical disciplines before and after the completion of the course were handed out.

Results

The 19 participating students (12 female, 7 male; median age 24 ± 2.24) were in their 8.31 ± 1.20 semester. Results of the tests showed improvement in knowledge following the courses (before 52.68 ± 12.64 vs. after 77.89 ± 11.37; p < 0.05). Based on the Likert scale, an increase in interest in a career in OFMS was observed (3.90 ± 1.18 vs. 2.72 ± 1.33; p < 0.05), but this was not so marked with regard to a career in a surgical discipline in general (1.93 ± 1.30 vs. 1.62 ± 1.19; p > 0.05). Perception of OMFS as a surgical discipline changed (3.68 ± 1.09 vs. 1.80 ± 0.64; p < 0.05). The following values also changed: students´ perception of PRS in OMFS (14 (74.68 %) vs. 5 (25.32 %); 19 (100 %) vs. 0 (0 %)), evaluation of PRS as a study subject for medical students (7 (36.84 %) vs. 12 (63.16 %); 19 (100 %) vs. 0 (0 %)), and the interest in an OMFS elective subject (6 (31.58 %) vs. 13 (68.42 %); 18 (94.74 %) vs. 1 (5.26 %)) and as a final clinical year subject (4 (21.05 %) vs. 15 (78.95 %); 14 (73.68 %) vs. 5 (26.32 %)).

Conclusions

Hands-on courses with complex facial defects can be used to gain new professionals, even in niche specialties such as OMFS. Moreover, a hands-on course design, including innovative teaching methods and structured objective tests combined with a close student-teacher relationship and motivated instructors, is able to promote complex surgical skills in PRS.

Supply versus demand: a review of application trends to Canadian surgical training programs

Despite increases in medical school enrolment, applications to surgical residency programs in Canada have been in decline over the past decade, with an increasing number of unmatched surgical residency positions. We examined the current status of surgical residency in Canada and analyzed application trends (2002–2013) for surgical training programs across Canada. Our findings suggest that most undergraduate medical schools across Canada are having difficulty fostering interest in surgical careers. We propose that a lack of adequate early exposure to the surgical specialties during undergraduate training is a critical factor. Moving forward, we must examine how the best-performing institutions and surgical programs have maintained interest in pursuing surgical careers and adapt our recruitment methods to both maintain and grow future interest. As Mary Engelbreit said, "If you don't like something, change it; if you can't change it, change the way you think about it."

Medical student experience in surgery influences their career choices: a systematic review of the literature

OBJECTIVES

Student experiences during surgical rotations may dictate interest in future surgical careers. The objective of this study was to systematically examine the effect of surgical experience (SE) on student attitudes toward surgical careers and also to identify variables influencing the educational value of SE.

METHODS

A systematic review of the available literature was conducted by 2 independent researchers searching Medline, EMBASE, Google Scholar, and Cochrane databases, in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses recommendations. Studies assessing SE during the students' surgical rotations were identified. The quality of the included studies was assessed using a validated quality index. Factors affecting student surgical rotation experience and perceptions of surgical careers were recorded.

RESULTS

Overall, 204 studies were identified; 20 unique studies met the inclusion criteria with a median cohort size of 169 (interquartile range: 107-262) respondents. Most were cross-sectional surveys (n = 16/20) and administered to clinical students (n = 16/20). All studies investigating the effect of SE on career choices (n = 8) found that positive experiences during the surgical placement were associated with an increased interest in surgical careers. The operating theater experience was identified as a defining feature of overall SE. Involvement in operative procedures, a welcoming environment, and avoidance of syncopal events positively influenced the SE, particularly in those who actively sought educational opportunities. Study limitations included single-center and single-year cohort designs (70%) with the use of nonvalidated research tools (95%).

CONCLUSIONS

A systematic review of the literature highlights a number of factors associated with a positive surgical rotation, which may lead to more students deciding to pursue a career in surgery. Understanding the factors that contribute to these decisions through multicenter studies using validated research tools may lead to more effective surgical rotations, ultimately improving the delivery of the surgical education.

Exposure to plastic surgery during undergraduate medical training: A single-institution review

BACKGROUND

Applications to surgical residency programs have declined over the past decade. Even highly competitive programs, such as plastic surgery, have begun to witness these effects. Studies have shown that early surgical exposure has a positive influence on career selection.

OBJECTIVE

To review plastic surgery application trends across Canada, and to further investigate medical student exposure to plastic surgery.

METHODS

To examine plastic surgery application trends, national data from the Canadian Resident Matching Service database were analyzed, comparing 2002 to 2007 with 2008 to 2013. To evaluate plastic surgery exposure, a survey of all undergraduate medical students at the University of Toronto (Toronto, Ontario) during the 2012/2013 academic year was conducted.

