1
|
Unal HS, Aydin MO, Bilgic E, Eser P, Alper Z, Taskapılıoğlu MO, İlker Kafa M, Kocaeli H, Dogan S, Yılmazlar S, Bekar A, Sekerci Z, Aksoy K. Neurosurgery training camp for medical student: experience of the Turkish neurosugery academy and Bursa Uludag University. Front Surg 2024; 11:1433780. [PMID: 39157292 PMCID: PMC11327150 DOI: 10.3389/fsurg.2024.1433780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 07/22/2024] [Indexed: 08/20/2024] Open
Abstract
Introduction To highlight the importance of hands-on experiences and mentorship in shaping the future workforce of specialized medical professionals via a Neurosurgery Training Camp. Methods Responses of the questionnaire regarding the Neurosurgery Training Camp organized by Bursa Uludag University's Faculty of Medicine and the Turkish Neurosurgery Academy were reviewed retrospectively. A one-day program was organized to introduce neurosurgery to medical students. During the camp, the students participated in interactive presentations delivered by faculty members, had lunch together, became acquainted with neurosurgical tools and technologies, and performed interventions. With pre and postworkshop questionnaire, student's expectations and thoughts about camp was evaluated. Results Forty-one students from 10 medical schools, spanning every year of study, attended the camp. Approximately 39% of the attendees (n = 16) were women and 61% (n = 25) were men. The post-workshop survey results demonstrated that 73% of the students (n = 30) were inclined to pursue a career in neurosurgery after the camp, 21.9% (n = 9) remained undecided, and 4.8% (n = 2) chose not to pursue neurosurgery. Feedback from the post-workshop questionnaire highlighted that all students perceived the camp as beneficial in providing insights into their future careers and aiding in making a decision regarding their career paths. Discussion The neurosurgical training camp effectively inspired and educated medical students about the discipline of neurosurgery. Furthermore, the camp effectively altered the career aspirations and perceptions of neurosurgery among the participating students.
Collapse
Affiliation(s)
- H Setenay Unal
- Department of Neurosurgery, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Mevlut Okan Aydin
- Department of Medical Education, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Esma Bilgic
- Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Pınar Eser
- Department of Neurosurgery, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Zuleyha Alper
- Department of Medical Education, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - M Ozgur Taskapılıoğlu
- Department of Neurosurgery, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - M İlker Kafa
- Department of Anatomy, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Hasan Kocaeli
- Department of Neurosurgery, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Seref Dogan
- Department of Neurosurgery, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Selcuk Yılmazlar
- Department of Neurosurgery, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Ahmet Bekar
- Department of Neurosurgery, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Zeki Sekerci
- Department of Neurosurgery, President Turkish Neurosurgery Academy, Medipol University School of Medicine, Istanbul, Turkiye
| | - Kaya Aksoy
- Private Practitioner, Head of Turkish Neurosurgery Academy, Bursa, Turkiye
| |
Collapse
|
2
|
McLennan S, Purich K, Verhoeff K, Mador B. Attitudes of Canadian medical students towards surgical training and perceived barriers to surgical careers: a multicentre survey. CANADIAN MEDICAL EDUCATION JOURNAL 2023; 14:71-76. [PMID: 38045085 PMCID: PMC10690001 DOI: 10.36834/cmej.74694] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background Medical student interest in surgical specialties continues to decline. This study aims to characterize attitudes of Canadian medical students towards surgical training and perceived barriers to surgical careers. Methods An anonymous survey was custom designed and distributed to medical students at the University of Alberta and University of Calgary. Survey questions characterized student interest in surgical specialties, barriers to pursuing surgery, and influence of surgical education opportunities on career interest. Results Survey engagement was 26.7% in 2015 and 24.2% in 2021. General surgery had the highest rate of interest in both survey years (2015: 38.3%, 2021: 39.2%). The most frequently reported barrier was worry about the stress that surgical careers can put on personal relationships (2015: 70.9%, 2021: 73.8%, p= 0.50). Female respondents were significantly more likely to cite gender discrimination as a deterrent to surgical careers (F: 52.0%, M: 5.8%, p < 0.001). Conclusions Despite substantial interest, perception of work-life imbalance was the primary reported barrier to surgical careers. Further, female medical students' awareness of gender discrimination in surgery highlights the need for continued efforts to promote gender inclusivity within surgical disciplines to support early career women interested in surgery.
