Increased Exposure Improves Recruitment: Early Results of a Program Designed to Attract Medical Students Into Surgical Careers

Characteristics and career outcomes of dermatology-focused medical student research grant recipients

Although several dermatology-focused research grants for medical students exist, studies have yet to evaluate the outcomes of grant recipients, such as entry into dermatology residency and academic careers. We have described the characteristics of recipients of dermatology-focused medical student research grants and outcomes, including entry into dermatology residency and academic careers, and we have focused on seven dermatology-focused national and regional research grants eligible for US medical students. Data were obtained from publicly available online sources for grants from 2004 to 2023. Of the 235 medical student recipients of dermatology research grants between 2004 and 2023, 45.5% attended one of the top 20 medical schools funded by National Institutes of Health research grants. Of those who completed medical school, 68.3% advanced to a dermatology residency (n = 123/180). Among board-certified dermatologists, 44.7% held an academic position (n = 34/76); among those who attended a top 20 medical school, 50% held an academic position (n = 23/46) compared with 36.7% who did not (n = 11/30). Limitations of this study include selection bias and incomplete data availability. Medical student research grants allow students to thoughtfully engage in dermatology research early in medical education. These grants may facilitate entry into dermatology residency and academic careers and lead to continued research endeavors.

Grit and Thoracic Surgery Interest Among Medical Students

OBJECTIVE

This study evaluated the relationship between medical student Grit and thoracic surgery career interest.

DESIGN

An online questionnaire was designed to measure self-reported ratings of Grit among medical student using the Short-Grit scale, as well as thoracic surgery career interest.

SETTING

Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.

PARTICIPANTS

From 2019 to 2021, 192/367 (52.3%) participants in their first or second year of medical school. The cohort was comprised of 109 (56.8%) females while 115 (59.9%) were <24 years of age.

RESULTS

Mean Grit was high (M = 4.159 +/- 0.450) among medical students. There were 80 (41.2%) students interested in thoracic surgery. There was a significant difference in Grit between students with a career interest in thoracic surgery (4.256 +/- 0.442) and those uninterested in thoracic surgery (4.089 +/- 0.444); t(190) = 2.572, p = 0.011; Cohen's D = 0.442. Career interest in thoracic surgery was not influenced by career factor interest.

CONCLUSIONS

Grittier students have a career interest in thoracic surgery. Recruitment teams in thoracic surgery residency programs with high rates of burnout and poor psychological wellbeing among trainees may take interest in these findings.

Enhancing Our Workforce: Recruitment and Retention in Anesthesiology

Increasingly, both healthcare leaders and studies of healthcare outcomes recommend a medical workforce that is representative of the patient population as a method to reduce health disparities and medical costs. Anesthesiology remains a specialty with lower proportions of women and underrepresented in medicine (URiM) physicians as compared to the overall physician workforce, with 26.1% of anesthesiologists identifying as women and 31.3% of anesthesiologists as URiM. Two areas of focus are commonly identified when discussing inadequate representation in the workforce: recruitment into the specialty and retention in the profession. As medical educators, we provide a critical role in the recruitment and retention of women and URiM anesthesiologists, through implementation of processes, programs, and cultural change. Here, we will discuss the current problems of recruitment and retention of women and URiM anesthesiologists and suggest action plans for now and the future to enhance our specialty's diversity.

Impact of medical school experiences on the career choice of neurosurgery: a cross- sectional study from Pakistan

BACKGROUND

Pakistan grapples with the issue of an inadequate neurosurgery workforce but the reasons for such a disparity remain uncertain. Previous studies have highlighted how various factors including medical school experiences have an impact on career choice, but no study has delved into the impact of medical school exposure among Pakistani medical students, especially for the field of neurosurgery. This study aims to evaluate the impact of neurosurgery exposure, mentorship, and interest groups on medical students' decision to pursue neurosurgery.

METHODS

A national cross-sectional survey was conducted in Pakistan, collecting data from medical students, interns, and medical officers over a one-month period. Ethical approval was obtained from the Ethical Review Committee at Aga Khan University, Pakistan. The data was analyzed using SPSS version 26.

RESULTS

Out of 2618 participants, 38.0% were male and 62.0% were female, with an average age of 21.82 years (± 2.65). Among them, only 358 (13.6%) were interested in pursuing neurosurgery as a career, while the remaining 2,260 (86.3%) were not. More females (58.9%) than males (41.1%) expressed interest in pursuing neurosurgery as their intended career. Most medical students interested in pursuing neurosurgery were in the early years of their medical school (1st Year: 19.6%, 2nd Year: 26.0%, 3rd Year: 20.9%). In our study, students from public sector institutions (52.2%) showed more interest in neurosurgery as a career choice compared to those from private sector institutions (44.1%). The main deterrents for choosing neurosurgery were intense training (42.2%), work-life balance (39.9%), limited residency slots (56.7%), medical knowledge (34.1%), and surgical skills (36.6%).

CONCLUSION

This study highlights the need for increased student engagement to inculcate the decision to pursue neurosurgery among medical students in Pakistan. A significant gap is highlighted, with the majority of interested students in early years. Public sector students show higher interest than their private sector counterparts. However, barriers like intense training, limited residency slots, and work-life balance concerns influence career choice. Targeted interventions like mentorship programs are crucial for fostering future neurosurgeons and advancing patient care and research. By addressing the identified disparities in experiences and promoting a supportive educational environment, it is possible to cultivate a future generation of skilled and dedicated neurosurgeons who can contribute to advancements in patient care and research in the field.

Engaging medical students in cardiac surgery: a focus on equity, diversity, and inclusion

PURPOSE OF REVIEW

The Coronavirus Disease 2019 pandemic prohibited Canadian medical students from in-person observerships. This may be particularly detrimental to under-represented groups that may consider surgical subspecialties. To address the unprecedented need for alternative surgical career exploration and diversity within the profession, The University of Toronto Cardiac Surgery Interest Group and Division of Cardiac Surgery collaborated on virtual experiential programming.

RECENT FINDINGS

Medical students were invited to virtual (1) observerships of a cardiac bypass case, (2) mentorship sessions with surgeons, (3) resident teaching sessions, (4) multidisciplinary case-based Heart Team discussions to further their understanding of the scope of Cardiac surgery, and (5) a virtual coronary anastomosis training program. Additionally, a comprehensive virtual program was spearheaded to increase interest in Cardiac surgery among low-income Black high school students.