RESULTS

Comparing 2002 to 2007 and 2008 to 2013, the average number of national plastic surgery training positions nearly doubled, while first-choice applicants decreased by 15.3%. The majority of Canadian academic institutions experienced a decrease in first-choice applicants; 84.7% of survey respondents indicated they had no exposure to plastic surgery during their medical education. Furthermore, 89.7% believed their education had not provided a basic understanding of issues commonly managed by plastic surgeons. The majority of students indicated they receive significantly less plastic surgery teaching than all other surgical subspecialties. More than 44% of students not considering plastic surgery as a career indicated they may be more likely to with increased exposure.

CONCLUSION

If there is a desire to grow the specialty through future generations, recruiting tactics to foster greater interest in plastic surgery must be altered. The present study suggests increased and earlier exposure for medical students is a potential solution.

Exposure to plastic surgery during undergraduate medical training: A single-institution review

Background

Applications to surgical residency programs have declined over the past decade. Even highly competitive programs, such as plastic surgery, have begun to witness these effects. Studies have shown that early surgical exposure has a positive influence on career selection.

Objective

To review plastic surgery application trends across Canada, and to further investigate medical student exposure to plastic surgery.

Methods

To examine plastic surgery application trends, national data from the Canadian Resident Matching Service database were analyzed, comparing 2002 to 2007 with 2008 to 2013. To evaluate plastic surgery exposure, a survey of all undergraduate medical students at the University of Toronto (Toronto, Ontario) during the 2012/2013 academic year was conducted.

Results

Comparing 2002 to 2007 and 2008 to 2013, the average number of national plastic surgery training positions nearly doubled, while first-choice applicants decreased by 15.3%. The majority of Canadian academic institutions experienced a decrease in first-choice applicants; 84.7% of survey respondents indicated they had no exposure to plastic surgery during their medical education. Furthermore, 89.7% believed their education had not provided a basic understanding of issues commonly managed by plastic surgeons. The majority of students indicated they receive significantly less plastic surgery teaching than all other surgical subspecialties. More than 44% of students not considering plastic surgery as a career indicated they may be more likely to with increased exposure.

Conclusion

If there is a desire to grow the specialty through future generations, recruiting tactics to foster greater interest in plastic surgery must be altered. The present study suggests increased and earlier exposure for medical students is a potential solution.

Inspiring tomorrow's surgeons: the benefits of student surgical society membership☆?

OBJECTIVES

To assess the perceived value of medical school student surgical society membership and its effect on determining future career aspirations.

DESIGN

Cross-sectional survey.

SETTING

Three UK medical school student surgical societies.

PARTICIPANTS

Undergraduate and postgraduate students.

RESULTS

Of 119 students, 60 (50.4%) completed the survey. Of the respondents, 62.3% indicated that the surgical society had increased their awareness and knowledge about the different surgical specialties. Of the respondents who had decided on a career in surgery before joining the society, 67.6% stated that participating in society events had better prepared them for the career. Plastic surgery (13.3%), general surgery (11.7%), and neurosurgery (11.7%) were the 3 most popular specialties for future careers. Surgical skills workshops (21.9%), conferences (21.1%), and careers talks (16.4%) were chosen by students as the most useful career-guiding events organized by surgical societies.

CONCLUSION

Participation in medical school surgical societies is perceived as a valuable part of undergraduate and postgraduate medical education in aiding students to decide on future careers.

What factors influence British medical students' career intentions?

AIM

The aim of this study was to identify factors that influence career choice in UK medical students.

METHODS

Students at seven institutions were invited to rate how important various factors were on influencing their career choices and how interested they were in pursuing different specialties. The influence of interpersonal relationship networks on career choice was also evaluated.

RESULTS

641 responses were collected. 44% (283) were male, 16% (105) were graduates and 41% (263) were final-year students. For Dermatology (p = 0.009), Paediatrics (p = 0.000), Radiology (p = 0.000), Emergency Medicine (p = 0.018) and Cardiothoracic Surgery (p = 0.000), there was a clear correlation between completing a clinical attachment and an interest in pursuing the specialty. Perceived characteristics of the speciality, individually and in clusters were considered important by specific subgroups of students, such as those interested in surgery. These students considered prestige (p = 0.0003), role models (p = 0.014), financial rewards after training (p = 0.0196) and technical challenge (p = 0.0011) as important factors. Demographics such as sex and age played a significant role in career choice. Interpersonal relationship networks do not have a significant influence on career intentions.

CONCLUSIONS

This study shows that the career intentions of British medical students are influenced by their undergraduate experience and by the weight they place on different specialty-related factors.