Collapse
Affiliation(s)
| | - Kieran Purich
- Department of Surgery, University of Alberta, Alberta, Canada
| | - Kevin Verhoeff
- Department of Surgery, University of Alberta, Alberta, Canada
| | - Brett Mador
- Department of Surgery, University of Alberta, Alberta, Canada
| |
Collapse
|
3
|
Hakami N, Madkhali A, Hakami F, ALshekh M, Masmali E, Hamithi D, Zogel B. Obstacles Deterring Medical Students From Pursuing a Career in the Field of Surgery in Jazan University, Saudi Arabia. Cureus 2023; 15:e43233. [PMID: 37692738 PMCID: PMC10491465 DOI: 10.7759/cureus.43233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Particularly in Saudi Arabia, there is a dearth of trained specialists in the field of surgery. Understanding the obstacles that discourage medical students and residents from pursuing a surgical career is essential for resolving this shortage. This study intended to investigate the characteristics that influence medical students and trainees at Jazan University, Saudi Arabia, to pursue a career in surgery. METHODOLOGY This observational study employed a descriptive, cross-sectional approach. The intended audience consisted of fourth- to sixth-year medical students and medical residents. The questionnaire gathered information on demographics, academic year, previous surgical experience, perceptions of surgery as a specialty, and variables influencing career selections. RESULTS Out of 413 participants, 74.3% were considering a surgical career, with 24.4% interested in general surgery, followed by cardiac surgery (14.3%) and pediatric surgery (12.4%). Factors influencing career decisions included potential income (82%), the possibility of part-time work (82%), and partial leave (74%). A significant proportion of participants agreed or strongly agreed that the incidence of suicide (62%) and the risk of depression (72%) are higher in surgical specialties. Female participants were more likely to agree that their chance of becoming a spouse could be affected by a surgical career (p=0.002) and that meeting role models could influence their choice of surgical specialty (p=0.015). CONCLUSION Work-life balance, long working hours, and mental health concerns are identified as variables that discourage medical students and residents from pursuing a surgical career in the study. Efforts to encourage work-life balance, minimize workload, and provide support and resources for mental health issues should help surgeons suffer less stress and burnout. Moreover, encouraging an open-minded attitude and de-stigmatizing mental health concerns in the medical field should encourage individuals to seek assistance when necessary and lower the incidence of suicide and depression. Finally, tackling gender discrimination and encouraging diversity and inclusion in surgical specialties could attract more skilled surgeons.
Collapse
Affiliation(s)
| | | | | | | | - Enas Masmali
- Faculty of Medicine, Jazan University, Jazan, SAU
| | | | - Basem Zogel
- Faculty of Medicine, Jazan University, Jazan, SAU
| |
Collapse
|
4
|
Alozai T, Huizing E, Schreve MA, Mooij MC, van Vlijmen CJ, Wisselink W, Ünlü Ç. A systematic review and meta-analysis of treatment modalities for anterior accessory saphenous vein insufficiency. Phlebology 2021; 37:165-179. [PMID: 34965757 DOI: 10.1177/02683555211060998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate and compare the outcomes of the available treatment modalities for anterior accessory saphenous vein (AASV) incompetence. METHODS A systematic literature search was performed in MEDLINE, Embase, and the Cochrane Library. Studies reporting the outcomes of patients who were treated for primary AASV incompetence were included. The methodologic quality of the articles was assessed using the Methodological Index for Non-Randomized Studies (MINORS). A random-effects model was used to estimate anatomic success, defined as AASV occlusion. The secondary outcomes were pain during and after treatment, venous clinical severity score, quality of life, esthetic result, time to return to daily activities, and complications. RESULTS The search identified 860 articles, of which 16 met the inclusion criteria. A total of 609 AASVs were reported. The included studies were of poor or moderate quality according to MINORS score. The pooled anatomic success rates were 91.8% after endovenous laser ablation and radiofrequency ablation (EVLA, RFA, 11 studies), 93.6% after cyanoacrylate closure (3 studies), and 79.8% after sclerotherapy (2 studies). The non-pooled anatomic success rate was 97.9% after phlebectomy and 82% after CHIVA. Paresthesia was seen after EVLA in 0.7% of patients (6 studies). Phlebitis was seen in 2.6% of patients after RFA (2 studies), 27% after sclerotherapy (1 study), and 12% after the phlebectomy (1 study). Deep venous thrombosis and skin burn did not occur. CONCLUSION Treatment of AASV incompetence is safe and effective. Despite limited evidence, occlusion of the AASV can be achieved with endovenous thermal ablation and cyanoacrylate. There does not appear to be a benefit of EVLA compared to RFA regarding treatment efficacy. Phlebectomy shows promising results if the saphenofemoral junction is competent. Lower results are seen after sclerotherapy and CHIVA. However, studies with sufficient sample sizes of solely treatment of AASV incompetence are needed to draw firm conclusions.
