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Unal HS, Aydin MO, Bilgic E, Eser P, Alper Z, Taskapılıoğlu MO, İlker Kafa M, Kocaeli H, Dogan S, Yılmazlar S, Bekar A, Sekerci Z, Aksoy K. Neurosurgery training camp for medical student: experience of the Turkish neurosugery academy and Bursa Uludag University. Front Surg 2024; 11:1433780. [PMID: 39157292 PMCID: PMC11327150 DOI: 10.3389/fsurg.2024.1433780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 07/22/2024] [Indexed: 08/20/2024] Open
Abstract
Introduction To highlight the importance of hands-on experiences and mentorship in shaping the future workforce of specialized medical professionals via a Neurosurgery Training Camp. Methods Responses of the questionnaire regarding the Neurosurgery Training Camp organized by Bursa Uludag University's Faculty of Medicine and the Turkish Neurosurgery Academy were reviewed retrospectively. A one-day program was organized to introduce neurosurgery to medical students. During the camp, the students participated in interactive presentations delivered by faculty members, had lunch together, became acquainted with neurosurgical tools and technologies, and performed interventions. With pre and postworkshop questionnaire, student's expectations and thoughts about camp was evaluated. Results Forty-one students from 10 medical schools, spanning every year of study, attended the camp. Approximately 39% of the attendees (n = 16) were women and 61% (n = 25) were men. The post-workshop survey results demonstrated that 73% of the students (n = 30) were inclined to pursue a career in neurosurgery after the camp, 21.9% (n = 9) remained undecided, and 4.8% (n = 2) chose not to pursue neurosurgery. Feedback from the post-workshop questionnaire highlighted that all students perceived the camp as beneficial in providing insights into their future careers and aiding in making a decision regarding their career paths. Discussion The neurosurgical training camp effectively inspired and educated medical students about the discipline of neurosurgery. Furthermore, the camp effectively altered the career aspirations and perceptions of neurosurgery among the participating students.
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Affiliation(s)
- H Setenay Unal
- Department of Neurosurgery, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Mevlut Okan Aydin
- Department of Medical Education, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Esma Bilgic
- Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Pınar Eser
- Department of Neurosurgery, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Zuleyha Alper
- Department of Medical Education, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - M Ozgur Taskapılıoğlu
- Department of Neurosurgery, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - M İlker Kafa
- Department of Anatomy, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Hasan Kocaeli
- Department of Neurosurgery, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Seref Dogan
- Department of Neurosurgery, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Selcuk Yılmazlar
- Department of Neurosurgery, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Ahmet Bekar
- Department of Neurosurgery, Bursa Uludag University School of Medicine, Bursa, Turkiye
| | - Zeki Sekerci
- Department of Neurosurgery, President Turkish Neurosurgery Academy, Medipol University School of Medicine, Istanbul, Turkiye
| | - Kaya Aksoy
- Private Practitioner, Head of Turkish Neurosurgery Academy, Bursa, Turkiye
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Ferreira T, Collins AM, French B, Fortescue A, Handscomb A, Plumb E, Bolton E, Feng O. Factors Affecting Specialty Training Preference Among UK Medical Students (FAST): Protocol for a National Cross-Sectional Survey. JMIR Res Protoc 2024; 13:e55155. [PMID: 39059007 PMCID: PMC11316162 DOI: 10.2196/55155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND The UK medical education system faces a complex landscape of specialty training choices and heightened competition. The Factors Affecting Specialty Training Preference Among UK Medical Students (FAST) study addresses the need to understand the factors influencing UK medical students' specialty choices, against a backdrop of increasing challenges in health care workforce planning. OBJECTIVE The primary objectives of the FAST study are to explore UK medical students' preferred specialties and the factors that influence these choices. Secondary objectives are to evaluate students' confidence in securing their chosen specialty, to understand how demographic and academic backgrounds affect their decisions, and to examine how specialty preferences and confidence levels vary across different UK medical schools. METHODS A cross-sectional survey design will be used to collect data from UK medical students. The survey, comprising 17 questions, uses Likert scales, multiple-choice formats, and free-text entry to capture nuanced insights into specialty choice factors. The methodology, adapted from the Ascertaining the Career Intentions of UK Medical Students (AIMS) study, incorporates adjustments based on literature review, clinical staff feedback, and pilot group insights. This approach ensures comprehensive and nondirective questioning. Data analysis will include descriptive statistics to establish basic patterns, ANOVA for group comparisons, logistic regression for outcome modeling, and discrete choice models for specialty preference analysis. RESULTS The study was launched nationally on December 4, 2023. Data collection is anticipated to end on March 1, 2024, with data analysis beginning thereafter. The results are expected to be available later in 2024. CONCLUSIONS The FAST study represents an important step in understanding the factors influencing UK medical students' career pathways. By integrating diverse student perspectives across year groups and medical schools, this study seeks to provide critical insights into the dynamics of specialty, or residency, selection. The findings are anticipated to inform both policy and educational strategies, aiming to align training opportunities with the evolving needs and aspirations of the future medical workforce. Ultimately, the insights gained may guide initiatives to balance specialty distribution, improve career guidance, and improve overall student satisfaction within the National Health Service, contributing to a more stable and effective health care system. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55155.
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Affiliation(s)
- Tomas Ferreira
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | | | - Benjamin French
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Amelia Fortescue
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Arthur Handscomb
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Ella Plumb
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Emily Bolton
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Oliver Feng
- Department of Mathematical Sciences, University of Bath, Bath, United Kingdom
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Homberg A, Narciß E, Obertacke U, Schüttpelz-Brauns K. Surgical experiences of final-year undergraduates and the impact on their career aspiration stratified by sex/gender. GMS JOURNAL FOR MEDICAL EDUCATION 2024; 41:Doc28. [PMID: 39131898 PMCID: PMC11310790 DOI: 10.3205/zma001683] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/07/2024] [Accepted: 04/30/2024] [Indexed: 08/13/2024]
Abstract
Objectives Surgical undergraduate training takes place in a male-dominated work environment that struggles with recruitment problems. Experiences of cultural and sex/gender-specific barriers of women in surgery have been reported worldwide. Overall, the experiences that students have in coping with the emotional impact of surgery as a profession are thought to be crucial to their subsequent career choices. We investigated whether students' self-reported experiences differed by sex/gender in terms of frequency and content, and whether they were related to their career aspirations. Methods In Germany, the final year represents the last part of the undergraduate medical study program. At the Mannheim Medical Faculty, a 12-week surgical training is mandatory. After completing their surgical training, the students were asked about their experiences and their later career aspirations. These experiences were analysed using quantitative content analysis. The relationship between the quality of experience and career aspirations as well as sex/gender differences were statistically measured. Results In the 475 questionnaires analysed (response rate 52%), the number of positive and negative mentions does not differ by sex/gender. However, male students feel more actively involved and female students feel poorly briefed and think that supervisors are less interested in their training. A significant influence on career aspirations was found in the performance category for female and male students, and in the supervision category for female students. Conclusion The positive experiences that students gain while performing surgical activities have an impact on their subsequent career choices. In particular, a good settling-in period and encouragement to actively participate could help to attract more women to surgery.