SUMMARY

Trainee response to the virtual education, mentorship, and skill acquisition was positive. Trainees reported high levels of interest in the profession, particularly among females and under-represented minorities, supporting the principles of equity diversity, and inclusion in Cardiac surgery.

Evolution of a Plastic Surgery Summer Research Program: Lessons Learned from Programmatic Evaluation and Quality Enhancement

Early surgical exposure and research fellowships can influence medical students' specialty choice, increase academic productivity, and impact residency match. However, to our knowledge, there is no published guidance on the programmatic evaluation and quality enhancement necessary for the sustainability of formal plastic surgery summer research programs for first year medical students. We present seven years (2013-2020) of institutional experience in an effort to inform program development at other institutions.

Methods

From 2013 to 2016, a sole basic science research arm existed. In 2017, a clinical research arm was introduced, with several supplemental activities, including surgical skills curriculum. A formalized selection process was instituted in 2014. Participant feedback was analyzed annually. Long-term outcomes included continued research commitment, productivity, and residency match.

Results

The applicant pool reached 96 applicants in 2019, with 85% from outside institutions. Acceptance rate reached 7% in 2020. With adherence to a scoring rubric for applicant evaluation, good to excellent interrater reliability was achieved (intraclass correlation coefficient = 0.75). Long-term outcomes showed that on average per year, 28% of participants continued involvement in departmental research and 29% returned for dedicated research. Upon finishing medical school, participants had a mean of 7 ± 4 peer-reviewed publications. In total, 62% of participants matched into a surgical residency program, with 54% in integrated plastic surgery.

Conclusions

A research program designed for first year medical students interested in plastic surgery can achieve academic goals. Students are provided with mentorship, networking opportunities, and tools for self-guided learning and career development.

Near-Peer Teaching in Conjunction with Flipped Classroom to Teach First-Year Medical Students Basic Surgical Skills

BACKGROUND

There is increasing evidence that students are completing medical school with insufficient surgical education. Near-peer tutoring and flipped classroom formatting may be used to enhance learning while simultaneously relieving faculty burden of teaching. Here, we qualitatively evaluate a 3-month course that integrates the use of near-peer teaching and flipped classroom formatting, with the goal of increasing first-year medical students' self-perceived confidence in performing basic sutures and knot-ties as well as interest in surgery.

METHODS

Twenty-one first-year medical students participated in a suturing and knot-tying course led by senior medical students. The course consisted of 2-h sessions held every 2 weeks for a total of five sessions. Students were sent publicly available videos prior to each session by which to learn the upcoming techniques and received live feedback from instructors during sessions. Questionnaires were completed pre-course and post-course.

RESULTS

Compared to pre-course ratings, post-course ratings of self-perceived confidence to perform various knot-ties and sutures all increased significantly (p < 0.05). All students stated that the course strengthened their desire to pursue a career in surgery. Student feedback of the course was overall positive.

CONCLUSIONS

Near-peer teaching can be used in conjunction with flipped classroom to increase first-year medical students' self-perceived confidence in surgical suturing and knot-tying as well as interest in surgery. This curriculum may serve as an outline for student-led courses at other institutions.

Designing a Plastic and Reconstructive Surgery Virtual Curriculum (PRSVC): Assessment of Medical Student Knowledge, Surgical Skill, and Community Building

BACKGROUND

The COVID-19 pandemic displaced medical students from their rotations and into virtual classrooms. We aimed to develop a virtual curriculum with the goals for students to gain knowledge in plastic surgery, to acquire technical skills, and to be able to promote community.

METHODS

We developed a four-week educational curriculum of topics in plastic surgery using the American Society of Plastic Surgeons Resident Education Curriculum and an online plastic surgery curriculum. Virtual flipped classroom case discussions and weekly surgical skills workshops were offered. Pre- and post-course surveys were administered, and results analyzed using IBM SPSS Statistics version 25.0.

RESULTS

303 medical students and recent graduates enrolled in the course in June 2020. 182 students completed the pre-course survey (60% response rate), and of those, 50.0% (n=91) completed the post-course survey for paired comparison. Students reported significant improvement in confidence discussing the relevant anatomy, work-up and surgical approaches to clinical cases, as well as confidence in knowledge of all topic areas (p<0.001). Confidence in suturing and knot-tying techniques significantly improved among workshop participants (p<0.001). Students applying to residency programs this cycle felt significantly more prepared for sub-internships (p<0.001) and significantly more connected to the community of applicants (p<0.001).

CONCLUSIONS

The Plastic and Reconstructive Surgery Virtual Curriculum (PRSVC) improved knowledge, surgical skills, and community in the field among medical student participants. This course may serve to provide a framework for structured virtual learning activities for students interested in plastic surgery and may have significant long-lasting utility for students interested in the field.

Impact of Medical Student Participation in Student-Run Clinics on Education, Residency Selection, and Patient Care: A Review of Selected Articles

Student-run clinics (SRCs) are becoming increasingly popular at medical schools in the United States. These clinics have provided a variety of benefits, including serving disadvantaged populations and providing early clinical exposure for students. There has been no consensus on the impact of SRCs on medical education, specialty selection, and patient care. This review provides a thorough overview of student and patient outcomes as a function of medical students volunteering at SRCs. We queried PubMed for original literature published in English between the years 2000 and 2020. Inclusion criteria included primary research articles evaluating the impact of medical student participation in SRCs on education, specialty selection, and patient care. All articles included in the final review were agreed upon by three reviewers, and the pertinent data were extracted. Of 10,200 initial search results, seven papers were included in this review. These included two studies evaluating medical education, five studies evaluating residency selection, and three studies analyzing patient care. Three studies were included in multiple evaluations. The relationship between volunteering at SRCs and academic performance is unclear. Clinic volunteers had increased retention of empathy compared to non-volunteers. Additionally, clinic volunteers provided satisfactory care as determined by patient-reported outcomes, and were not more likely to pursue primary care specialties. As SRCs are increasing in number, research into the impact on medical students and patients is necessary to understand how these clinics may affect the field of health care. It is important to further evaluate how medical student involvement in SRCs can further improve patient care and outcomes.

Medical Students' Exposure to Plastic Surgery: A Cross-sectional Review of Scholarly and Academic Opportunities

Specialty exposure is most influential in a medical student's decision to pursue plastic surgery training. We aimed to understand what opportunities exist for students through national plastic surgery organizations.