Collapse
Affiliation(s)
- Tamana Alozai
- Department of Surgery, 1140Northwest Clinics, Alkmaar, The Netherlands
| | - Eline Huizing
- Department of Surgery, 1140Northwest Clinics, Alkmaar, The Netherlands
| | - Michiel A Schreve
- Department of Surgery, 1140Northwest Clinics, Alkmaar, The Netherlands
| | - Michael C Mooij
- Department of Phlebology, Skin and Vein Clinic Oosterwal, Alkmaar, The Netherlands
| | | | - Willem Wisselink
- Department of Vascular Surgery, 1209Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Çağdaş Ünlü
- Department of Surgery, 1140Northwest Clinics, Alkmaar, The Netherlands
| |
Collapse
|
5
|
Barriers to Pursuing a Career in Surgery: An Institutional Survey of Harvard Medical School Students. Ann Surg 2021; 273:1120-1126. [PMID: 31599803 DOI: 10.1097/sla.0000000000003618] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to elucidate current medical student perceptions on barriers to a career in surgery, with a particular focus on gender-specific differences. SUMMARY BACKGROUND DATA Although gender parity in medical school composition has been reached, women continue to be underrepresented in the field of surgery. METHODS An anonymous, single-institution, internet-based survey conducted at Harvard Medical School. RESULTS Approximately 720 medical students were surveyed and 261 completed the questionnaire (36.3%; 58.6% women, 41% men, 0.4% transgender). Overall, there was no significant gender difference in intention to pursue surgery (27% of men, 22% of women; P = 0.38). Sixty-nine percent of all students and 75% of those pursuing surgery reported verbal discouragement from pursuing a surgical career. Women were significantly more likely to perceive that the verbal discouragement was based on gender (P < 0.0001), age (P < 0.0001), and family aspirations (P = 0.043) compared to men. Surgical work hours and time for outside interests were the greatest deterrents for both genders. Significantly more women reported concerns about time to date or marry (P = 0.042), time to spend with family (P = 0.015), finding time during residency to have a child (P < 0.0001), taking maternity/paternity leave during residency (P < 0.0001), and being too old after residency to have a child (P < 0.0001). CONCLUSIONS Both men and women reported high rates of verbal discouragement, but more women perceived that the discouragement was gender-based. Concerns about marriage and childbearing/rearing significantly deterred more women than men. Family aspirations were also a significant factor for men to choose an alternative career path. Additional support within the surgical field is needed to mitigate these concerns and support trainees in both their career and familial aspirations.
Collapse
|
6
|
H E, K M. An analysis of the cost of postgraduate training in surgery in Ireland compared to other specialties. Ir J Med Sci 2021; 191:945-950. [PMID: 34050495 PMCID: PMC8983625 DOI: 10.1007/s11845-021-02641-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 04/25/2021] [Indexed: 11/29/2022]
Abstract
Introduction Postgraduate specialty training in Ireland is associated with considerable cost. Some of these are mandatory costs such as medical council fees, while others are necessary to ensure career progression, such as attendance at courses and conferences. In particular, surgical specialities are believed to be associated with high training costs. It is unknown how these costs compare to those borne by counterparts in other specialities. Aims The aims of this study were toQuantify the amount that trainees in Ireland spend on postgraduate training Determine whether a difference exists between surgery and other non-skill-based specialties in terms of expenditure on training
Methods A standardised non-mandatory questionnaire was circulated to trainees across two training centres in Ireland. Trainees at all levels were invited to participate. Results Sixty responses were obtained. Fifty-seven questionnaires were fully completed and included for analysis. The median expenditure on training was higher for surgical than non-surgical specialities. Subgroup analysis revealed surgical training was associated with higher expenditure on higher degrees and courses compared to medical training (p = 0.035). > 95% of trainees surveyed felt that greater financial support should be available for trainees during the course of their training. Conclusions This study demonstrated that a career in surgery is associated with higher ongoing costs for higher degrees and courses than counterparts in non-surgical training. All surgical trainees surveyed felt that better financial support should be available. Increasing financial support for may be a tangible way to mitigate against attrition during training.
Collapse
Affiliation(s)
- Earley H
- Department of General Surgery, Wexford General Hospital, Newton Road, Wexford, Ireland. .,Royal College of Surgeons, 123 St Stephen's Green, Dublin, Ireland.