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Affiliation(s)
- Angelika Homberg
- Medical Faculty Mannheim, Heidelberg University, Division for Study and Teaching Development, Department of Medical Education Research, Mannheim, Germany
| | - Elisabeth Narciß
- Medical Faculty Mannheim, Heidelberg University, Division for Study and Teaching Development, Competence Center for final-year education, Mannheim, Germany
| | - Udo Obertacke
- Medical Faculty Mannheim, Heidelberg University, Division for Study and Teaching Development, Competence Center for final-year education, Mannheim, Germany
- University Medical Center Mannheim, Centre for Orthopaedics and Trauma Surgery, Mannheim, Germany
| | - Katrin Schüttpelz-Brauns
- Medical Faculty Mannheim, Heidelberg University, Division for Study and Teaching Development, Department of Medical Education Research, Mannheim, Germany
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Iwai Y, Yu AYL, Thomas SM, Quinsey CS, Beasley GM, Sudan R, Fayanju OM. Survey Study of Clerkship Curriculum on Learner's Choice to Pursue Surgery: Positive Impact of Extracurricular Opportunities. JOURNAL OF SURGICAL EDUCATION 2023; 80:1221-1230. [PMID: 37442696 PMCID: PMC10806402 DOI: 10.1016/j.jsurg.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/09/2023] [Accepted: 06/11/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE Prior studies have focused on the role of the learning environment on students' decisions to pursue surgery, but few have analyzed the impact of the clerkship curriculum. This study assessed surgical clerkship curricula across United States (US) medical schools and their impact on students' likelihood of pursuing a surgical residency. DESIGN A cross-sectional survey was developed to assess surgery clerkship characteristics. Questions included clerkship duration, number of offered and required surgical services, method of service assignment, and number of advanced clinical electives (e.g., fourth-year sub-internships) and additional surgical clinical opportunities (e.g., surgical elective rotations). Survey results were merged by the Association of American Medical Colleges with the percentages of students who matched into a surgical specialty. Linear regression models estimated the association of covariates with the percentage of students who (1) matched in surgical specialties, (2) were interested in surgery at medical school matriculation and ultimately matched into surgical residency (retention rate), and (3) were not interested in surgery at medical school matriculation but ultimately matched into surgical residency (recruitment rate). SETTING The survey was distributed to clerkship directors and coordinators at 66 medical schools through the Association for Surgical Education (ASE) from 5/1/2021 to 8/1/2021. PARTICIPANTS All US medical schools in the ASE. RESULTS A total of 21 medical schools responded (34.8% response rate). The overall retention rate was 36.4%, and the overall recruitment rate was 25.0%. Clerkships were 4 to 12 weeks. In 81% of programs, students submitted preferences and were assigned services. The percentage of students applying to surgical specialties was not associated with clerkship duration (p=0.79) or the number of required services (p=0.15), subspecialty services offered (p=0.33), or advanced clinical electives (p=0.24) but was associated with a program's having additional surgical clinical opportunities (p=0.02). Most of these factors were not associated with retention or recruitment rates. CONCLUSIONS Offering more extracurricular surgical clinical opportunities was associated with having more students pursue surgical careers. Though limited by a relatively small sample size, our findings suggest that having shorter clerkships or limited subspecialty offerings may not have a significant influence on students' career choices.
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Affiliation(s)
- Yoshiko Iwai
- Department of Surgery, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina.
| | - Alice Yunzi L Yu
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago, Illinois.
| | - Samantha M Thomas
- Duke Cancer Institute, Duke University School of Medicine, Durham, North Carolina; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina
| | - Carolyn S Quinsey
- Department of Neurosurgery, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
| | - Georgia M Beasley
- Duke Cancer Institute, Duke University School of Medicine, Durham, North Carolina; Department of Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Ranjan Sudan
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Oluwadamilola M Fayanju
- Division of Breast Surgery, Department of Surgery, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania; Rena Rowan Breast Center, Abramson Cancer Center, Philadelphia, Pennsylvania; Penn Center for Cancer Care Innovation (PC3I), The University of Pennsylvania, Philadelphia, Pennsylvania; Leonard Davis Institute of Health Economics (LDI), The University of Pennsylvania, Philadelphia, Pennsylvania.
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Sheu L, Goglin S, Collins S, Cornett P, Clemons S, O'Sullivan PS. How Do Clinical Electives during the Clerkship Year Influence Career Exploration? A Qualitative Study. TEACHING AND LEARNING IN MEDICINE 2022; 34:187-197. [PMID: 33792448 DOI: 10.1080/10401334.2021.1891545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Problem: Although many students begin medical school with some idea of their specialty interest, up to 80% of these students choose a different specialty by their final year. This pivot tends to happen in the clerkship year, when students are immersed in the clinical environment, gaining a practical understanding of the day-to-day work in different fields. Yet, in this year students have limited experiences with specialties. Clinical electives during the clerkship year may aid students in career development. The authors examined student career exploration through the lens of social cognitive career theory (SCCT). SCCT posits three variables that influence career development: personal goals, self-efficacy, and understanding outcome expectations. With this framework, the authors sought to understand how a program of clinical electives during the clerkship year influences students' perceptions of their career exploration. We aimed to: (1) describe an innovative clerkship elective program designed for career exploration, and (2) explore how this influenced students' career exploration using qualitative analysis. Intervention: Beginning in 2018, students at our institution were required to participate in three 2-week clinical electives during their clerkship year, called Clinical Immersive Experiences (CIExes). CIExes were categorized into four different types: apprenticeship, clinical skills building, integrative (multi-disciplinary), or subspecialty. Authors invited fourth year students to participate in interviews (January to March 2019) about how they selected electives and how these electives contributed to their career exploration. Interviews continued until reaching information sufficiency. Authors coded and analyzed transcripts using template analysis. Context: This curricular intervention took place in the context of large-scale curricular redesign. Students began clerkships partway into their second year of medical school. The family and community medicine clerkship, which was previously a 6-week core clerkship, was changed to a longitudinal format, thus freeing up 6 weeks for electives. Other core clerkships included anesthesia (2 weeks), medicine (8 weeks), neurology (4 weeks), obstetrics and gynecology (6 weeks), pediatrics (6 weeks), psychiatry (4 weeks), and surgery (8 weeks). Impact: From 15 student interviews, we identified three major themes. First, CIExes facilitated personalized career exploration. All students felt that at least one elective helped them solidify their decision about a specialty choice. Second, CIExes promoted focused learning and skills development that complemented core rotations. They noted the benefit of positive relationships with supervisors, particularly attendings, during these electives. Third, students highlighted how these electives fostered a positive learning environment and enhanced wellbeing. SCCT clarified how the CIEx program helped students advance their personal goals, self-efficacy, and outcome expectations during a pivotal time in medical school. Lessons Learned: We learned that from the student perspective, the inclusion of clinical electives in the clerkship year benefited students' career exploration by helping them develop and refine their career goals, increase self-efficacy, and test outcome expectations in a meaningful way as anticipated from SCCT. In addition, we found that CIExes created a positive learning environment that allowed deep relationships to develop in fields of interest and that supported a strong sense of wellbeing. Supplemental data for this article is available online at https://doi.org/10.1080/10401334.2021.1891545.
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Affiliation(s)
- Leslie Sheu
- Department of Medicine, University of California, San Francisco, California, USA
| | - Sarah Goglin
- Department of Medicine, University of California, San Francisco, California, USA
| | - Sally Collins
- Office of Medical Education, University of California, San Francisco, California, USA
| | - Patricia Cornett
- Department of Medicine, University of California, San Francisco, California, USA
| | - Sara Clemons
- Office of Medical Education, University of California, San Francisco, California, USA
| | - Patricia S O'Sullivan
- Department of Medicine, University of California, San Francisco, California, USA
- Office of Medical Education, University of California, San Francisco, California, USA
- Department of Surgery, University of California, San Francisco, California, USA
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Ji YD, McKinley SK, Farrell M, Hemingway M, Qadan M, Saillant N, Phitayakorn R. Operating Room Staff Perceptions of Medical Students. JOURNAL OF SURGICAL EDUCATION 2022; 79:370-382. [PMID: 34876370 DOI: 10.1016/j.jsurg.2021.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 09/27/2021] [Accepted: 10/23/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE While the operating room (OR) is a keystone experience, medical students often report negative experiences and intimidation in the OR. The purpose of this study is to describe the perceived role of medical students in the OR by registered nurses and certified surgical technologists to improve medical student education. DESIGN A cross-sectional survey of select Massachusetts General Hospital perioperative staff in surgery was conducted through an anonymous survey in March 2021. Statistical analysis included inductive thematic analysis, descriptive statistics, and Mann-Whitney U tests, with a p-value of <0.05. The survey instrument characterized the perception of medical student preparedness for OR-related tasks and free-text responses on the role of medical students in the OR and opportunities for improvement. SETTING The study was conducted at the Massachusetts General Hospital, Boston, MA. PARTICIPANTS Participants included Massachusetts General Hospital perioperative staff in the Department of Surgery, with 262 registered nurses and 90 certified surgical technologists receiving the survey. RESULTS There were 86 completed responses (24.4% response rate). A total of 71.23% of respondents believe medical students should be observational learners in the OR. Areas for improvement include OR etiquette (37.5%), awareness of the surgical field (26.79%), and scrubbing skills (26.79%). A total of 48.8% of staff agreed they enjoy working with medical students, followed by 20.9% who somewhat agree. A total of 27.91% of respondents somewhat agreed that medical students were knowledgeable about OR sterility and scrubbing procedures, followed by 25.58% who somewhat disagreed. CONCLUSIONS Operating room staff enjoy working with medical students. The majority of staff believe medical students' role in the OR is that of observational learning. Areas of improvement for medical students include OR etiquette, awareness of the surgical field, scrubbing and gowning skills, and assisting staff whenever needed. Possible solutions include incorporating nursing staff as surgery clerkship stakeholders to optimize medical student experiences in the OR.
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Affiliation(s)
- Yisi D Ji
- Harvard Medical School, Boston, Massachusetts.
| | - Sophia K McKinley
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Michael Farrell
- Perioperative Services, Massachusetts General Hospital, Boston, Massachusetts
| | - Maureen Hemingway
- Perioperative Services, Massachusetts General Hospital, Boston, Massachusetts
| | - Motaz Qadan
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Noelle Saillant
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Roy Phitayakorn
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
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Theiss LM, Prather JC, Porterfield JR, Corey B, Chen H, McGwin G, Johnson MD, Theiss SM. Prevalence, Bias, and Rank List Impact of Illegal Questions in Surgical Specialty Residency Interviews. JOURNAL OF SURGICAL EDUCATION 2022; 79:69-76. [PMID: 34400121 DOI: 10.1016/j.jsurg.2021.07.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/23/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The purpose of this study is to characterize illegal questions as defined by federal law and to assess their impact on applicants' rank lists across four surgical specialties. DESIGN A survey was developed and sent to surgical specialty residency applicants. The survey asked demographics, the frequency of questions about age, gender, religion, sexual orientation, family status and impact on final rank list. Applicants were asked to respond anonymously based on their experience at all institutions at which they interviewed during the interview cycle. Results were compared by applicant specialty and gender. SETTING A large university-affiliated academic medical center PARTICIPANTS: Survey was administered to 3854 applicants (comprising between 28.9% and 41.2% of applicants nationwide) to general surgery, orthopaedic surgery, urology, and otolaryngology residency programs at a single institution during the 2018 and 2019 cycles. A total of 1066 applicants completed the survey. RESULTS A total of 789 (74.0%) of applicants reported being asked at least one illegal question during the interview process at any institution. Applicants to orthopaedic surgery programs were most likely to be asked illegal question (n = 315, 81.6%), and general surgery applicants were least likely to be asked illegal questions (n = 324, 66.8%, p < 0.001). Females were more likely than males to be asked about gender (n = 99, 26.3% vs. n = 18, 2.6%, p < 0.001) and plans for pregnancy (n = 78, 20.8% vs. n = 78, 11.4%, p < 0.001). 152 (19.4%). Applicants reported that being asked an illegal question lowered a program on their rank list. Female applicants were more likely to lower a program on their rank list as a result of an illegal question (n = 102, 35.4% vs. n = 50, 10.1%, p < 0.001). CONCLUSIONS Illegal questions in surgical specialty residency interviews are common, vary by specialty and applicant gender, and lower programs on applicants' rank lists. This data should serve to inform larger and more inclusive studies in the future. Programs should focus on educating interviewers on illegal topics in an effort to minimize illegal topics that may alienate applicants and contribute to workplace discrimination.
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Affiliation(s)
- Lauren M Theiss
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - John C Prather
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - John R Porterfield
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Britney Corey
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Herbert Chen
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gerald McGwin
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Michael D Johnson
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Steven M Theiss
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
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Tan R, Bond E, Muir D. Perceived barriers to a career in orthopaedic surgery for women: A comparison between Orthopaedic and general surgery. ANZ J Surg 2021; 91:1650-1651. [PMID: 34506058 DOI: 10.1111/ans.17112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/14/2021] [Accepted: 07/15/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Ruth Tan
- Waikato Hospital, Hamilton, New Zealand
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Vaysburg DM, Cortez AR, Hanseman DJ, Delman AM, Morris C, Kassam AF, Kutz D, Lewis J, Van Haren RM, Quillin RC. An analysis of applicant competitiveness to general surgery, surgical subspecialties, and integrated programs. Surgery 2021; 170:1087-1092. [PMID: 33879334 DOI: 10.1016/j.surg.2021.03.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/27/2021] [Accepted: 03/12/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND General surgery was once the gateway into a career in surgery. Over time, surgical subspecialties developed separate residency programs, and recently, integrated programs have emerged. It is unknown what impact the presence of surgical subspecialties and integrated programs have had on general surgery. Our objective was to evaluate match trends and quantify competitiveness of the general surgery, integrated programs, and surgical subspecialties matches. METHODS National Residency Matching Program match data and applicant characteristics from 2010 through 2020 were analyzed for US senior allopathic applicants. Integrated programs were defined as plastic and vascular surgery, and surgical subspecialties were defined as otolaryngology, orthopedic surgery, and neurosurgery. Trends were evaluated using linear regression, programs were compared on 10 metrics by Wilcoxon rank-sum tests, and a logistic regression was used to rank each specialty match. RESULTS The number of US senior applicants per position to integrated programs decreased and approached that of general surgery and surgical subspecialties, but the median number of applicants per position to general surgery was lower than to surgical subspecialties or integrated programs (1.21 interquartile range). Our logistic regression showed United States Medical Licensing Examination scores, research experience, Alpha Omega Alpha Honor Society membership, and graduation from a top medical school to be the most important factors in the match, and our weighted rank score found general surgery (2.85) to be less competitive than surgical subspecialties (1.92) or integrated programs (1.17). CONCLUSION Throughout the last decade, integrated programs and surgical subspecialties have matched more competitive applicants based on the most significant predictors of the match. Moving forward, it is important that general surgery strives to attract the best and brightest out of medical school.
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Affiliation(s)
- Dennis M Vaysburg
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, OH. https://twitter.com/DMVaysburg
| | - Alexander R Cortez
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, OH. https://twitter.com/AlexCortezMD
| | - Dennis J Hanseman
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, OH
| | - Aaron M Delman
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, OH. https://twitter.com/AaronDelman
| | - Christopher Morris
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, OH
| | - Al-Faraaz Kassam
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, OH. https://twitter.com/afkassam
| | - David Kutz
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, OH
| | - Jaime Lewis
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, OH. https://twitter.com/JaimeDLewis
| | - Robert M Van Haren
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, OH; Division of Thoracic Surgery, University of Cincinnati, OH. https://twitter.com/rvanharen
| | - R Cutler Quillin
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, OH.
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Darlington CD, Mammen R, Mammen K. Focused aptitude and pathway to be an accomplished urologist. CHRISMED JOURNAL OF HEALTH AND RESEARCH 2021. [DOI: 10.4103/cjhr.cjhr_82_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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The Influence of an Acting or Subintern on Third-Year Medical School Surgery Clerkship Students. J Surg Res 2020; 259:8-13. [PMID: 33278797 DOI: 10.1016/j.jss.2020.11.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 10/14/2020] [Accepted: 11/01/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Previous reports demonstrated a positive relationship between the surgical clerkship and student likelihood of pursuing a surgical career, but no studies have examined the influence a peer has on comfort during a surgical clerkship. We hypothesized that a fourth-year acting intern (AI) would positively impact third-year medical students' experience during their surgical clerkship. METHODS All third-year medical students at our institution who completed their surgical clerkship in 2019 were surveyed regarding the preclerkship and postclerkship perceptions. RESULTS Of the 110 students surveyed, 52 responded (47.3% response rate), and 25 students (48.1%) reported having an AI during their clerkship rotation, and 27 did not (51.9%). Presence of an AI had no significant effect on the postclerkship perception of surgery, likelihood of pursuing general surgery, or comfort in the OR. Analysis of all responses demonstrated the surgery clerkship had no significant impact on students' perception of surgery or likelihood of pursuing general surgery but did statistically increase students' comfort in the OR. CONCLUSIONS The results of this study suggest that AI presence did not significantly influence a student's clerkship experience or comfort in the OR. Further studies are needed to determine what, if any effect, an AI could have on third-year clerkship students.
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Winer LK, Vivero MP, Scully BF, Cortez AR, Kassam AF, Nowygrod R, Griesemer AD, Emond JC, Quillin RC. Exploring Medical Students' Perceptions of Organ Procurement: Need for a Formalized Medical Student Curriculum. JOURNAL OF SURGICAL EDUCATION 2020; 77:329-336. [PMID: 31753606 DOI: 10.1016/j.jsurg.2019.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/13/2019] [Accepted: 10/04/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE We evaluated the medical student experience with a deceased-donor multiorgan procurement program at a single center. The program provided the opportunity to assist with organ procurement, but no formal curriculum was offered. DESIGN, SETTING, PARTICIPANTS In 2018, medical students who registered for the program between 2014 and 2017 completed a voluntary survey about the experience and its impact on surgery interest and organ donation knowledge and advocacy. RESULTS Of 139 respondents, 53.3% (N = 74) of students participated in at least one procurement. The experience was resoundingly positive: 81.7% (N = 58) believed it exceeded expectations, with less than one-third missing class and only 4.3% (N = 3) reporting a negative impact on academics. Although 60.6% (N = 43) students studied prior to procurement, 57.8% (N = 41) expressed the need for increased preparation. Preferred learning modalities included videos, discussion with the transplant fellows, and focused anatomy overview. Following participation, 53.5% (N = 38) of students had increased interest in pursuing an acting internship and career in surgery. However, participation was not associated with improved familiarity with organ donation concepts or advocacy. CONCLUSIONS Adding a structured curriculum may turn medical students from passive observers into active learners, maximizing the educational value of procurement and better equipping future providers to promote organ donation.
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Affiliation(s)
- Leah K Winer
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Matthew P Vivero
- Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Alexander R Cortez
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Al-Faraaz Kassam
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Roman Nowygrod
- Department of Surgery, Columbia University, New York, New York
| | - Adam D Griesemer
- Center for Liver Disease and Transplantation, Columbia University, New York, New York
| | - Jean C Emond
- Center for Liver Disease and Transplantation, Columbia University, New York, New York
| | - Ralph C Quillin
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, Ohio.
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Core content of the medical school surgical curriculum: Consensus report from the association of surgeons in training (ASIT). Int J Surg 2020; 84:186-193. [PMID: 31926325 DOI: 10.1016/j.ijsu.2019.12.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/19/2019] [Accepted: 12/30/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The length of time dedicated to the undergraduate surgical curriculum is decreasing. With reduced time on surgical placements, students may be underexposed to their core learning needs. The aim of this study was to reach a national consensus on the core content of the undergraduate surgical curriculum in the UK. This will support medical students and medical schools in designing curricula to meet the core learning needs of students to prepare them for clinical practice. MATERIALS AND METHODS A proposed consensus document was created, using the Royal College of Surgeons of England undergraduate curriculum as a guide. This was circulated to an external advisory group for electronic suggestions of additional content not already described. Suggestions were discussed with the steering committee prior to inclusion within document. The resulting consensus document was presented to a face-face consensus meeting of medical students and foundation doctors at the Association of Surgeons in Training (ASiT) conference 2019 for live voting. Eighty percent agreement required to reach consensus. Any discussion of topics was transcribed to allow qualitative summary of discussion of those topics which did not reach consensus agreement. RESULTS Electronic suggestions yielded an extra 8 topics for inclusion into the final consensus document. A total of 52 people participated in the consensus session. The consensus discussed a total of 69 knowledge topics, practical skills and clinical examinations; of which 10 did not reach consensus agreement. Areas failing to reach consensus included knowledge topics in Ear Nose and Throat surgery, Vascular surgery and Neurosurgery as the consensus concluded that these topics were supplementary to core needs. CONCLUSION This paper presents a national consensus of the undergraduate surgical curriculum. This document should be used in conjunction with the RCS of England undergraduate curriculum to ensure students have an adequate surgical education.
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Sansosti AA, Jacobs RC, Safonova A, Jani RH, Schumann J, Friedlander RM, Lunsford LD, McDowell MM, Sekula RF. Impact of a Hands-on Pre-Clinical Neurosurgery Elective Course on Second-Year Medical Student Interest and Attitudes. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2020; 7:2382120520964852. [PMID: 33150209 PMCID: PMC7580150 DOI: 10.1177/2382120520964852] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 09/11/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Medical student involvement opportunities and educational experiences with surgical residents during medical school have been shown to increase the chance of students deciding to specialize in surgical specialties. This study aims to determine the effect of a neurosurgery elective during the second preclinical year on student interest and opinion of neurosurgery. METHODS Thirty-nine students completed opinion-based surveys and factual knowledge quizzes during a neurosurgical elective course over 3 iterations, which included lecture and skills lab instruction. Pre- and post-course surveys used the Likert scale, with a score of 1 corresponding to the most negative opinion and a score of 10 corresponding to the most positive opinion, in order to measure various aspects including interest in neurological surgery, understanding of the field, and perception of female inclusion in the field. Weekly pre- and post-lecture quizzes assessed practical knowledge of neurosurgical topics. RESULTS A higher percentage of students rated neurosurgery highly as a career possibility (⩾8/10 interest level) post-course (58.6%) compared to pre-course (45.7%). Post-course, students reported a significantly increased mean understanding of neurosurgery on the Likert scale compared to pre-course (6.1 ± 1.7 vs 4.4 ± 2.0; P = .001). Knowledge based-content assessment revealed a significant increase in overall correct answers after lectures (meanpre = 3.85, meanpost = 5.05, P = .001). Inclusion of female instructors in the second and third iteration of the course resulted in a significant increase in students' perception of female inclusion in the field of neurosurgery (7.6 compared to 5.6, P = .01). CONCLUSIONS Early exposure to subspecialties may assist in making important career decisions. The implementation of this neurosurgical elective improved medical students' perception of the field and enhanced knowledge of the lectures and procedures. This study can be used as a framework for implementation of this curriculum at other institutions.
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Affiliation(s)
| | | | | | | | | | - Robert M Friedlander
- University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - L Dade Lunsford
- University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Michael M McDowell
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Raymond F Sekula
- University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Impact of medical student involvement on outcomes following spine surgery: A single center analysis of 6485 patients. J Clin Neurosci 2019; 69:143-148. [PMID: 31427233 DOI: 10.1016/j.jocn.2019.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 08/05/2019] [Indexed: 11/21/2022]
Abstract
Medical student (MS) observation and assistance in the operating room (OR) is a critical component of medical education. Though participation in the operating room has many benefits to the medical student, the potential cost of these experiences to the patients must be taken into account. Other studies have shown differences in outcomes with resident involvement, but the effect of medical students in the OR has been poorly understood. The objective of this study was to understand how medical students and residents impacted surgical outcomes in posterior spinal fusions, anterior cervical discectomy and fusions (ACDFs), and lumbar discectomies. We conducted a retrospective study of patients undergoing posterior spinal fusions, ACDFs, and lumbar discectomies over 15 years. There were 6485 patients met the inclusion criteria of either undergoing a posterior fusion, ACDF or lumbar discectomy (1250 posterior fusion, 1381 ACDF, 3854 lumbar discectomies). Overall, little difference was observed when a medical student was present for surgical outcomes including length of stay, infection, and readmission. For ACDFs, having a medical student present had a significantly longer procedure durations (OR = 1.612, p = 0.001) than cases without. Besides slightly longer operative time (in posterior fusions), there were no major differences in outcomes when a medical student was present in the OR.
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Garstka M, Honda M, Crowther J, Hess A, Schroll R, Killackey M, DuCoin C. Effect of Community and Academic Surgical Rotation Sites on Medical Student Performance Outcomes and Career Choices. JOURNAL OF SURGICAL EDUCATION 2019; 76:970-974. [PMID: 30686778 DOI: 10.1016/j.jsurg.2019.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/27/2018] [Accepted: 01/07/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE We hypothesize that students exposed to both academic and community surgery clerkship sites will have higher National Board of Medical Examiners Subject Exam in Surgery (NBME SES) scores and be more likely to pursue a career in a surgical specialty. DESIGN The NBME surgery subject exam scores and National Resident Matching Program (NRMP) results were collected for all medical students rotating through the surgery clerkship over 4 years. Permutations of sites were analyzed against exam scores and match rates into surgical and nonsurgical specialties. SETTING This study was performed at the Tulane University School of Medicine, in New Orleans, Louisiana, United States of America. PARTICIPANTS Data for a total of 910 students rotating through the surgery clerkship over a period of 4 years was collected and analyzed. RESULTS There was no statistical difference in NBME subject exam scores (p = 0.44) or match rates into a surgical specialty (p = 0.13) as stratified by site placement. Average NBME surgery subject exam scores were higher for those pursuing a surgical specialty (p < 0.001). CONCLUSIONS The combination of sites experienced during the surgery clerkship did not affect NBME surgery subject exam scores nor lead to a tendency to match into a surgical specialty.
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Affiliation(s)
- Meghan Garstka
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Michelle Honda
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Jason Crowther
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Annie Hess
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Rebecca Schroll
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Mary Killackey
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Christopher DuCoin
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
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Neurosurgery Training Camp for Sub-Internship Preparation: Lessons From the Inaugural Course. World Neurosurg 2019; 127:e707-e716. [PMID: 30947014 DOI: 10.1016/j.wneu.2019.03.246] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 03/23/2019] [Accepted: 03/23/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Historically, medical student education in neurological surgery has generally limited student involvement to assisting in research projects with minimal formal clinical exposure before starting sub-internships and application for the neurosurgery match. Consequently, students have generally had little opportunity to acquire exposure to clinical neurosurgery and attain minimal proficiency. A medical student training camp was created to improve the preparation of medical students for the involvement in neurological surgery activities and sub-internships. METHODS A 1-day course was held at Weill Cornell Medicine, which consisted of a series of morning lectures, an interactive resident lunch panel, and afternoon hands-on laboratory sessions. Students completed self-assessment questionnaires regarding their confidence in several areas of clinical neurosurgery before the start of the course and again at its end. RESULTS A significant increase in self-assessed confidence was observed in all skill areas surveyed. Overall, rising fourth year students who were starting sub-internships in the subsequent weeks reported a substantial increase in their preparedness for the elective rotations in neurosurgery. CONCLUSIONS The preparation of medical students for clinical neurosurgery can be improved. Single-day courses such as the described training camp are an effective method for improving knowledge and skill gaps in medical students entering neurosurgical careers. Initiatives should be developed, in addition to this annual program, to increase the clinical and research skills throughout medical student education.
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Walker NR, Deekonda P, Glasbey JC, Rashid S, Gokani VJ, Humm G, Mohan H, Harries RL. Attracting medical students and doctors into surgical training in the UK and Ireland. Int J Surg 2019; 67:107-112. [PMID: 30668992 DOI: 10.1016/j.ijsu.2019.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 01/11/2019] [Indexed: 12/23/2022]
Abstract
AIMS Core surgical training (CST) programmes in the UK have seen a significant reduction in competition ratios over the past five years. This study aimed to determine motivating factors and perceived barriers to pursuing a career in surgery amongst junior doctors in training and medical students attending an annual conference. METHODS A self-reported, electronic questionnaire was distributed to medical students, foundation year doctors, and doctors in postgraduate surgical training programmes (DIPST) who attended the Association of Surgeons in Training (ASiT) Conference in 2016. Respondents ranked factors attracting them to a career in surgery and factors that could improve perceptions of surgical careers. Chi-square test was used to test for differences between groups (a = 0.05, R Studio, V3.3.1). RESULTS Of 394 respondents (response rate = 50.9%), 44.9% were medical students or foundation doctors ('Pre-CST') and 55.1% were DIPST ('Peri/post-CST'). Practical application of skills (97.4%), enjoyment of the theatre environment (95.4%) and positive experiences in surgical firms (84.7%) were primary driving factors towards a surgical career. Availability of private practice (32.2%), and sustainability of consultant jobs (49.0%) had less influence. For 'Pre-CST' respondents, role models (82.8% pre-CST v 74.9% peri-post CST, p < 0.05) and defined career progression (67.2% pre-CST v 47.0% peri-post CST, p < 0.001) were particularly important. 91% of all respondents agreed that a better balance of training and service within worked hours would improve perceptions of surgery. CONCLUSION Addressing the motivating factors and perceived barriers to surgical careers will help bolster recruitment of the future surgical workforce.
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Affiliation(s)
- N R Walker
- Association of Surgrons in Training, 35-43 Lincoln's Inn Fields, London, WC2A 3PE, United Kingdom
| | - P Deekonda
- Association of Surgrons in Training, 35-43 Lincoln's Inn Fields, London, WC2A 3PE, United Kingdom
| | - J C Glasbey
- Association of Surgrons in Training, 35-43 Lincoln's Inn Fields, London, WC2A 3PE, United Kingdom
| | - S Rashid
- Association of Surgrons in Training, 35-43 Lincoln's Inn Fields, London, WC2A 3PE, United Kingdom
| | - V J Gokani
- Association of Surgrons in Training, 35-43 Lincoln's Inn Fields, London, WC2A 3PE, United Kingdom
| | - G Humm
- Association of Surgrons in Training, 35-43 Lincoln's Inn Fields, London, WC2A 3PE, United Kingdom
| | - H Mohan
- Association of Surgrons in Training, 35-43 Lincoln's Inn Fields, London, WC2A 3PE, United Kingdom
| | - R L Harries
- Association of Surgrons in Training, 35-43 Lincoln's Inn Fields, London, WC2A 3PE, United Kingdom.
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- Association of Surgrons in Training, 35-43 Lincoln's Inn Fields, London, WC2A 3PE, United Kingdom
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Cortez AR, Winer LK, Kim Y, Hanseman DJ, Athota KP, Quillin RC. Predictors of medical student success on the surgery clerkship. Am J Surg 2019; 217:169-174. [DOI: 10.1016/j.amjsurg.2018.09.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 09/04/2018] [Accepted: 09/16/2018] [Indexed: 11/27/2022]
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Paracha M, Hirsch AE, Tseng JF, McAneny DB, Sachs TE. Scholarly impact of student authorship on surgical research. Am J Surg 2019; 217:175-179. [DOI: 10.1016/j.amjsurg.2018.07.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 07/24/2018] [Accepted: 07/27/2018] [Indexed: 10/28/2022]
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Thomas A, Murtaza AN, Michael Spiers HV, Zargaran A, Turki M, Mathur J, Fukui A, Zargaran D, Khan O. Declining interest in general surgical training - Challenging misconceptions and improving access at undergraduate level. Ann Med Surg (Lond) 2018; 40:3-8. [PMID: 30962923 PMCID: PMC6423304 DOI: 10.1016/j.amsu.2018.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 10/30/2018] [Accepted: 11/01/2018] [Indexed: 11/29/2022] Open
Abstract
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.
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Affiliation(s)
- Amal Thomas
- St. George's, University of London, London, UK
| | | | | | | | | | - Jai Mathur
- St. George's, University of London, London, UK
| | - Akiko Fukui
- St. George's, University of London, London, UK
| | - David Zargaran
- Academic Foundation Doctor, Imperial College Healthcare NHS Trust, London, UK
| | - Omar Khan
- St. George's University Hospital NHS Trust, London, UK
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Kashkoush A, Feroze R, Myal S, Prabhu AV, Sansosti A, Tonetti D, Agarwal N. Fostering Student Interest in Neurologic Surgery: The University of Pittsburgh Experience. World Neurosurg 2017; 108:101-106. [DOI: 10.1016/j.wneu.2017.08.125] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 08/17/2017] [Accepted: 08/18/2017] [Indexed: 10/18/2022]
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Abstract
BACKGROUND Exposure to the plastic surgery department is an important experience for medical students interested in the field. However, the impact of medical students in the plastic surgery operating room has not been previously examined. The aim of this study is to understand whether the presence of medical students impacted overall procedure time and postoperative complications for bilateral reduction mammoplasties. MATERIALS AND METHODS A retrospective review was performed on all patients who underwent bilateral reduction mammoplasty from January 2010 to December 2015. Procedures were divided into operations with medical students present and operations without medical students present. Patient average operation time and average procedure time were analyzed. A 2-tailed t-test was used to compare times with statistical significance set at P less than 0.05. A multivariate regression analysis was performed to control for potential confounders. RESULTS A total of 157 patients underwent bilateral reduction mammoplasties. Seventy-five of these cases had at least 1 medical student present; 82 of these cases had no medical student present. Patient information was not statistically different between groups. The average total operative time was 150.32 minutes, and the average procedure time (skin-incision to skin-closure) was 109.15 minutes. The total operative time was significantly longer in procedures with medical students: 158.25 minutes versus 143.06 minutes in procedures without medical students (P = 0.013). However, the total procedure time was not significantly longer: 113.95 minutes with medical students versus 104.75 minutes without medical students (P = 0.096). There were no differences in perioperative complications and multivariate regression analysis showed no statistically significant confounders for the duration of surgery.
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Simulation-based camera navigation training in laparoscopy-a randomized trial. Surg Endosc 2016; 31:2131-2139. [PMID: 27770252 PMCID: PMC5411407 DOI: 10.1007/s00464-016-5210-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 08/23/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Inexperienced operating assistants are often tasked with the important role of handling camera navigation during laparoscopic surgery. Incorrect handling can lead to poor visualization, increased operating time, and frustration for the operating surgeon-all of which can compromise patient safety. The objectives of this trial were to examine how to train laparoscopic camera navigation and to explore the transfer of skills to the operating room. MATERIALS AND METHODS A randomized, single-center superiority trial with three groups: The first group practiced simulation-based camera navigation tasks (camera group), the second group practiced performing a simulation-based cholecystectomy (procedure group), and the third group received no training (control group). Participants were surgical novices without prior laparoscopic experience. The primary outcome was assessment of camera navigation skills during a laparoscopic cholecystectomy. The secondary outcome was technical skills after training, using a previously developed model for testing camera navigational skills. The exploratory outcome measured participants' motivation toward the task as an operating assistant. RESULTS Thirty-six participants were randomized. No significant difference was found in the primary outcome between the three groups (p = 0.279). The secondary outcome showed no significant difference between the interventions groups, total time 167 s (95% CI, 118-217) and 194 s (95% CI, 152-236) for the camera group and the procedure group, respectively (p = 0.369). Both interventions groups were significantly faster than the control group, 307 s (95% CI, 202-412), p = 0.018 and p = 0.045, respectively. On the exploratory outcome, the control group for two dimensions, interest/enjoyment (p = 0.030) and perceived choice (p = 0.033), had a higher score. CONCLUSIONS Simulation-based training improves the technical skills required for camera navigation, regardless of practicing camera navigation or the procedure itself. Transfer to the clinical setting could, however, not be demonstrated. The control group demonstrated higher interest/enjoyment and perceived choice than the camera group.
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Cook MR, Deal SB, Scott JM, Moren AM, Kiraly LN. Teaching communication and supporting autonomy with a team-based operative simulator. Am J Surg 2016; 212:552-6. [PMID: 27378354 DOI: 10.1016/j.amjsurg.2016.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 01/26/2016] [Accepted: 03/31/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Changing residency structure emphasizes the need for formal instruction on team leadership and intraoperative teaching skills. A high fidelity, multi-learner surgical simulation may offer opportunities for senior learners (SLs) to learn these skills while teaching technical skills to junior learners (JLs). METHODS We designed and optimized a low-cost inguinal hernia model that paired JLs and SLs as an operative team. This was tested in 3 pilot simulations. Participants' feedback was analyzed using qualitative methods. RESULTS JL feedback to SLs included the themes "guiding and instructing" and "allowing autonomy." Senior Learner feedback to JLs focused on "mechanics," "knowledge," and "perspective/flow." Both groups focused on "communication" and "professionalism." CONCLUSIONS A multi-learner simulation can successfully meet the technical learning needs of JLs and the teaching and communication learning needs of SLs. This model of resident-driven simulation may illustrate future opportunities for operative simulation.
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Affiliation(s)
- Mackenzie R Cook
- Department of Surgery, Oregon Health and Science University, Mail Code L611, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA.
| | - Shanley B Deal
- Department of Surgery, Virginia Mason Medical Center, Seattle, WA, USA
| | - Jessica M Scott
- Department of Surgery, Oregon Health and Science University, Mail Code L611, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - Alexis M Moren
- Department of Surgery, Oregon Health and Science University, Mail Code L611, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - Laszlo N Kiraly
- Department of Surgery, Oregon Health and Science University, Mail Code L611, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
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Schmidt LE, Cooper CA, Guo WA. Factors influencing US medical students' decision to pursue surgery. J Surg Res 2016; 203:64-74. [PMID: 27338536 DOI: 10.1016/j.jss.2016.03.054] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/09/2016] [Accepted: 03/22/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Interest and applications to surgery have steadily decreased over recent years in the United States. The goal of this review is to collect the current literature regarding US medical students' experience in surgery and factors influencing their intention to pursue surgery as a career. We hypothesize that multiple factors influence US medical students' career choice in surgery. METHODS Six electronic databases (PubMed, SCOPUS, Web of Science, Education Resources Information Center, Embase, and PsycINFO) were searched. The inclusion criteria were studies published after the new century related to factors influencing surgical career choice among US medical students. Factors influencing US medical student surgical career decision-making were recorded. A quality index score was given to each article selected to minimize risk of bias. RESULTS We identified 38 relevant articles of more than 1000 nonduplicated titles. The factors influencing medical student decision for a surgical career were categorized into five domains: mentorship and role model (n = 12), experience (clerkship n = 9, stereotype n = 4), timing of exposure (n = 9), personal (lifestyle n = 8, gender n = 6, finance n = 3), and others (n = 2). CONCLUSIONS This comprehensive systemic review identifies mentorship, experience in surgery, stereotypes, timing of exposure, and personal factors to be major determinants in medical students' decisions to pursue surgery. These represent areas that can be improved to attract applicants to general surgery residencies. Surgical faculty and residents can have a positive influence on medical students' decisions to pursue surgery as a career. Early introduction to the field of surgery, as well as recruitment strategies during the preclinical and clinical years of medical school can increase students' interest in a surgical career.
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Zinchenko R, Perry FM, Dheansa BS. Burns teaching in UK medical schools: Is it enough? Burns 2016; 42:178-183. [DOI: 10.1016/j.burns.2015.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 09/17/2015] [Accepted: 10/01/2015] [Indexed: 10/22/2022]
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Abstract
BACKGROUND Medical student interest in neurosurgery is decreasing and resident attrition is trending upwards in favor of more lifestyle-friendly specialties that receive greater exposure during medical school. The University of Toronto began offering an annual two week comprehensive, focused surgical experience (Surgical Exploration and Discovery (SEAD) program) to 20 first year medical students increasing exposure to surgical careers. This study determines how SEAD affects students' views of a career in neurosurgery. METHODS Surveys were administered to 38 SEAD participants over two program cycles. Information was obtained regarding demographics, impacts of SEAD, and factors affecting career decision making. Subgroup analyses assessed for factors predicting pre- and post-intervention interest in neurosurgery. RESULTS Ninety-seven percent (n=37) of students completed the survey. Before SEAD, 25% were interested in neurosurgery but this decreased to 10% post-SEAD (p=0.001). However, post-SEAD interest increased from 10% to 38% if lifestyle factors were theoretically controlled across surgical specialties (p<0.005). A majority (81%) felt SEAD improved their understanding of neurosurgery, 62.2% felt that exposure to other surgical specialties reduced their interest in neurosurgery, and 21% felt SEAD increased their interest in neurosurgery. Nineteen percent intended to explore neurosurgery further with observerships and one student planned to organize neurosurgical research. CONCLUSIONS This surgical exposure intervention increased understanding about neurosurgery and reduced overall interest in neurosurgery as a career. However, those remaining interested were motivated to plan further neurosurgical clinical experiences. The SEAD program may, therefore, aid in early selection of students motivated to satisfy the demands of a neurosurgical career.
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Helder MRK, Rowse PG, Ruparel RK, Li Z, Farley DR, Joyce LD, Stulak JM. Basic Cardiac Surgery Skills on Sale for $22.50: An Aortic Anastomosis Simulation Curriculum. Ann Thorac Surg 2015; 101:316-22; discussion 322. [PMID: 26499816 DOI: 10.1016/j.athoracsur.2015.08.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 07/30/2015] [Accepted: 08/07/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Current resident and student duty-hour restrictions necessitate efficient training, which may be aided by simulation. Data on the utility of low-cost simulation in cardiothoracic surgery are scant. We evaluated the effect and value of a low-cost, low-fidelity aortic anastomosis simulation curriculum. METHODS Twenty participants (11 medical students, 9 residents) completed an aortic anastomosis on a porcine heart as a pretest. Participants were then provided access to a 14-minute online video created by a cardiac surgeon and given a low-cost task trainer for self-directed practice. Five weeks later, participants performed another aortic anastomosis on a porcine heart as a posttest. Pretest and posttest performances were filmed, deidentified, and graded blindly and independently by two cardiac surgeons using a standardized assessment tool (perfect score, 110; passing score, 58 or higher). Participants were surveyed anonymously after the posttest. RESULTS The mean (SD) aortic anastomosis performance score improved significantly from pretest (53.3 [25.3]) to posttest (83.6 [15.3]; p < 0.001). Pass rates also improved significantly (35% versus 95%, p < 0.001). Medical students' scores improved most (p = 0.01). All 20 participants reported improved confidence in performing the task, and 18 believed that the online video was essential to better performance. The cost of the curriculum totaled $22.50 per participant, with 6 hours of total staff time required for assessment. CONCLUSIONS An aortic anastomosis training and simulation curriculum improves the skills of student and resident trainees with minimal expense and staff time commitment. Such a curriculum may be of great value to both cardiothoracic training programs and their trainees.
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Affiliation(s)
| | | | - Raaj K Ruparel
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Zhuo Li
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - David R Farley
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Lyle D Joyce
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - John M Stulak
- Department of Surgery, Mayo Clinic, Rochester, Minnesota.
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Mori M, Liao A, Hagopian TM, Perez SD, Pettitt BJ, Sweeney JF. Medical students impact laparoscopic surgery case time. J Surg Res 2015; 197:277-82. [PMID: 25963166 DOI: 10.1016/j.jss.2015.04.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 03/22/2015] [Accepted: 04/03/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Medical students (MS) are increasingly assuming active roles in the operating room. Laparoscopic cases offer unique opportunities for MS participation. The aim of this study was to examine associations between the presence of MS in laparoscopic cases and operation time and postoperative complication rates. MATERIALS AND METHODS Data from the American College of Surgeons National Surgical Quality Improvement Program were linked to operative records for nonemergent, inpatient, and laparoscopic general surgery cases at our institution from January, 2009-January, 2013. Cases were grouped into eight distinct procedure categories. Hospital records provided information on the presence of MS. Demographics, comorbidities, intraoperative variables, and postoperative complication rates were analyzed. RESULTS Seven hundred laparoscopic cases were included. Controlling for wound class, procedure group, and surgeon, MS were associated with an additional 28 min of total operative time. The most significant increase occurred between the skin incision and skin closure. No significant association between the presence of MS and postoperative complications was observed. CONCLUSIONS This is the first retrospective analysis to examine the effect of MS presence during laparoscopic procedures. Increase in the operation time associated with the presence of MS should be examined further, to optimize the educational experience without incurring increased cost due to increased operation time.
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Affiliation(s)
- Makoto Mori
- Department of Surgery, Emory University School of Medicine, Emory University, Atlanta, Georgia
| | - Albert Liao
- Department of Surgery, Emory University School of Medicine, Emory University, Atlanta, Georgia
| | - Thomas M Hagopian
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Sebastian D Perez
- Department of Surgery, Emory University School of Medicine, Emory University, Atlanta, Georgia
| | - Barbara J Pettitt
- Department of Surgery, Emory University School of Medicine, Emory University, Atlanta, Georgia
| | - John F Sweeney
- Department of Surgery, Emory University School of Medicine, Emory University, Atlanta, Georgia.
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Cook MR, Yoon M, Hunter J, Kwong K, Kiraly L. A nonmetropolitan surgery clerkship increases interest in a surgical career. Am J Surg 2015; 209:21-5. [DOI: 10.1016/j.amjsurg.2014.08.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 08/01/2014] [Accepted: 08/26/2014] [Indexed: 11/29/2022]
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Ibrahim M, Fanshawe A, Patel V, Goswami K, Chilvers G, Ting M, Pilavakis Y, Rao C, Athanasiou T. What factors influence British medical students' career intentions? MEDICAL TEACHER 2014; 36:1064-1072. [PMID: 24934092 DOI: 10.3109/0142159x.2014.923560] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The aim of this study was to identify factors that influence career choice in UK medical students. METHODS Students at seven institutions were invited to rate how important various factors were on influencing their career choices and how interested they were in pursuing different specialties. The influence of interpersonal relationship networks on career choice was also evaluated. RESULTS 641 responses were collected. 44% (283) were male, 16% (105) were graduates and 41% (263) were final-year students. For Dermatology (p = 0.009), Paediatrics (p = 0.000), Radiology (p = 0.000), Emergency Medicine (p = 0.018) and Cardiothoracic Surgery (p = 0.000), there was a clear correlation between completing a clinical attachment and an interest in pursuing the specialty. Perceived characteristics of the speciality, individually and in clusters were considered important by specific subgroups of students, such as those interested in surgery. These students considered prestige (p = 0.0003), role models (p = 0.014), financial rewards after training (p = 0.0196) and technical challenge (p = 0.0011) as important factors. Demographics such as sex and age played a significant role in career choice. Interpersonal relationship networks do not have a significant influence on career intentions. CONCLUSIONS This study shows that the career intentions of British medical students are influenced by their undergraduate experience and by the weight they place on different specialty-related factors.
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Sutton PA, Mason J, Vimalachandran D, McNally S. Attitudes, motivators, and barriers to a career in surgery: a national study of U.K. undergraduate medical students. JOURNAL OF SURGICAL EDUCATION 2014; 71:662-667. [PMID: 24776853 DOI: 10.1016/j.jsurg.2014.03.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 03/05/2014] [Accepted: 03/10/2014] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Numerous factors influence the career choices of undergraduate medical students, although little work has focused specifically on the surgical specialties. We aimed to investigate medical students' early experiences of surgery along with the motivators and barriers to selecting a surgical career. METHODS All final-year medical students were invited to participate in an online survey. A range of quantitative data (expressed as a proportion of total respondents) and qualitative data (grouped and thematically analyzed) were collected to evaluate students' attitudes to careers in surgery and potential influences on these. RESULTS A total of 482 students from 20 medical schools throughout England and Wales completed the survey. Overall, 91% of respondents had work experience before medical school, in which the greatest satisfaction was reported in the 21% who undertook placements in surgery. In addition, 58% expressed a desire to spend time working abroad and 59% to undertake a period of research; the primary motivator for both was career/professional development. Surgery was the most popular career choice amongst respondents. The 2 most important factors in decisions pertaining to their career were reported as interest in the specialty and work-life balance. Students draw career advice from numerous sources, most commonly mentors (49%) and student surgical societies (46%). Only 1% wanted more website information, with personal contact being paramount. DISCUSSION It is vital for the continuing strength of the profession and the quality of surgery for the public that we continue to attract the best undergraduates into careers in surgery. Surgeons of all grades must be aware that how they are perceived by students affects future career choices. Early experiences of surgery are fundamental in assisting medical students to make informed career choices.
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Affiliation(s)
- Paul A Sutton
- Royal College of Surgeons of England, London, United Kingdom; Countess of Chester Hospital NHS Foundation Trust, Chester, United Kingdom
| | - John Mason
- Royal College of Surgeons of England, London, United Kingdom
| | - Dale Vimalachandran
- Royal College of Surgeons of England, London, United Kingdom; Countess of Chester Hospital NHS Foundation Trust, Chester, United Kingdom
| | - Scarlett McNally
- Royal College of Surgeons of England, London, United Kingdom; East Sussex Healthcare NHS Trust, Sussex, United Kingdom.
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Daly SC, Deal RA, Rinewalt DE, Francescatti AB, Luu MB, Millikan KW, Anderson MC, Myers JA. Higher clinical performance during a surgical clerkship is independently associated with matriculation of medical students into general surgery. Am J Surg 2014; 207:623-7. [DOI: 10.1016/j.amjsurg.2013.07.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 07/10/2013] [Accepted: 07/10/2013] [Indexed: 11/25/2022]
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Agarwal N, Norrmén-Smith IO, Tomei KL, Prestigiacomo CJ, Gandhi CD. Improving Medical Student Recruitment into Neurological Surgery: A Single Institution's Experience. World Neurosurg 2013; 80:745-50. [DOI: 10.1016/j.wneu.2013.08.027] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 07/23/2013] [Accepted: 08/23/2013] [Indexed: 12/01/2022]
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Pousatis SM, Marshall MB. Trends in applications for thoracic fellowship in comparison with other subspecialties. Ann Thorac Surg 2013; 97:624-32; discussion 632-3. [PMID: 24210619 DOI: 10.1016/j.athoracsur.2013.08.073] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Revised: 08/19/2013] [Accepted: 08/21/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Length of training (LOT), lifestyle, and decreasing reimbursement have been credited with contributing to the decline in applications to thoracic surgery (TS). Other surgical specialties share similarities in LOT and lifestyle; however, trends in applications for these specialties have not been compared. One cannot look at applications to TS without examining concurrent changes in the pool of residents finishing general surgery. To clarify the relative impact of LOT, lifestyle, applicant pool, and reimbursement on applications to TS, we analyzed these trends concurrently. METHODS National Resident Matching Program residency and fellowship match placement data (1997 to 2012) for general, TS, pediatric, transplant, and vascular surgery, including integrated TS and vascular surgery, were analyzed. Corresponding trends in reimbursement were analyzed from Medical Group Management Association data (1996 to 2010). RESULTS During the study period, percentage of medical students matching into general surgery has remained relatively constant (4.9% to 5.5%). Applications for TS have declined since 1997. Applications for pediatric and transplant surgery have increased. Vascular surgery has remained relatively constant, with an applicant to position ratio approximately 1:1. Integrated programs (thoracic and vascular) have been popular; 3 to 7.4 applicants per position and 2 to 3.47 applicants per position, respectively. Cardiovascular surgery median salaries have remained largely the same; salaries for general thoracic, pediatric, transplant, and vascular surgery have increased (1.95% to 7.13% per year) although cardiovascular surgeons continue to have the highest median salary. CONCLUSIONS Given the above data, it does not appear that LOT is the critical issue associated with the decline in fellowship applications for TS. The increased demand for integrated training programs may be reflective of other factors rather than LOT. The success of abbreviated programs in training competent thoracic surgeons has not yet been determined. Given that LOT does not appear to affect applications to surgical specialty, we may be able to maintain applications to the specialty without compromising LOT.
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Affiliation(s)
| | - M Blair Marshall
- Georgetown University School of Medicine, Washington, District of Columbia; Division of Thoracic Surgery, MedStar Georgetown University Hopsital, Washington, District of Columbia.
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Dias MS, Sussman JS, Durham S, Iantosca MR. Perceived benefits and barriers to a career in pediatric neurosurgery: a survey of neurosurgical residents. J Neurosurg Pediatr 2013; 12:422-33. [PMID: 23992238 DOI: 10.3171/2013.7.peds12597] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Research suggests that there may be a growing disparity between the supply of and demand for both pediatric specialists and neurosurgeons. Whether pediatric neurosurgeons are facing such a disparity is disputable, but interest in pediatric neurosurgery (PNS) has waxed and waned as evidenced by the number of applicants for PNS fellowships. The authors undertook a survey to analyze current neurosurgical residents' perceptions of both benefits and deterrents to a pediatric neurosurgical career. METHODS All residents and PNS fellows in the United States and Canada during the academic year 2008-2009 were invited to complete a Web-based survey that assessed 1) demographic and educational information about residents and their residency training, particularly as it related to training in PNS; 2) residents' exposure to mentoring opportunities from pediatric neurosurgical faculty and their plans for the future; and 3) residents' perceptions about how likely 40 various factors were to influence their decision about whether to pursue a PNS career. RESULTS Four hundred ninety-six responses were obtained: 89% of the respondents were male, 63% were married, 75% were in at least their 3rd year of postgraduate training, 61% trained in a children's hospital and 29% in a children's "hospital within a hospital," and 72% were in programs having one or more dedicated PNS faculty members. The residencies of 56% of respondents offered 6-11 months of PNS training and nearly three-quarters of respondents had completed 2 months of PNS training. During medical school, 92% had been exposed to neurosurgery and 45% to PNS during a clinical rotation, but only 7% identified a PNS mentor. Nearly half (43%) are considering a PNS career, and of these, 61% are definitely or probably considering post-residency fellowship. On the other hand, 68% would prefer an enfolded fellowship during residency. Perceived strengths of PNS included working with children, developing lasting relationships, wider variety of operations, fast healing and lack of comorbidities, and altruism. Perceived significant deterrents included shunts, lower reimbursement, cross-coverage issues, higher malpractice premiums and greater legal exposure, and working with parents and pediatric health professionals. The intrinsic nature of PNS was listed as the most significant deterrent (46%) followed by financial concerns (25%), additional training (12%), longer work hours (12%), and medicolegal issues (4%). The majority felt that fellowship training and PNS certification should be recommended for surgeons treating of all but traumatic brain injuries and Chiari I malformations and performing simple shunt-related procedures, although they felt that these credentials should be required only for treating complex craniosynostosis. CONCLUSIONS The nature of PNS is the most significant barrier to attracting residents, although reimbursement, cross-coverage, and legal issues are also important to residents. The authors provide several recommendations that might enhance resident perceptions of PNS and attract trainees to the specialty.
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Drolet BC, Sangisetty S, Mulvaney PM, Ryder BA, Cioffi WG. A mentorship-based preclinical elective increases exposure, confidence, and interest in surgery. Am J Surg 2013; 207:179-86. [PMID: 24269035 DOI: 10.1016/j.amjsurg.2013.07.031] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 06/17/2013] [Accepted: 07/04/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND The predicted shortage of surgeons is of growing concern with declining medical student interest in surgical careers. We hypothesized that earlier exposure to operative experiences and the establishment of resident mentors through a preclinical elective would enhance student confidence and interest in surgery. METHODS We developed a preclinical elective in surgery, which served as an organized curriculum for junior medical students to experience surgery through a paired resident-mentorship model. We assessed student exposure and confidence with clinical activities before and after the elective (N = 24, 100% response rate). We compared these students with a cohort of peers not enrolled in the elective (N = 147, 67% response rate). RESULTS We found significantly improved confidence (2.8 vs 4.4) and clinical exposure (2.4 vs 4.3) before versus after the elective, with precourse scores equal to matched peers. CONCLUSIONS This elective incorporates elements that have been shown to positively influence student decision making in surgical career choice. The mentorship model promotes residents as educators, whereas the elective provides a means for early identification of students interested in surgery.
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Affiliation(s)
- Brian C Drolet
- Department of Surgery, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA; Department of Plastic Surgery, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, 2 Dudley Street, COOP 500, Providence, RI 02902, USA.
| | - