Factors that impact medical student and house-staff career interest in brain related specialties

Neurosurgery in Saudi Arabia: Navigating Through Future Pathways and Students' Perspectives

BACKGROUND

Neurosurgery is a surgical discipline that demands comprehensive knowledge in other specialties. It is regarded as one of the most competitive specialties. However, there is a new trend toward considering life-style friendly specialties. Therefore, this study aims to assess the neurosurgery perception and identify potential factors influencing such attitudes.

METHODS

An observational, survey-based study was conducted on medical students at the College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia. An online-based questionnaire was administered to the participants. It consisted of 2 main parts: the first part collected demographic data, while the second part included 20 Likert scale-based questions. Pearson's χ2 test was utilized, with statistical significance set at P < 0.05.

RESULTS

A total of 305 medical students from various academic years participated in the questionnaire survey, with nearly an equal gender distribution. Remarkably, a significant majority (76.72%) expressed uncertainty or disagreement regarding the adequacy of neurosurgery education during their medical studies. While a substantial portion of participants (69.5%) found neurosurgery intriguing, almost half (47.87%) indicated that they would not pursue it as their future specialty. The consideration of neurosurgery as a career path showed statistically significant differences in relation to both gender and academic year (P = 0.009 and P < 0.001, respectively).

CONCLUSIONS

This study emphasizes how gender and academic year affect choosing neurosurgery as a career but notes limitations like self-reporting bias and a single-institution scope, which may affect generalizability. Future research might consider national summer training programs to engage more students in neurosurgery.

The PBL teaching method in neurology education in the traditional Chinese medicine undergraduate students: An observational study

The objective of this study was to investigate the impact of the problem-based learning (PBL) method on Neurology education for Traditional Chinese Medicine (TCM) undergraduate students. This observational study was conducted during the 2020/02 and 2020/04 intakes of the third year TCM undergraduate students at School of Traditional Chinese Medicine, Xiamen University Malaysia. A total of 86 students were enrolled in the study and randomly assigned to either conventional learning groups or PBL groups. Students who missed more than 1 session of the course or did not complete the questionnaires during the evaluation periods were excluded from the study (n = 0). An independent sample t test was used to compare the results between the 2 groups, with a significance level set as P < .05. The PBL group demonstrated significantly higher scores in theoretical and clinical practical examinations, satisfaction with the teaching level, students perspectives, and self-learning skills. Additionally, the PBL group had significantly higher scores on the dundee ready educational environment measure compared to students in the conventional group (P < .05). The implementation of the PBL teaching method in Neurology education for TCM undergraduate students proved to be an engaging and effective learning approach. It significantly improved students learning performance and their ability to analyze and solve problems related to neurology diseases and their management knowledge.

Are Undergraduates Familiar with Nephrology as a Medical Specialty? A Single Site Survey of Undergraduate Students

Background

Over the past decade, nephrology has experienced a 43% decline in the number of fellowship applicants. Previous studies examining why residents choose a fellowship program cite lack of exposure as a main factor having an effect against a career in nephrology; however, no studies have surveyed the undergraduate population to inquire whether they recognize nephrology as a medical specialty compared with other medical specialties. We conducted a survey at a primarily undergraduate institution in the Southeast United States to test whether undergraduate students identified the word "nephrology."

Methods

A total of 274 undergraduates responded to a survey that requested them to select every medical specialty that they recognized by name (15 real specialties and one fictitious specialty). Demographics regarding sex, race, collegiate level, high school location, premedical track, and household income were collected. Correlations between survey findings and rates of application and average salary per specialty were assessed.

Results

Out of 15 medical specialties, nephrology (29%) and pulmonology (40%) were the least recognized. Pediatrics (97%) and surgery (97%) ranked highest. Sex, race, collegiate level, and household income were not different between those students who recognized "nephrology" and those who did not. Premedical students were about twice as likely to have recognized nephrology versus nonpremedical students (49% versus 22%, respectively; P<0.001). STEM majors were about twice as likely to identify nephrology versus non-STEM majors (40% versus 20%, respectively; P<0.001). The proportion of undergraduate students who recognized a specific medical specialty significantly correlated only with the number of US applicants per fellowship position across different medical specialties in 2020 (P<0.05).

Conclusions

On the basis of word association alone, nephrology is the one of the least recognized specialties by undergraduates. The discrepancy between nephrology and other specialties highlights a gap in name recognition at an early career stage, even among premedical students.

Subspecialty and Training Preferences for United States Neurosurgery Faculty with International Training

BACKGROUND

Academic neurosurgeons with international medical training play a large role in the US neurosurgical workforce. We aim to compare US trained with internationally trained neurosurgeons to uncover differences in subspecialty preferences and training opportunities abroad.