| | - Mealy K
- Department of General Surgery, Wexford General Hospital, Newton Road, Wexford, Ireland.,Royal College of Surgeons, 123 St Stephen's Green, Dublin, Ireland
| |
Collapse
|
7
|
CANBEYLİ İD, ÇIRPAR M. Anticipated decrease in surgeons: does orthopedic internship affect medical students career choice? JOURNAL OF HEALTH SCIENCES AND MEDICINE 2020. [DOI: 10.32322/jhsm.769373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
8
|
Corless KG, Samy A, Kamil A, Ryan EJ, Shafik L, Bassily K, Basil Ali A, O'Brien K, Hogan AM. The future of general surgery in Ireland: factors influencing career decisions of medical students. Ir J Med Sci 2020; 190:741-747. [PMID: 32812116 DOI: 10.1007/s11845-020-02347-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/13/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The decline in popularity of general surgery as a career has been well described. A number of factors have been put forward to explain this, for example, trainee burnout and perceived difficulty with work/life balance. The aim of this study was to elucidate the reasons for this among medical students in Ireland. METHOD A questionnaire was distributed to clinical year medical students in Ireland using an online survey via SurveyMonkey™. Domains assessed included demographics, career plan and associated rationale. Anonymised responses were collated and evaluated. RESULTS There were 307 responses (response 23%). Females accounted for 66% (202). Mean age was 24 years (SD = 2.89). One hundred twelve responses (36%) were contemplating becoming surgeons. One hundred nine-five responses were not considering surgery: however 87 had previously considered. Of the 87, 41 (47%) attributed the decision to work/life balance, 30 (35%) to impact on personal relationships and 10 (11%) blamed unclear career projection. Students interested in surgery were asked to quantify their knowledge of the application process-17 (15%) good, 39 (35%) fair and 56 (50%) poor. CONCLUSION A small proportion of respondents plan to pursue a career in general surgery. This is concerning in view of attrition rates through junior years. Although lifestyle factors are significant, clarity regarding training pathways was also reported. Undergraduate education regarding career trajectory, quality of life and practicalities of a career in general surgery may increase applications.
Collapse
Affiliation(s)
| | - Amir Samy
- Department of Surgery, University Hospital Galway, Galway, Ireland
| | - Ahmed Kamil
- Department of Surgery, University Hospital Galway, Galway, Ireland
| | - Eanna J Ryan
- Department of Surgery, University Hospital Galway, Galway, Ireland
| | - Lidia Shafik
- Medical School, National University of Ireland Galway, Galway, Ireland
| | | | - A Basil Ali
- Medical School, Royal College of Surgeons Ireland, Dublin, Ireland
| | | | | |
Collapse
|
9
|
Influence of Cardiorespiratory Clinical Placements on the Specialty Interest of Physiotherapy Students. Healthcare (Basel) 2019; 7:healthcare7040148. [PMID: 31744262 PMCID: PMC6956292 DOI: 10.3390/healthcare7040148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/14/2019] [Accepted: 11/14/2019] [Indexed: 11/16/2022] Open
Abstract
Clinical placements are an important part of health students’ training. Whilst much value is placed on the clinical environment as a place to learn, there is a paucity of direct evidence about its effectiveness. The aim of this study was to compare the competence, importance, and interest in cardiorespiratory physiotherapy of students before and after one month of clinical practice. A pre- and post-placement questionnaire about students’ interest in different physiotherapy subspecialties was used. The students with a cardiorespiratory clinical placement showed a significant change in their perception about the importance of the cardiorespiratory specialty (0.348 ± 1.01; p < 0.001), while no significant change was observed in the students without cardiorespiratory placement (−0.014 ± 0.825; p = 0.883). The presence or absence of clinical placements seems to have a definitive impact on students’ choice of a specialty. This implies the need for developing a set of clinical placements in all the subareas of physiotherapy in order to give undergraduate students the opportunity to make a better decision.
Collapse
|
10
|
Zaheer F, Rehman HU, Fareed W, Khan MO, Rizvi SAH. Factors Affecting the Choice of a Career in the Field of Surgery Among Medical Students of Karachi. Cureus 2018; 10:e3542. [PMID: 30648075 PMCID: PMC6324860 DOI: 10.7759/cureus.3542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction Medical students choose to pursue their careers based on multiple internal and external factors. These factors, in turn, not only affect their personal future but the overall status of the health care system of their country. A recent decline in the interest of medical students towards the surgical career is being observed and, therefore, the factors influencing their choice need to be evaluated. We aimed to identify these factors in medical students of a public sector university of Karachi. Methods A cross-sectional study was conducted at Dow Medical College from April 2018 to May 2018. A pre-tested questionnaire was administered to a sample of 250 students. Besides sociodemographic factors, the choice of career was identified and the factors that influenced it were assessed. Students' opinions were collected using a Likert scale. Data were entered and analyzed using the IBM Statistical Package for the Social Sciences 23.0 (IBM, NY, USA). Frequencies were calculated for individual variables. The chi-square test was used to measure statistical differences between categorical variables and a p-value of <0.05 was considered to be significant. Results In this study, 224 out of 250 questionnaires were returned with complete data, yielding a response rate of 89.6%. We found that 48.2% of students reported a desire to pursue a career in surgery. Students whose fathers were more qualified and belonged to the field of health care were more likely to pick a surgical career (p-value of 0.034 and 0.039, respectively). Students who were willing to pursue a path in surgery more often thought that the social standing of surgeons had its importance (p=0.037). These students also agreed that high salary has a role to play in affecting the choice of career (p=0.023). The most common factors that encouraged students for the choice of a surgical career included the practical implication of skills (57.4%) followed by an academic interest in the field (53.7%), and high income (42.6%). The most common discouraging factors included lifestyle and long working hours (56.9%), followed by less academic interest (31%). Conclusion Our study provides a valuable insight into the factors that influence the choice of medical students for pursuing a career in surgery. We also identified the factors that demotivated them from doing so. In our opinion, better incorporation of surgery into the curriculum, proper attention given to students during their surgical rotation and restructuring of the surgical training program are some of the ways that may improve the interest of students in the field of surgery.
Collapse
Affiliation(s)
- Farhan Zaheer
- Surgery, Civil Hospital, Dow University of Health Sciences, Karachi, PAK
| | - Hafeez Ur Rehman
- Surgical, Civil Hospital, Dow University of Health Sciences, Karachi, PAK
| | - Wajahat Fareed
- Surgery, Civil Hospital, Dow University of Health Sciences, Karachi, PAK
| | - Mohammad O Khan
- Internal Medicine, Civil Hospital, Dow University of Health Sciences, Karachi, PAK
| | | |
Collapse
|
11
|
Scanlan GM, Cleland J, Johnston P, Walker K, Krucien N, Skåtun D. What factors are critical to attracting NHS foundation doctors into specialty or core training? A discrete choice experiment. BMJ Open 2018; 8:e019911. [PMID: 29530910 PMCID: PMC5857684 DOI: 10.1136/bmjopen-2017-019911] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Multiple personal and work-related factors influence medical trainees' career decision-making. The relative value of these diverse factors is under-researched, yet this intelligence is crucially important for informing medical workforce planning and retention and recruitment policies. Our aim was to investigate the relative value of UK doctors' preferences for different training post characteristics during the time period when they either apply for specialty or core training or take time out. METHODS We developed a discrete choice experiment (DCE) specifically for this population. The DCE was distributed to all Foundation Programme Year 2 (F2) doctors across Scotland as part of the National Career Destination Survey in June 2016. The main outcome measure was the monetary value of training post characteristics, based on willingness to forgo additional potential income and willingness to accept extra income for a change in each job characteristic calculated from regression coefficients. RESULTS 677/798 F2 doctors provided usable DCE responses. Location was the most influential characteristic of a training position, followed closely by supportive culture and then working conditions. F2 doctors would need to be compensated by an additional 45.75% above potential earnings to move from a post in a desirable location to one in an undesirable location. Doctors who applied for a training post placed less value on supportive culture and excellent working conditions than those who did not apply. Male F2s valued location and a supportive culture less than female F2s. CONCLUSION This is the first study focusing on the career decision-making of UK doctors at a critical careers decision-making point. Both location and specific job-related attributes are highly valued by F2 doctors when deciding their future. This intelligence can inform workforce policy to focus their efforts in terms of making training posts attractive to this group of doctors to enhance recruitment and retention.
Collapse
Affiliation(s)
- Gillian Marion Scanlan
- Centre for Healthcare Education Research and Innovation (CHERI), Institute of Education for Medical and Dental Sciences, School of Medicine, Dentistry and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Jennifer Cleland
- Centre for Healthcare Education Research and Innovation (CHERI), Institute of Education for Medical and Dental Sciences, School of Medicine, Dentistry and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Peter Johnston
- NHS Education for Scotland, Scotland Deanery, Aberdeen, UK
| | - Kim Walker
- NHS Education for Scotland, Scotland Deanery, Aberdeen, UK
| | - Nicolas Krucien
- Health Economics Research Unit (HERU), School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK
| | - Diane Skåtun
- Health Economics Research Unit (HERU), School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK
| |
Collapse
|
12
|
Peel JK, Schlachta CM, Alkhamesi NA. A systematic review of the factors affecting choice of surgery as a career. Can J Surg 2018; 61:58-67. [PMID: 29368678 PMCID: PMC5785290 DOI: 10.1503/cjs.008217] [Citation(s) in RCA: 138] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2017] [Indexed: 01/04/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- John K. Peel
- From the Faculty of Medicine, University of British Columbia, Vancouver, BC (Peel); and Canadian Surgical Technologies and Advanced Robotics (CSTAR), London Health Sciences Centre and Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Schlachta, Alkhamesi)
| | - Christopher M. Schlachta
- From the Faculty of Medicine, University of British Columbia, Vancouver, BC (Peel); and Canadian Surgical Technologies and Advanced Robotics (CSTAR), London Health Sciences Centre and Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Schlachta, Alkhamesi)
| | - Nawar A. Alkhamesi
- From the Faculty of Medicine, University of British Columbia, Vancouver, BC (Peel); and Canadian Surgical Technologies and Advanced Robotics (CSTAR), London Health Sciences Centre and Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ont. (Schlachta, Alkhamesi)
| |
Collapse
|
13
|
Bartlett J. Addressing the recruitment shortfall in surgery - How do we inspire the next generation? Ann Med Surg (Lond) 2017; 25:30-32. [PMID: 29321919 PMCID: PMC5751997 DOI: 10.1016/j.amsu.2017.11.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 11/29/2017] [Indexed: 11/24/2022] Open
Abstract
•Application rates to surgery by medical students have declined in recent years.•More hands-on experience, information and mentorship is needed in medical schools.•Within surgery, gendered stereotyping of roles and environments must be challenged.•Reform of the current systems of outcome reporting is necessary.
Collapse
|
14
|
Vo A, McLean L, McInnes MD. Medical specialty preferences in early medical school training in Canada. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2017; 8:400-407. [PMID: 29140793 PMCID: PMC5694695 DOI: 10.5116/ijme.59f4.3c15] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 10/28/2017] [Indexed: 05/22/2023]
Abstract
OBJECTIVES To understand what medical students consider when choosing their specialty, prior to significant clinical exposure to develop strategies to provide adequate career counseling. METHODS A cross-sectional study was performed by distributing optional questionnaires to 165 first-year medical students at the University of Ottawa in their first month of training with a sample yield of 54.5% (n=90). Descriptive statistics, analysis of variance, Spearman's rank correlation, Cronbach's alpha coefficient, Kaiser-Meyer-Olkin Measure, and exploratory factor analyses were used to analyze the anonymized results. RESULTS "Job satisfaction", "lifestyle following training" and, "impact on the patient" were the three highest rated considerations when choosing a specialty. Fifty-two and seventeen percent (n=24) and 57.89% (n=22) of males and females ranked non-surgical specialties as their top choice. Student confidence in their specialty preferences was moderate, meaning their preference could likely change (mean=2.40/5.00, SD=1.23). ANOVA showed no significant differences between confidence and population size (F(2,86)=0.290, p=0.75) or marital status (F(2,85)=0.354, p=0.70) in both genders combined. Five underlying factors that explained 44.32% of the total variance were identified. Five themes were identified to enhance career counseling. CONCLUSIONS Medical students in their first month of training have already considered their specialty preferences, despite limited exposure. However, students are not fixed in their specialty preference. Our findings further support previous results but expand what students consider when choosing their specialty early in their training. Medical educators and administrators who recognize and understand the importance of these considerations may further enhance career counseling and medical education curricula.
Collapse
Affiliation(s)
- Anthony Vo
- Department of Diagnostic Radiology, University of Alberta, Canada
| | - Laurie McLean
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Canada
| | | |
Collapse
|
15
|
Ahmed O, Nugent M, Cahill R, Mulsow J. Attitudes to trainee-led surgical mentoring. Ir J Med Sci 2017; 187:821-826. [DOI: 10.1007/s11845-017-1703-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 10/20/2017] [Indexed: 11/29/2022]
|
16
|
Ng-Sueng LF, Vargas-Matos I, Mayta-Tristán P, Pereyra-Elías R, Montenegro-Idrogo JJ, Inga-Berrospi F, Ancalli F, Bonilla-Escobar F, Diaz-Velez C, Gutierrez-Quezada E, Gomez-Alhach J, Muñoz-Medina CE, Sanchez-Pozo A, Vidal M. Gender Associated with the Intention to Choose a Medical Specialty in Medical Students: A Cross-Sectional Study in 11 Countries in Latin America. PLoS One 2016; 11:e0161000. [PMID: 27519055 PMCID: PMC4982605 DOI: 10.1371/journal.pone.0161000] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 07/28/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction The selection of a medical specialty has been associated with multiple factors, such as personal preferences, academic exposure, motivational factors and sociodemographic factors, such as gender. The number of women in the medical field has increased in recent years. In Latin America, we have not found any studies that explore this relationship. Objective To determine whether there is an association between gender and the intention to choose a medical specialty in medical students from 11 countries in Latin America. Methods Secondary analysis of the Collaborative Working Group for the Research of Human Resources for Health (Red-LIRHUS) data; a multi-country project of students in their first year and fifth year of study, from 63 medical schools in 11 Latin American countries. All students who referred intention to choose a certain medical specialty were considered as participants. Results Of the 11073 surveyed students, 9235 indicated the name of a specific specialty. The specialties chosen most often in the fifth year were General Surgery (13.0%), Pediatrics (11.0%), Internal Medicine (10.3%) and Obstetrics/Gynecology (9.0%). For women, the top choices were Pediatrics (15.8%), Obstetrics/Gynecology (11.0%), Cardiology (8.7%), General Surgery (8.6%), and Oncology (6.4%). In the adjusted analysis, the female gender was associated with the choice of Obstetrics/Gynecology (RP: 2.75; IC95%: 2.24–3.39); Pediatric Surgery (RP: 2.19; IC95%: 1.19–4.00), Dermatology (RP: 1.91; IC95%:1.24–2.93), Pediatrics (RP: 1.83; IC95%: 1.56–2.17), and Oncology (RP: 1.37; IC95%: 1.10–1.71). Conclusions There is an association between the female gender and the intention to choose Obstetrics/Gynecology, Pediatrics, Pediatric Surgery, Dermatology, and Oncology. We recommend conducting studies that consider other factors that can influence the choice of a medical specialty.
Collapse
Affiliation(s)
- Luis Fernando Ng-Sueng
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
- Sociedad Científica Estudiantes de Medicina UPC, Lima, Perú
| | - Iván Vargas-Matos
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Percy Mayta-Tristán
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
- * E-mail:
| | | | | | | | - Felix Ancalli
- Universidad Nacional Jorge Basadre Grohmann, Tacna, Perú
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Cleland J, Johnston P, Watson V, Krucien N, Skåtun D. What do UK doctors in training value in a post? A discrete choice experiment. MEDICAL EDUCATION 2016; 50:189-202. [PMID: 26812998 DOI: 10.1111/medu.12896] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 07/20/2015] [Accepted: 08/21/2015] [Indexed: 06/05/2023]
Abstract
CONTEXT Many individual and job-related factors are known to influence medical careers decision making. Medical trainees' (residents) views of which characteristics of a training post are important to them have been extensively studied but how they trade-off these characteristics is under-researched. Such information is crucial for the development of effective policies to enhance recruitment and retention. Our aim was to investigate the strength of UK foundation doctors' and trainees' preferences for training post characteristics in terms of monetary value. METHODS We used an online questionnaire study incorporating a discrete choice experiment (DCE), distributed to foundation programme doctors and doctors in training across all specialty groups within three UK regions, in August-October 2013. The main outcome measures were monetary values for training-post characteristics, based on willingness to forgo and willingness to accept extra income for a change in each job characteristic, calculated from regression coefficients. RESULTS The questionnaire was answered by 1323 trainees. Good working conditions were the most influential characteristics of a training position. Trainee doctors would need to be compensated by an additional 49.8% above the average earnings within their specialty to move from a post with good working conditions to one with poor working conditions. A training post with limited rather than good opportunities for one's spouse or partner would require compensation of 38.4% above the average earnings within their specialty. Trainees would require compensation of 30.8% above the average earnings within their specialty to move from a desirable to a less desirable locality. These preferences varied only to a limited extent according to individual characteristics. DISCUSSION Trainees place most value on good working conditions, good opportunities for their partners and desirable geographical location when making career-related decisions. This intelligence can be used to develop alternative models of workforce planning or to develop information about job opportunities that address trainees' values.
Collapse
Affiliation(s)
- Jennifer Cleland
- Division of Medical and Dental Education (DMDE), School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK
| | - Peter Johnston
- NHS Education for Scotland, Northern Deanery, Aberdeen, UK
| | - Verity Watson
- Health Economics Research Unit (HERU), School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK
| | - Nicolas Krucien
- Health Economics Research Unit (HERU), School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK
| | - Diane Skåtun
- Health Economics Research Unit (HERU), School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK
| |
Collapse
|
18
|
Attitudes of GP trainees towards the training received in urology on the GP training scheme. Ir J Med Sci 2015; 185:165-9. [PMID: 25673163 DOI: 10.1007/s11845-015-1261-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 01/17/2015] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The majority of patients with scrotal problems or urinary symptoms will first present to their general practitioner (GP). The importance of the initial examination performed by the GP is often underestimated; however, it frequently determines the course of investigation and ultimately treatment. Unfortunately, medical schools have devoted increasingly less time to teaching urology over the past decade. The impact of this decline in teaching on a GP trainee's assessment of urological complaints remains unclear. The aim of this study was to investigate the self-reported competency of GP trainees in assessing urological presentations. METHODS A questionnaire was circulated to 101 GP trainees from five separate training programmes. Respondents rated their confidence in evaluating four different urological presentations. They were also invited to give their opinion regarding the teaching of urology on their current scheme and whether they would be in favour of the addition of urology as an optional rotation. RESULTS Only 18 trainees (19 %) felt urology was adequately covered on their curriculum. A small yet significant number of respondents felt uncomfortable in their assessment of testicular (28 %, 28/101) or prostate (35 %, 35/101) pathology and male (17 %, 17/101) or female (10 %, 10/101) urinary symptoms. Twenty-six trainees (26 %) would choose a rotation in urology if available. Another ten trainees felt that attending urology outpatient clinics would benefit training. CONCLUSION This study highlights a number of concerns among GP trainees in relation to their training in urology. These issues should be addressed to ensure that the training scheme sufficiently prepares GPs to manage common urological conditions.
Collapse
|
19
|
An analysis of medical students' attitude to surgical careers and pursuing intercalated research degrees. Ir J Med Sci 2015; 185:177-82. [PMID: 25652952 DOI: 10.1007/s11845-015-1264-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 01/24/2015] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Major changes are occurring in surgical training in the UK and Ireland. Training time is reduced due to the introduction of run-through training and the EWTD. Streamlined training also may affect the number of trainees engaging in full-time higher degrees by research, in spite of the fact that those who do engage are more academically productive. This study assesses the attitudes of medical students towards a career in surgery and their attitudes to research, especially in the context of an intercalated degree programme. METHODS 615 students comprising both undergraduates and postgraduates from RCSI were surveyed. The influence of a number of factors was ranked using five-point Likert scales. Students were asked to rate the importance of research to their future careers. RESULTS 595 (97 %) of those surveyed completed the questionnaire satisfactorily. Those interested in surgery were more likely to be male, undergraduate students and younger. Factors encouraging students to pursue a surgical career were prestige, identification of a surgical mentor, financial reward and research opportunities on offer (p < 0.001 in all cases). Almost 27 % of students had already engaged with some form of research project. A significant proportion of those interested and not interested in surgery (26 and 29 % respectively) would consider taking time out to do an intercalated research degree as part of their primary medical studies. CONCLUSION Surgical training faces significant challenges. One way to encourage the next generation of academic surgeons may be to offer some candidates intercalated research degrees while pursuing their medical qualification.
Collapse
|
20
|
Seelandt JC, Kaderli RM, Tschan F, Businger AP. The surgeon's perspective: promoting and discouraging factors for choosing a career in surgery as perceived by surgeons. PLoS One 2014; 9:e102756. [PMID: 25025428 PMCID: PMC4099181 DOI: 10.1371/journal.pone.0102756] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 06/22/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The aim of this study was to identify the factors perceived by surgeons that promote surgery as an attractive or unattractive career choice for today's graduates. In addition, it examined whether the perspectives of surgeons in different professional situations converges. The content of work, contextual work conditions, and calling to this job are discussed in the context of choosing surgery as a career. METHODS Eight hundred sixty-nine surgeons were asked to answer open-ended questions regarding the factors that promote surgery as an attractive or unattractive career choice for today's graduates. Four hundred ninety-two surgeons participated, and 1,525 statements were analyzed using Mayring's content-analyses method. Chi-square tests were used to analyze the differences among hierarchical positions. RESULTS With respect to the factors that promote surgery as a profession, 40.8% (209/492) of the surgeons stated that surgery is a calling, 29.1% (149/492) of the surgeons provided at least one argument related to the positive task characteristics, and 12.9% (66/492) of the surgeons provided statements related to the positive contextual factors. With respect to the factors that discourage surgery as a profession, 45.7% (234/492) of the surgeons provided at least one argument related to the discouraging work characteristics, and 67.6% (346/492) of the surgeons provided problematic contextual characteristics. CONCLUSION This study emphasizes the importance of the calling to surgery as an important factor for choosing surgery as a career. However, the extensive workload, training, and poor work-family balance have been identified as factors that discourage graduates from choosing surgery as a career. The identified positive factors could be used to attract and maintain graduates in surgical disciplines.
Collapse
Affiliation(s)
- Julia C. Seelandt
- Institute of Work Psychology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Reto M. Kaderli
- Department of Visceral Surgery and Medicine, Inselspital University Hospital Bern, Bern, Switzerland
| | - Franziska Tschan
- Institute of Work Psychology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Adrian P. Businger
- Military Medical Service, Swiss Armed Forces, Ittigen-Bern, Switzerland
- Private University in the Principality of Liechtenstein, Triesen, Liechtenstein
| |
Collapse
|
21
|
Dolan-Evans E, Rogers GD. Barriers for students pursuing a surgical career and where the Surgical Interest Association can intervene. ANZ J Surg 2014; 84:406-11. [PMID: 24456298 DOI: 10.1111/ans.12521] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There are some concerns that medical student interest in surgery is suffering. The aims of this project were to investigate the proportion of medical students interested in surgery from years 1 to 4, explore influential attitudinal and demographic factors, and establish baseline data to study the future effects of the Surgical Interest Association. METHODS Students were surveyed through an audience response system in year orientation sessions. For a majority of the analyses, respondents were dichotomized based on expressing an interest in surgery or not. RESULTS There were no significant differences in the interest students had for a surgical career between medical student year levels in a cross-sectional analysis. However, available longitudinal data demonstrated a significant decrease in surgical interest from first years in 2012 to second years in 2013. Lifestyle, working hours and training length concerns had minimal effects as career influences on students interested in surgery, whereas academic interest and career opportunities were motivating factors in choosing this career. CONCLUSION The results suggested no difference between levels of interest from first to final year students in surgery as a career, though only 22% of final year students were interested in surgery. This study also suggested that promoting the academic and scientific side of surgery, along with career opportunities available, may be an important avenue to encourage students into surgery. Future research will investigate the changing interests of students in surgery longitudinally throughout the medical school and to analyse the effects of the Surgical Interest Association.
Collapse
Affiliation(s)
- Elliot Dolan-Evans
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | | |
Collapse
|