Methods

The American Board of Plastic Surgery, American Society of Plastic Surgeons, and The Aesthetic Society provide online lists of related organizations. Cross-referencing lists yielded 47 unique organizations. Screening for presence of annual meeting and relevance to student and resident education yielded 14 organizations. Bylaws/web-domains were reviewed for information related to the annual meeting, leadership opportunities, membership, grants, and travel scholarships. If available, previrtual/in-person and virtual meeting prices were collected. Lastly, discrepancies between webpage information and phone/email correspondence were noted.

Results

All (100%) organizations welcomed students at annual meetings. Eleven promoted student presentation/submission. Average student registration fee was $109.3 ± SD$136.5 compared with $181.20 ± SD$157.20 for residents. Of organizations providing previrtual and virtual pricing (n = 10, 71.4%), there was an average price reduction in student registration of $92 (range: $0-375). Average student membership was $31.70/year ± SD $45.50 compared with $38.80 per year ± SD $65.90 for residents. The percentages of organizations offering student research grants, travel scholarships, and national student leadership were 21.4% (n = 3), 35.8% (n = 5), and 28.6% (n = 4) respectively. No organizations had student chapters/committees. All organizations (100%) contained at least one discrepancy between webpage/bylaw and email/phone.

Conclusions

Our results suggest that although national opportunities seem to be limited, a role exists for further engagement, with interested students eager to take the initiative. Virtual conferences present a lower-cost alternative for students and residents.

The State of Racial and Gender Diversity In Cardiothoracic Surgery Training

BACKGROUND

The field of cardiothoracic surgery has been striving to increase its gender and racial diversity. We sought to examine changes in gender and racial diversity in cardiothoracic fellowships and integrated residencies in the past decade.

METHODS

Accreditation Council for Graduate Medical Education data was obtained from 2011 to 2019. Presence of linear trends was assessed for year-by-year data. Average percentages of women and under-represented minorities were then calculated in three-year intervals. Intervals were compared with t-test and chi-square tests.

RESULTS

There was no statistically significant increase in percent female trainees in cardiothoracic fellowships (18.5% to 22.1% [p=0.10]) or integrated residencies (22.8% to 27.8% [p=0.17]), despite a significant increase in percent female applicants to fellowship (18.2% to 35.3% [p<0.01]) and integrated residency (8.9% to 33.0% [p<0.01]). Cardiothoracic fellowships had no increase in under-represented minority trainees (8.3% to 9.4% [p=0.48]). Under-represented minority trainees in integrated residencies increased from 2.7% to 6.9% [p=0.03]. Although there was no significant increase in under-represented minority applicants to fellowships (10.2% to 11.3% [p=0.66]), the percent of under-represented minority applicants to integrated residencies increased from 13.1% to 19.3% [p<0.01].

CONCLUSION

Cardiothoracic surgery training programs are attracting more female applicants, but this has not resulted in more female trainees. While percentages of under-represented minorities increased among integrated residency applicants and trainees, they remain low compared to other specialties. This data reflects positive changes but highlights that much remains to be done to increase diversity in cardiothoracic surgery training.

Factors Associated with Matching into Surgical Specialties

BACKGROUND

The United States medical education system has a vested interest in understanding medical student specialty choice. The purpose of this study is to identify the demographic, educational, lifestyle preference, and other factors associated with matching into surgical specialties.

METHODS

An annual survey was given to students at the University of Iowa Carver College of Medicine from 2013-2019. 456 medical students were eligible to participate and 374 completed at least one survey. Surveys were distributed 5 times; M1, M2, M3, and M4 years and after the residency match process. Logistic regression was used to estimate the association between various factors and the likelihood of matching into a surgical specialty.

RESULTS

Exposure to surgical fields, through a family member practicing surgery (aOR = 3.21), mentorship (aOR = 2.78), or research (aOR = 2.96) increase the likelihood of matching into a surgical specialty. Married students are less likely to pursue surgical specialties (aOR = 0.246). White students interested in surgery in their first two years of medical school were more likely (aOR = 6.472) to match into surgery than non-white students also interested in surgery (aOR = 0.155).

CONCLUSIONS

Factors associated with an increased likelihood of matching into surgical specialties include having surgical mentors, performing surgical research, and having family members in surgical specialties. Of the students interested in surgery early in medical school, being of Caucasian ethnicity is associated with higher rates of matching into surgery. Students who are married without children are less likely to enter a surgical field.

Orthopaedic Surgery Residency Match After an Early-Exposure Research Program for Medical Students

Introduction:

The purpose of this study was to determine the proportion of students matching in orthopaedic surgery after a structured, early-exposure mentored research program and what factors were associated with those students compared with participants who matched in other specialties.

Methods:

Program data were reviewed from 2007 to 2015. Multivariable binary logistic regression analysis was used to evaluate student and research factors associated with orthopaedic surgery match.

Results:

Of 174 students, 117 (67%) matched into surgical residency programs, with 49% (n = 85) matching into orthopaedic surgery. The percentage of women matching into orthopaedic surgery (37%) was less than that of men (53%), which, however, increased over the study period. Students who matched in orthopaedic surgery had greater numbers of publications (3.55 [range 0 to 17] average publications) compared with students who matched in other specialties (1.98 (range 0 to 11) average publications). The average number of publications per student increased from 0.79 (±1.44, range 0 to 10, 40%) preprogram to 1.95 (±2.28, range 0 to 11, 71%) postprogram. Measured factors associated with orthopaedic surgery match were publications with program mentor, postprogram first authorship, and total publications.

Discussion:

Approximately half of the participants matched into orthopaedic surgery. Analysis showed that research productivity increased after program participation and was statistically associated with increased likelihood of orthopaedic surgery match.

Barriers to Pursuing a Career in Surgery: An Institutional Survey of Harvard Medical School Students

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.

Foundation rotations in medical training: is it love at first sight?

PURPOSE OF STUDY

Factors influencing physician specialty choice is a prominent topic given the recruitment challenges faced by various specialties. We aimed to assess whether specialty exposure in the first foundation year was a positive predictive factor for permanent career choice.

STUDY DESIGN

A questionnaire-based study was distributed online using a survey tool. Questions recorded the foundation rotations of participants as well as their chosen medical specialty.