METHODS

1671 neurosurgeons from 115 ACGME accredited neurosurgical residency programs were identified in 2020. Data on demographics, institution characteristics, and chosen subspecialty were collected and faculty were divided based on location of training. Univariate analysis and multivariable logistic regression compared faculty characteristics between training locations.

RESULTS

Compared to the US Medical School+US Residency group, the international medical graduate (IMG)+US residency group was more likely to subspecialize in oncology/skull base and vascular neurosurgery and complete a fellowship in the US or internationally (p<0.05). The IMG+International residency group was more likely to subspecialize in oncology/skull base, more likely to do an international fellowship, and less likely to practice general neurosurgery (p<0.05). Pediatrics, radiosurgery, and vascular subspecialties were more likely to receive fellowship training in any location (p<0.05). Additionally, functional neurosurgeons were more likely to complete fellowships internationally, spinal neurosurgeons were less likely to pursue international fellowships, and peripheral nerve neurosurgeons were more likely to have dual fellowship training in both the US and abroad (p<0.05).

CONCLUSIONS

International medical training affected subspecialty choice and fellowship training. Internationally trained neurosurgeons more often specialized in oncology and vascular neurosurgery. Functional neurosurgeons were more likely to complete international fellowships, spine neurosurgeons were less likely to complete international fellowships, and peripheral nerve neurosurgeons more often had both US and international fellowships.

Gender Differences in Perceptions and Attitudes of Medical Students Towards Neurosurgery: A German Nationwide Survey

BACKGROUND

Despite advances in gender equity, the paucity of women neurosurgeons remains. In Germany, women accounted for only 24% of the specialists who completed their neurosurgical training in 2019. We sought to explore the perceptions of medical students in Germany towards a neurosurgical career, focusing on gender-specific differences.

METHODS

A digital 26-item questionnaire with a Likert 4-point scale and open-ended questions was distributed to the German Medical School student bodies. Data was analyzed to determine statistically significant intra-group variability between women and men.

RESULTS

210 medical students participated in the survey. Women and men were equally interested in brain pathologies (38% vs. 47%, strongly agreed), whereas interest in neurosurgery was significantly greater in men (12% vs. 26%, strongly agreed). Men were less likely to believe that women neurosurgery residents would face inequality at work. They were also less likely to support a gender quota in neurosurgery. Yet, both women and men were convinced that a rise in the number of women would positively impact the field. No gender-dependency was seen in students' strive for success and prestige. Men felt discouraged from pursuing neurosurgery because they feared an unpleasant work environment whereas women were concerned about neurosurgery not being family-friendly. Regardless of gender, the greatest factor deterring students from neurosurgery was poor work-life balance.

CONCLUSION

Awareness must be raised concerning gender inequity and discrimination in our specialty. A multifaceted approach is imperative to develop neurosurgery into a profession where gender no longer hinders access to training and success in the field.

Introduction of the Modified Neuroanatomy Motivation Questionnaire and Its Role in Comparing Medical Student Attitudes Towards Learning Neuroanatomy Between Neuro-enthusiasts and Standard Students

BACKGROUND

Neurophobia has been identified as a potential barrier to adequate knowledge of neurology in the medical community, and therefore to patient safety. There is a drive to identify the source of neurophobia, in the hope of tackling it. Comparing the learning motivations of standard medical students with those who enjoy neuroanatomy may be a way of doing this.

METHODS

The science motivation questionnaire (SMQ) was modified for neuroanatomy. It was distributed to three cohorts of second year medical students and students attending the extracurricular National Undergraduate Neuroanatomy Competition (NUNC). Cohen's D test for effect size was used to compare standard medical students and those attending the NUNC.

RESULTS

Five hundred ninety-seven questionnaires were completed by second year students, and 320 by NUNC attendees. The differences in motivation to learn neuroanatomy between the 2 groups mainly fell into themes of career motivation, personal relevance, intrinsic motivation and assessment anxiety.

CONCLUSION

This study has demonstrated the use of the SMQ in neuroanatomy, and found differences in motivators to learn neuroanatomy between self-selecting "neurophiles" and standard medical students, mainly relating to intrinsic motivation and its role in their lives. More research is needed to further explore these differences and how they might apply to interventions in medical school curricula.

Ophthalmology Services at Student-Run Free Clinics: A National Survey

IMPORTANCE

Student-run free clinics (SRFCs) primarily service the uninsured and are a unique way for medical students to gain hands-on exposure to ophthalmology. The free clinic model takes many different forms- some with episodic and longitudinal models-- and this is mirrored in corresponding eye services.

OBJECTIVE

To describe SRFC ophthalmology services nationwide.

DESIGN

This was a telephone survey study administered from June through July of 2018.

SETTING

This study surveyed medical school SRFC clinics across the United States.

PARTICIPANTS

Survey request was sent to 19 SRFCs previously identified as having ophthalmology services via internet search. Fourteen SRFCs (73%) participated; participants were either student clinic leaders or medical directors. One respondent no longer had a distinct eye clinic so was excluded from relevant results.

MAIN OUTCOME AND MEASURE

Characteristics of ophthalmology SRFCs including participants, frequency of sessions, common diagnoses treated, and challenges encountered were assessed through this survey.

RESULTS

On average, each SRFC provided 5.15 hours per month of ophthalmology services. The mean number of medical students involved per session was 8.7. Lack of infrastructure to ensure adequate patient follow-up and faculty recruiting were cited as the main challenges in providing ophthalmology services. Most SRFC leaders indicated exposure to ophthalmology and practice with the exam as the main experiences that students sought and achieved. The most common conditions treated were refractive error (92.3%) and diabetic retinopathy (69.2%).

CONCLUSION

There are a small number of SRFCs that have ophthalmology services, and they share common features in terms of participants, staffing, and, barriers to sustainability. Ophthalmology services at SRFCs offer a unique venue for medical students to gain exposure to an under-represented field in medical school curricula. The growth of this critical venue for medical student training could be enhanced by recruitment strategies aimed at ophthalmology faculty with a strong interest in service and teaching.

NeuroQ: A neurophobia screening tool assesses how roleplay challenges neurophobia

BACKGROUND

Neurophobia is a chronic disease of medical students and junior doctors. Early detection is needed to facilitate prevention and management as this fear can negatively impact patient care.

METHODS

We conducted a two-part mono-centric study at the faculty of Medicine, Sorbonne University, in Paris. Part one: a cross-sectional study to validate a newly constructed neurophobia scale, NeuroQ. Part two: a prospective longitudinal study to assess the impact of The Move on student neurophobia using NeuroQ. A population-based sample of second-year medical students of the 2019 and 2020 class of the Faculty of Medicine of Sorbonne University were invited to participate.

RESULTS

NeuroQ incorporates the main themes of the neurophobia definition and demonstrates uni-dimensionality. Three hundred and ninety-five medical students participated in the study (mean age was 20.0 years, SD: 2.1 years) assessing the effect of The Move teaching on neurophobia. Two hundred and eighty-eight (72.9%) students were female. After the Move teaching the mean NeuroQ score was significantly lower compared to the baseline NeuroQ score (mean [SD] variation, -1.1 [2.6], p < 0.001). There was a 22.3% relative reduction in the number of neurophobic students after The Move teaching.

CONCLUSION

Our results highlight the utility of NeuroQ in assessing (i) baseline neurophobia and (ii) the impact of pre-clinical educational interventions on neurophobia. Furthermore, we have shown the importance of pre-clinical educational interventions, such as The Move, in tackling neurophobia.

Factors associated with medical students' choice of psychiatry as future specialty: a cross-sectional study

BACKGROUND

Despite the fact that mental illnesses are highly prevalent, shortage of trained human resource, particularly psychiatrists, in the field is disproportionately low. This is especially challenging in developing countries. We report factors affecting medical students' choice of psychiatry specialty as a future career.

METHODS

A facility-based cross-sectional study design incorporating demographics, psychiatry specialty choice and a list of factors related to psychiatry was administered to fourth year medical students. Chi-squared test was used to identify factors associated with psychiatry choice. Multiple logistic regression analysis was done to identify the association between demographics and history of mental illness against psychiatry choice.

RESULTS

One hundred and sixty-five medical students participated in the study. The majority, 139 (84.2%), of the students were male. From the medical students, 34 (21%) reported that they will choose to specialize in psychiatry for their future career. A chi-squared test result indicated that there were many factors associated with psychiatry choice. Family history of mental illness was found to be significantly associated with the future career choice of the psychiatry discipline (AOR=2.76; CI: 1.05-7.25).

CONCLUSION

Family history of mental illness seemed to be a significant factor in medical students' psychiatry choice. Positive attitude to psychiatry, ‎the manner in which psychiatry is taught, satisfaction related to practical and theoretical psychiatry education, having direct involvement in psychiatric patient care and the like were factors that affect psychiatry choice. Therefore, paying due attention to modifiable factors negatively affecting psychiatry choice may increase the selection of the field by medical students as a specialty.

Description and Assessment of a Neurosurgery Shadowing and Research Program: A Paradigm for Early and Sustained Exposure to Academic Neurosurgery

Objective

To describe and assess the educational value of a functional neurosurgery clinical shadowing and research tutorial for pre-medical trainees.

Design

Program participants observed functional neurosurgery procedures and conducted basic science and clinical research in neurosurgery fields. Former participants completed a brief online survey to evaluate their perspectives and experiences throughout the tutorial.

Setting

Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Participants

15 pre-medical and post-baccalaureate trainees participated in the tutorial. All former tutorial participants were emailed.

Results

11/15 former participants responded to the survey. Survey results suggest that the tutorial program increased participants' understanding of and interest in neurosurgery and related fields in neuroscience.

Conclusions

The functional neurosurgery medical tutorial provides valuable clinical and research exposure in neurosurgery fields for pre-medical trainees. Our work is a preliminary step in addressing the crucial challenge of training the next generation of neurosurgeon-scientists by providing a pedagogical paradigm for development of formal experiences that integrate original scientific research with clinical neurosurgery exposure.

Junior doctors' early career choices do not predict career destination in neurology: 40 years of surveys of UK medical graduates

BACKGROUND

The rapidly rising rates of brain diseases due to the growing ageing population and the explosion in treatment options for many neurological conditions increase the demand for neurologists. We report trends in doctors' career choices for neurology; investigate factors driving their choices; and compare doctors' original choices with their specialty destinations.

METHODS

A multi-cohort, multi-purpose nation-wide study using both online and postal questionnaires collected data on career choice, influencing factors, and career destinations. UK-trained doctors completed questionnaires at one, three, five, and ten years after qualification. They were classified into three groups: graduates of 1974-1983, graduates of 1993-2002, and graduates of 2005-2015.

RESULTS

Neurology was more popular among graduates of 2005-2015 than earlier graduates; however, its attraction for graduates of 2005-2015 doctors reduced over time from graduation. A higher percentage of men than women doctors chose neurology as their first career choice. For instance, among graduates of 2005-2015, 2.2% of men and 1.1% of women preferred neurology as first choice in year 1. The most influential factor on career choice was "enthusiasm for and commitment to the specialty" in all cohorts and all years after graduation. Only 39% who chose neurology in year 1 progressed to become neurologists later. Conversely, only 28% of practicing neurologists in our study had decided to become neurologists in their first year after qualification. By year 3 this figure had risen to 65%, and by year 5 to 76%.

CONCLUSIONS

Career decision-making among UK medical graduates is complicated. Early choices for neurology were not highly predictive of career destinations. Some influential factors in this process were identified. Improving mentoring programmes to support medical graduates, provide career counselling, develop professionalism, and increase their interest in neurology were suggested.

Neurologic and neuroscience education

Neurologic disorders are among the most frequent causes of morbidity and mortality in the United States. Moreover, the current shortfall of neurologists is expected to worsen over the coming decade. As a consequence, many patients with neurologic disorders will be treated by physicians and primary care providers without formal neurologic training. Furthermore, a pervasive and well-described fear of neurology, termed neurophobia, has been identified in medical student cohorts, residents, and among general practitioners. In this article, members of the American Academy of Neurology A.B. Baker Section on Neurological Education review current guidelines regarding neurologic and neuroscience education, contextualize the genesis and the negative consequences of neurophobia, and provide strategies to mitigate it for purposes of mentoring future generations of health care providers.

Factors Influencing Medical Student Interest in a Career in Neurosurgery

BACKGROUND

Exposure to neurosurgery at the undergraduate level is an important factor in determining future interest in and applications to the specialty. Given the high competition for training posts, this exposure is also becoming an almost essential addition to an applicant's portfolio. We organized a neurosurgical conference aimed at undergraduate medical students. The aim of this study was to determine factors attracting and deterring students from the specialty before and after the conference.

METHODS

Responses were collected prospectively from students attending a national neurosurgical conference organized by medical students with support from the local neurosurgical unit. Questionnaires were distributed before and after the conference examining students' perceptions of a career in neurosurgery using free-text responses.

RESULTS

Poor lifestyle or work-life balance was the most important factor deterring students from a career in the specialty both before (29.7%) and after (60%) the conference. The most important factor attracting students to the specialty before the conference was the practical (surgical approaches and techniques) aspect (21.9%). After the conference, the most important attracting factor was the rewarding nature of the specialty (18.9%).

CONCLUSIONS

The most notable factor deterring students from a career in neurosurgery was work-life balance. Other deterring factors were much less prevalent following the conference. Understanding how exposure to neurosurgery influences students' perceptions is important for developing future initiatives to prevent misconceptions and allow students to make informed choices as well as encourage the right candidates to apply.