RESULTS

1181 responses were included in the analysis. 23% of respondents had undertaken a Foundation Year 1 (F1) rotation in their career specialty. Having undertaken a foundation rotation in anaesthetics, cardiology, emergency medicine, endocrinology, gastroenterology, genito-urinary medicine, intensive care, obstetrics and gynaecology, oncology, paediatrics, palliative care, psychiatry, radiology, respiratory and rheumatology was found to be statistically significantly linked to choosing that specialty as a career (p<0.01). There was a significant correlation between the second foundation rotation and career choice (p=0.02).

CONCLUSIONS

For many specialties, direct experience within foundation training has a positive effect on later career choice.

Characteristics and Attitudes of Aspiring Cardiothoracic Surgeons: A Survey Study

BACKGROUND

Although recruiting highly qualified, diverse applicants into cardiothoracic surgery remains a national priority, their characteristics remain unknown. This study aims to describe current and future applicants in cardiothoracic surgery.

METHODS

Aspiring cardiothoracic surgeons (students interested in matriculating in a North American training program) were voluntarily enrolled in the study through Twitter and email outreach. A 33-question survey evaluated their backgrounds, research experiences, attitudes, and interests within cardiothoracic surgery. Standard descriptive statistics were used.

RESULTS

There were 111 participants, 40 of whom were female (36.0%) and 27 of whom identified as an underrepresented minority (24.3%). Of the total, 63 belonged to an institution with a cardiothoracic surgery training program (56.8%). A total of 91 students envisioned having a mostly operative career (82.0%) and 75 envisioned pursuing educational roles (67.6%). The most popular surgical specialties were heart transplantation (50.5%) and aortic surgery (47.8%). Participants selected having a high-intensity operative environment (81.2%) and an innovative academic environment (58.8%) as the most attractive qualities. Perceived lack of work-life balance (46%) and toxic training or work environment (28%) were the greatest deterrents. Finances during the application process were perceived as a potential barrier by 41 students (36.9%). Approximately 75% of students (83 of 111) had faculty as mentors; 46.8% (56 of 111) thought that cardiothoracic surgery faculty were approachable but had limited time for mentorship.

CONCLUSIONS

This survey study characterized a nationally selected pool of aspiring cardiothoracic surgeons using social media. Future studies involving larger and more diverse cohorts are warranted to find areas for improvement in recruitment, retention, and diversity.

Evaluating the Impact of Medical Student Inclusion Into Hands-On Surgical Simulation in Congenital Heart Surgery

OBJECTIVE

Over the last decade medical students' interest in pursuing surgery as a career has declined. This is more apparent in high-specialized specialities such as congenital heart surgery (CHS). Early hands-on simulation has shown to have a positive impact on medical students' interest in pursuing surgery, however, its incorporation into medical school curricula is lacking. This study aimed to evaluate the impact of incorporating medical students as surgical assistants during the Hands On Surgical Training course in CHS.

METHODS

Local preclinical medical students were invited to participate as surgical assistants during the 5th annual Hands On Surgical Training course in CHS. Among those who responded to the invitation, students were randomly selected and allocated to assist a congenital heart surgeon. All selected students attended an assistants' session prior to the course to familiarize themselves with assisting and to practice basic surgical skills. At the end of both courses students completed a questionnaire based on Likert 5-point scale to evaluate the courses' usefulness.

RESULTS

Fifteen medical students completed the questionnaires. All reported a beginner level of understanding of congenital heart disease. All students were highly satisfied with using 3D-printed models to help their understanding of congenital heart disease (4.80 ± 0.41) and agreed that the sessions improved their assisting skills (4.93 ± 0.26). All expressed a desire to attend similar sessions in the future and agreed that surgical simulation inclusion into medical school curricula would enhance learning (5.00 ± 0.00). Interest in pursuing a career in CHS increased from 33% (5) to 87% (13) by the end of the course.

CONCLUSIONS

Integration of preclinical medical students into surgical simulation increases interest in pursuing highly specialised surgical specialities such as CHS. Early exposure and the incorporation of such simulation programs into medical school curricula will likely improve surgical skill acquisition and may enable students to be better informed when selecting future career choices.

Fostering Passion and Skills in Surgical Research Across the Medical Education Continuum: The Transplant Research, Education, and Engagement Group

OBJECTIVE

We describe a multilevel, collaborative research group for trainees and faculty engaging in transplant surgery research within one institution.

DESIGN

Transplant Research, Education, and Engagement (TREE) was designed to develop trainees' research skills and foster enthusiasm in transplant surgery along the educational continuum. Our research model intentionally empowers junior researchers, including undergraduates and medical students, to assume active roles on a range of research projects and contribute new ideas within a welcoming research and learning environment.

SETTING

Section of Transplant Surgery, Department of Surgery, Michigan Medicine, Ann Arbor, Michigan.

PARTICIPANTS

Undergraduate premedical students, first through fourth year medical students, general surgery residents, transplant surgery fellows, and transplant surgery faculty.

RESULTS

TREE was founded in September 2019 and has grown to include over 30 active members who meet weekly and collaborate virtually on a range of research projects, many of which are led by students. Trainees can assume both mentee and mentor roles and build their research, presentation and writing skills while collaborating academically.

CONCLUSIONS

Our model has increased trainees' engagement in transplant research projects and fosters early enthusiasm for the field. This model can be feasibly replicated at other institutions and within other subspecialties.

Recruiting trainees to surgery in the United States and Canadian system - What strategies are effective?

BACKGROUND

There has been increasing concerns regarding the declining number of medical students entering surgical residencies. The aim of this study is to analyze strategies and outcomes to enhance recruitment to the surgical specialties.

METHODS

A systematic literature PRISMA-based search was performed. Study quality and bias were assessed. Meta-analysis was performed using DerSimonian Laird method.

RESULTS

Of 3288 unique titles identified, 73 studies met inclusion criteria. Median study unique sample size was 84 participants (range 15-910). Subjective interest was reported in 59 studies, while objective match rate was reported by only 21 studies. The cumulative odds of students interested in the studied specialty was 1.98 (95% CI 1.47-2.67, I² = 0%) and in any surgical specialty was 1.40 (95% 1.01-1.95, I² = 37%) after an intervention compared to baseline.

CONCLUSION

While studies show increased odds of "interested in" a surgical specialty, the results may be subject to high selective and confounding biases.

What Kind of Surgeon Will You Be? An Analysis of Specialty Interest Changes Over the Course of General Surgery Residency

BACKGROUND

Integrated surgical residency programs and early specialization tracts have increased, with proposed benefits including shorter training time and increased exposure. Drawbacks include a loss of breadth and the need for earlier trainee career decisions. We sought to assess the rate of changing specialty interests over the course of general surgery residency, and what, if any, factors influenced that decision.

METHODS

An 11-question, web-based survey was sent to alumni (2009-2019) of a single academic general surgery residency training program. It queried demographics and experiences during medical school and residency, whether specialty interest changed, and if so, what factors influenced that decision.

RESULTS

The survey was emailed to 53 alumni and completed by 59% (n = 31). The majority were male (n = 24, 77%) and Caucasian (n = 26, 84%). All 31 respondents went on to fellowship training. Three individuals (10%) did not declare a specialty interest when applying to residency. Of the 28 who declared an interest, the majority (n = 17, 61%) changed their interest over the course of residency and ultimately applied to fellowship in a different field. Amongst these, only six (25%) had previous exposure in medical school to the field they ultimately went in to. All who changed specialties (n = 17) reported an impactful clinical rotation influencing their decision.

CONCLUSIONS

Nearly two-thirds of general surgery residents at a single academic institution changed their specialty interest over the course of residency. Our findings suggest that while integrated programs may provide benefits, many medical students are not being exposed to these potential fields.

Curriculum Reform and New Technology to Fill the Void of Musculoskeletal Education in Medical School Curriculum

Musculoskeletal (MSK) disease comprises over 20% of all visits to healthcare providers each year, yet a disproportionately small percentage of medical school education focuses on MSK disease. Even among students applying into orthopaedic surgery, less than 50% demonstrate prerequisite anatomic knowledge before beginning their residency. Medical school curriculum reform is needed, given that only 15% have a required MSK curriculum. Inadequate education ultimately leads to poor patient care and forces clinicians to learn MSK medicine later in practice. Although this inadequacy in medical school MSK education has been recognized for decades, little has changed to address this critical deficiency. A successful curriculum development requires defining critical MSK topics, evaluative methods to assess knowledge acquisition, and ultimately assessment of applying that knowledge to the care of patients. Newer strategies for MSK education include "near-peer" learning from senior classmates and residents, clinical immersion within MSK care teams, peer interest groups, and standardize learning platforms and assessment tools. Technologies such as virtual reality simulation, adaptive video learning, and other technologies will inform the development of affordable, succinct, evidence-informed curriculums that can enhance medical student MSK education with universal implementation. As clinical practice evolves to optimize patient care, so should the education of physicians who deliver that care.

Clinical Exposure to Cardiothoracic Surgery for Medical Students and General Surgery Residents

BACKGROUND

The introduction of integrated 6-year cardiothoracic surgery (CTS) residency programs has shifted recruitment efforts to encompass not only general surgery (GS) residents, but also medical students.

OBJECTIVE

The aim of this paper is to assess medical student and GS resident clinical exposure to CTS.

DESIGN

Data from the Association of American Medical Colleges Visiting Student Application Service and the Accreditation Council for Graduate Medical Education Case Log Reports were collected from 2010 to 2017 and 2010 to 2018, respectively. The data extracted included medical students who applied and received an offer for elective rotations and the cases performed as a GS resident.

RESULTS

A mean of 95 ± 28.5 medical students applied for CTS rotations annually and the applicants for CTS rotations increased by an average of 11.8% per year. However, significantly less students received an offer compared to other specialties (53.4% CTS vs 74.1% GS, 79.3% plastic surgery, 86.3% urology, 85.7% otolaryngology, 88.6% neurological surgery, and 89.6% orthopedic surgery) (p < 0.001). GS residents performed a mean of 39.3 ± 0.8 CTS procedures during residency: 32.9 ± 1.0 performed as a junior resident and 6.3 ± 0.7 as a chief resident. Out of all CTS procedures, 7.3% were cardiac procedures, with rates increasing from 5.6% to 8.4% during the study period (p = 0.001).

CONCLUSIONS

Elective rotation opportunities in CTS are high in demand for medical students while GS residents receive limited CTS exposure, especially cardiac cases. Increasing clinical opportunities in both groups will aid in recruiting young talent to the field.

"Fighting an uphill battle": A mixed methods exploration of surgeon involvement in medical schools' preclinical curricula

BACKGROUND

Limited exposure to surgeons early on in medical school may adversely impact students' clerkship experiences and professional development. This explanatory sequential mixed methods study investigates a perceived discrepancy between surgical and nonsurgical instructors in our institution's preclinical curriculum.

METHODS

The demographics of preclinical faculty were assessed before and after a curricular reform. Semi-structured interviews with 13 surgical faculty explored barriers and facilitators to surgeon involvement. Responses were inductively coded and thematically analyzed.

RESULTS

Surgeons' contributions to preclinical instruction fell from 10% to 5% across the curriculum reform. Barriers both leading to and reinforced by surgeons' limited involvement relate to surgeon, medical school, and student factors. Participants proposed three solutions to barriers in each domain.

CONCLUSIONS

Surgeons provide a minority of our preclinical instruction and may be disproportionately impacted by reform efforts. Deliberate efforts are necessary to increase opportunities for surgeons to engage with preclinical medical students.

Preparing for Surgery Observerships During Medical School: A Cross-Sectional Study

OBJECTIVE

Observerships are self-organized experiences for medical students to accompany a university affiliated physician in a clinical setting. Our study's objective was to evaluate year 1 and 2 medical students' experience with and preparation methods for surgery observerships at a Canadian medical school.

DESIGN

A cross-sectional online survey of preclerkship students, capturing resources used to prepare for observerships, types of observerships completed, and reasons for participating. Descriptive statistics were used to report demographics, observership types, and preparation methods. Gender differences in observership types were analyzed using two-way analysis of variance.

SETTING

Queen's University.

PARTICIPANTS

All preclerkship medical students (years 1 and 2) were invited to participate.

RESULTS

Of the 64 respondents (64/202), 46 (71.9%) were female and 53 (82.8%) participated in at least 1 surgery observership. The most common observerships were General Surgery (53.8%, 28/53), Obstetrics and Gynecology (50.1%), and Orthopedic Surgery (37.7%). There was no significant difference between genders in the number of surgery versus nonsurgery observerships. Common reasons for participating in surgery observerships included: "may not have opportunities in the future" (52.8%) and "rule in surgery as a career" (50.9%). Majority (64.2%) of students prepared for observerships and spent on average 1.3 ± 0.6 hours preparing. Commonly used resources included class notes (82.4%), and online videos (73.5%). Most respondents (91.0%) who prepared noted preparation was associated with a positive learning experience. Most respondents (67.1%) reported a lack of resources provided on how to prepare.

CONCLUSIONS

Preparing for observerships was associated with a positive experience and most students used class notes and online videos. There was a lack of instructions and resources on how to prepare. Developing appropriate resources for pre-clerkship medical students to prepare may improve overall experiences and increase interest in surgery.

Improving medical student recruitment to neurosurgery

OBJECTIVE

Neurosurgery seeks to attract the best and brightest medical students; however, there is often a lack of early exposure to the field, among other possible barriers. The authors sought to identify successful practices that can be implemented to improve medical student recruitment to neurosurgery.

METHODS

United States neurosurgery residency program directors were surveyed to determine the number of medical student rotators and medical students matching into a neurosurgery residency from their programs between 2010 and 2016. Program directors were asked about the ways their respective institutions integrated medical students into departmental clinical and research activities.

RESULTS

Complete responses were received from 30/110 institutions. Fifty-two percent of the institutions had neurosurgery didactic lectures for 1st- and 2nd-year medical students (MS1/2), and 87% had didactics for MS3/4. Seventy-seven percent of departments had a neurosurgery interest group, which was the most common method used to integrate medical students into the department. Other forms of outreach included formal mentorship programs (53%), lecture series (57%), and neurosurgery anatomy labs (40%). Seventy-three percent of programs provided research opportunities to medical students, and 57% indicated that the schools had a formal research requirement. On average, 3 medical students did a rotation in each neurosurgery department and 1 matched into neurosurgery each year. However, there was substantial variability among programs. Over the 2010-2016 period, the responding institutions matched as many as 4% of the graduating class into neurosurgery per year, whereas others matched 0%-1%. Departments that matched a greater (≥ 1% per year) number of medical students into neurosurgery were significantly more likely to have a neurosurgery interest group and formal research requirements. A greater percentage of high-matching programs had neurosurgery mentorship programs, lecture series, and cadaver training opportunities compared to the other institutions.

CONCLUSIONS

In recent decades, the number of applicants to neurosurgery has decreased. A major deterrent may be the delayed exposure of medical students to neurosurgery. Institutions with early preclinical exposure, active neurosurgery interest groups, research opportunities, and strong mentorship recruit and match more students into neurosurgery. Implementing such initiatives on a national level may increase the number of highly qualified medical students pursuing neurosurgery.

The future of general surgery in Ireland: factors influencing career decisions of medical students

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.

Enhancing the Formal Preclinical Curriculum to Improve Medical Student Perception of Surgery

BACKGROUND

This study aims to determine the effect of formal, preclinical curricular interventions on medical students' perceptions of surgeons, surgical learning objectives, and concerns regarding the surgical clerkship.

METHODS

Thirty-eight medical students underwent a newly required, formal introduction to surgery during the preclinical curriculum. Two months later, these students were given surveys regarding their perception of surgery before and after a bootcamp-style transitions to the wards workshop that immediately preceded their core clinical rotations. Student responses were compared to historical peers.

RESULTS

Thirty-seven students participated in the study (97.4%). Relative to historical peers, students demonstrated improved overall perception of surgery (71.2 vs 66.6, p = 0.046). A smaller proportion of students indicated that they were worried about evaluation (18.9% in 2018 vs 55.3% in 2017, p = 0.001) and interactions with surgical educators (18.9% vs 50%, p = 0.005). Students' overall perception of surgery significantly improved after participation in the transition to the wards workshop (71.2 to 77.8, p ≤ 0.0001), as did student agreement with 9 of 21 specific items. Improvement in surgical perception across the bootcamp-style workshop was similar to that of a prior workshop (8.6 in 2018 vs 6.4 in 2017, p = 0.21).

CONCLUSIONS

A preclinical introduction to surgery can have a positive impact on medical student perception of surgery prior to entry to the wards and may mitigate student fears regarding their surgical rotation.

Intellectual stimulation in family medicine: an international qualitative study of student perceptions

Background

Globally, medical schools struggle to ensure there is a sufficient number of graduates choosing family medicine as a career to meet societal needs. While factors impacting career choice are complex, one possible disincentive to choosing family medicine is the perception that it is less intellectually stimulating than specialty care.

Aim

The study sought to elicit student views on intellectual stimulation in family medicine, and their understanding of academic family medicine.

Design & setting

This is a qualitative focus group study of volunteer students from the University of Calgary, Canada, and Newcastle University, UK.

Method

Six focus groups were conducted with 51 participants. The data were analysed thematically.

Results

Students associated intellectual stimulation in family medicine with clinical practice. Intellectual stimulation was related to problem solving and the challenge of having to know a little about everything, along with clinical uncertainty and the need to be vigilant to avoid missing diagnoses. Student awareness of academic family medicine was limited, and students identified it with teaching rather than research.

Conclusion

Promoting intellectual stimulation in family medicine requires educators to highlight the breadth and variety of knowledge required in family medicine, as well as the need to manage clinical uncertainty and to be vigilant to avoid missing diagnoses. Exposure to academic family medicine could enhance students’ understanding and appreciation of the role of research in family medicine.

Promoting Career Selection Through a Comprehensive Enrichment Experience: A Review of the Canadian Radiation Oncology Summer Studentship

PURPOSE

The impact that early clinical exposure to radiation oncology has on medical students' understanding of oncology and career choice is understudied. This study aims to review the experience and outcomes of medical students who participated in the Canadian Association of Radiation Oncology-Canadian Radiation Oncology Foundation 6-week summer studentship.

METHODS AND MATERIALS

Medical students who participated in the nationally funded studentship from 2014 to 2018 were asked to fill out a survey after completing the program. The survey asked about student experience related to radiation oncology before the studentship, student satisfaction with the studentship (scale of 1-5; 5 = outstanding, 3 = meets expectations, 1 = unsatisfactory), and student willingness to recommend it to other students (scale of 1-10; 1 = strongly disagree, 5 = neutral, 10 = strongly agree). The effect of studentship on interest in the specialty was assessed (scale of 1-10; 1 = strongly disagree, 5 = neutral, 10 = strongly agree), including intent to direct their career toward radiation oncology. Match rates to radiation oncology residency are reported for students who participated in the studentship from 2013 to 2016.

RESULTS

All 31 students responded to the survey. Overall, the program was highly rated: inclusion of a broad range of clinical problems (mean = 4.6/5); opportunity to learn assessment, investigation, and management (mean = 4.2/5); and overall educational value (mean = 4.8/5). Poststudentship, most students reported an increased interest in oncology (76%, n = 22/29), and specifically radiation oncology (83%, n = 24/29). They would highly recommend this program to another medical student (mean = 9.8/10). The average percentage of these students entering a radiation oncology career (30.5%) each year was higher than national residency match rates in radiation oncology (0.7%).

CONCLUSIONS

Clinical exposure to radiation oncology through a nationally funded Canadian Association of Radiation Oncology-Canadian Radiation Oncology Foundation summer studentship positively affected medical student interest in oncology. This study suggests a potential effect of the studentship program on career selection of radiation oncology.

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.

The Teacher-Learner Contract (TLC): An Objectives-Based Checklist for Surgical Shadowing

OBJECTIVE

A lack of structure and communication in physician shadowing experiences may prevent medical students from accruing its potential benefits. In this study, we evaluated the use of an objectives-based surgical shadowing teacher-learner contract (TLC) on the outcomes of shadowing experiences.

DESIGN

Cross-sectional study with 30 unique student-surgeon pairs who participated in a 1-time shadowing experience between December 2016 and May 2017.

SETTING

Eight hospitals and clinics in Metro Vancouver, British Columbia, Canada.

PARTICIPANTS

A convenience sample of preclinical medical students attending University of British Columbia and local surgeons from a variety of specialties were recruited by email. A random sample of 30 students was selected from a pool of interested students.

RESULTS

Twenty-eight students and 18 surgeons completed the study. In general, students and surgeons reported that the TLC focused learning and improved communication between teachers and learners. Students also commented that using the TLC prompted them to reflect on their goals and consider how the shadowing experience might contribute to their overall medical education. Both students and surgeons found benefit in using the checklist (mean 3.5 ± 0.75 and mean 3.8 ± 1.1, respectively, where 1 was not useful and 5 was very useful). All participants rated the TLC as easy to use (mean 1.429 ± 1.271 and mean 1.333 ± 0.686, respectively, where 1 was not difficult and 5 was very difficult), and 80% of respondents said they would use the tool again. Participants who benefited the most were students with limited surgical shadowing experience and surgeons with less experience teaching preclerkship students.

CONCLUSIONS

This study demonstrates that an objectives-based learning contract like the TLC can facilitate meaningful shadowing experiences for teachers and learners and may have longitudinal educational benefits. However, widespread implementation will require institutional support of this concept.

The Career Impact of the National Undergraduate Neuroanatomy Competition

BACKGROUND

Neurosurgery is a notoriously difficult career to enter and requires medical students to engage in extracurricular activities to demonstrate their commitment to the specialty. The National Undergraduate Neuroanatomy Competition (NUNC) was established in 2013 as a means for students to display this commitment as well as academic ability.

METHODS

A bespoke 22-item questionnaire was designed to determine career outcomes and the role of competition attendance in job applications. It was distributed using the SurveyMonkey website to the 87 attendees at the 2013 and 2014 competitions.

RESULTS

Responses were received by 40 competitors (response rate, 46.0%). Twenty-four responders (60.0%) intended to pursue a career in either neurosurgery (n = 18) or neurology (n = 6). This included 10 responders (25.0%) who had successfully entered either neurosurgery (n = 9) or neurology (n = 1). The performance of these 10 was significantly better than the other responders (57.0 ± 13.6% vs. 46.5 ± 13.5% [n = 30]; P = 0.036). Seventeen responders (42.5%) either included their attendance at NUNC in a post-Foundation job application or intend to.

CONCLUSIONS

The NUNC provides the opportunity for medical students to demonstrate their interest in neurosurgery. It has the potential to be used as a tool for recognizing medical students suitable for neurosurgery training.

Medical student exposure to cardiothoracic surgery in the United Kingdom

OBJECTIVES

There has been declining interest in cardiothoracic surgery amongst medical graduates. This survey examines the exposure of British medical students to cardiothoracic surgery in various settings and its relationship with students' interest in the speciality.

METHODS

A questionnaire composed of 14 quantitative and qualitative items was distributed amongst 162 medical students. The survey included questions on demographics, interest in cardiothoracic surgery, mechanisms of exposure to the speciality and desire to pursue a career in cardiothoracic surgery before and after exposure.

RESULTS

Amongst the surveyed students, 71.0% reported exposure to cardiothoracic surgery as part of their medical school curricula and 24.7% reported extracurricular exposure. Of the students, 46.7% reported clinical exposure. Overall, 27.1% of students reported interest in a career in cardiothoracic surgery, which was higher amongst students who had curricular (29.6%), clinical (35.5%) or extracurricular exposure (50.0%). Amongst interested students, 43.2% engaged in extracurricular cardiothoracic activities compared with 16.1% of students not interested in pursuing the speciality. Confidence in career choice after exposure increased more in interested students (20.4%) than not interested students (1.6%). Students rated exposure and mentorship as the most important factor in promoting a career in cardiothoracic surgery.

CONCLUSIONS

Medical students with an interest in cardiothoracic surgery are more likely to organize independent attachments in the speciality and attend extracurricular events; however, many students might fail to identify cardiothoracic surgery as an area of interest because of the lack of exposure at medical school.

Surgical Skills Workshops Should Be a Part of the United Kingdom Undergraduate Medical Curriculum

Introduction: Medical students across the United Kingdom (UK) report poor satisfaction with surgical teaching. The Surgical Skills Day (SSD) begins to address this by exposing medical students to surgery through an easily accessible one-day practical workshop. This study shows how the SSD encourages undergraduate engagement in surgery.

Method: Feedback forms were emailed to attendees of the SSD and their anonymised responses were used to evaluate the SSD.

Results: A total of 144 students attended the SSD across three years and the feedback response rate was 74% (n = 107). Key findings were that 100% of respondents (n = 107) would like the SSD to be an annual event, 79% (n = 83) were more inclined to pursue a surgical career following the event, and 97% (n = 103) would like to see practical surgical skills incorporated into the curriculum. The SSD was able to engage undergraduates with surgery through mentorship, practical skills, specialty exposure, and teaching of the General Medical Council (GMC) mandated skills.

Conclusions: Undergraduate surgical teaching in the UK is insufficient. The student-led annual SSD showed improved engagement in practical surgical skills and increased enthusiasm for a surgical career. In light of this, the authors feel the SSD or similar event should be integrated into the UK medical school curriculum.

"Development of an Academic Surgical Student Program for Enhancing Student-Faculty Engagement"

OBJECTIVE

We describe an innovative medical student surgery interest group and its influence on mentorship and career exploration.

DESIGN

SCRUBS, created to promote interest in academic surgery, is student-led, with continual surgical faculty and resident involvement. Its 3-component programming focuses on clinical skills, research, and mentorship opportunities for medical students to get involved in academic surgery early in medical education.

SETTING

The University of Michigan Medical School, Ann Arbor, MI.

PARTICIPANTS

First through fourth year medical students, surgery residents, and attending surgeons.

RESULTS

SCRUBS is a multifaceted student organization providing longitudinal exposure to various aspects of surgery and academic medicine. The group grew annually from 2010 to 2014, with students and faculty expressing positive feedback. Over the time period reviewed, we had a greater percentage of students applying into surgical specialties compared with the national average (16.8 vs 12% in 2014). The group supported and facilitated mentorship, clinical skills development, and research opportunities for interested students.

CONCLUSIONS

This innovative surgery interest group has been well received by students and surgeons, and our institution has seen above-average interest in surgical careers. Early, preclinical mentorship and exposure provided by SCRUBS may contribute to this higher surgical interest.

A Surgeon Led Clinically Focused Anatomy Course Increases Student Selection of General Surgery As a Career

OBJECTIVE

This study aims to identify program-specific critical factors in a student's path to general surgery and how different factors contribute to our high rate of matriculation.

DESIGN

Semi-structured interviews were conducted focusing on critical factors in student's decision processes to pursue general surgery. Three investigators independently evaluated the transcripts and identified recurring themes based on phenomenological qualitative methods until saturation was achieved. Inter-rater reliability was determined.

SETTING

The study took place at Tulane University School of Medicine, an academic medical center in New Orleans, Louisiana.

PARTICIPANTS

Current fourth-year students from our medical school, applying into general surgery, were interviewed for the study.

RESULTS

Twelve of 21 students were interviewed. The most common factor cited was the positive effect of clinically based anatomy and of having surgeons in anatomy (81%). Other factors mentioned included interest before medical school, clerkship experience, and mentor interactions; Kappa was 0.76 or higher for each theme.

CONCLUSIONS

A clinically focused anatomy course led by surgeons at our institution has a significant impact on a general surgery career choice. With the constant evolution of the medical field, understanding what guides students toward a career in general surgery will better assist medical education planners in providing resources that will positively impact future classes.

Cross sectional analysis of student-led surgical societies in fostering medical student interest in Canada

BACKGROUND

The objective of this study was to examine how surgery interest groups (SIGs) across Canada function and influence medical students' interest in surgical careers.

METHODS

Two unique surveys were distributed using a cross sectional design. The first was sent to SIG executives and the second to SIG members enrolled at a Canadian medical school in the 2016/17 academic year. The prior focused on the types of events hosted, SIG structure/ supports, and barriers/ plans for improvement. The second questionnaire focused on student experience, involvement, and suggestions for improvement.

RESULTS

SIG executives became involved in SIG through classmates and colleagues (8/17, 47%). Their roles focused on organizing events (17/17, 100%), facilitating student contact with resident/surgeons (17/17, 100%), and organizing funding (13/17, 76%). Surgical skills events were among the most successful and well received by students (15/17, 88%). Major barriers faced by SIG executives during their tenure included time conflicts with other interest groups (13/17, 76%), lack of funding (8/17, 47%), and difficulty booking spaces for events (8,17, 47%). SIGs were found to facilitate improvement in basic surgical skills (μ = 3.89/5 ± 0.70) in a comfortable environment (μ = 4.02/5, ±0.6), but were not helpful with final block examinations (μ = 2.98/5, ±0.80). Members indicated that more skills sessions, panel discussion and shadowing opportunities would be beneficial additions. Overall, members felt that SIGs increased their interest in surgical careers (μ = 3.50/5, ±0.79).

CONCLUSION

Canadian SIGs not only play a critical role in early exposure, but may provide a foundation to contribute to student success in surgery.

Medical students' perceptions and motivations prior to their surgery clerkship

BACKGROUND

This study aims to determine the effect of a pre-clerkship workshop on medical students' perceptions of surgery and surgeons and to describe their concerns and learning goals.

METHODS

Thirty-nine medical students completed surveys before and after a workshop preceding their surgery clerkship. Quantitative data and free responses that were inductively coded were used to assess effectiveness.

RESULTS

Perceptions from 38 students (response rate = 97.4%) significantly improved for 11 of 21 items. At pre-workshop, the most frequently cited learning goals were improving technical skills (58%), surgical knowledge (53%), and understanding surgical culture and work (53%). Students' top concerns were meeting clerkship demands (68%) and being evaluated (55%). After the workshop, student learning objectives and concerns remained largely unchanged.

CONCLUSIONS

A pre-clerkship workshop improved student perceptions of surgery and surgeons. Understanding students' intrinsic motivations may facilitate future clerkship curriculum improvement via better alignment of educator and student goals and objectives.

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.

The impact of junior surgical jobs in cardiothoracic surgery on career choice in the United Kingdom

OBJECTIVES

Cardiothoracic surgery is a small specialty, often with a limited presence on the undergraduate curriculum. In the past, there was a heavy reliance on postgraduate exposure to inform career choice. Recent changes in recruitment to the specialty in the United Kingdom may reduce exposure of the best trainees to the specialty, and reduce the quality of future surgeons. This study will evaluate the impact of junior surgical jobs on future career preferences.

METHODS

We asked all 126 core surgical trainees in the Northern Ireland Deanery their surgical specialty preferences over 2 years. Trainees were asked for their first and second preferences on each occasion. In total 502 first and second preferences were declared. Past and present postings were then correlated with this information to see if working in a cardiothoracic unit impacted on specialty preference choices.

RESULTS

Cardiothoracic surgery is the least popular of all the surgical specialties amongst junior surgical trainees (3.6%)-with general surgery, breast surgery, and orthopaedic surgery, drawing 53% of trainees. In trainees who had previously worked in cardiothoracic surgery, 75% expressed a wish to return to the specialty, making it the most dominant.

CONCLUSIONS

The role of junior surgical jobs in the specialty is immensely important on career choice. Moving to a more junior recruitment may exclude excellent candidates who have simply not experienced cardiothoracic surgery.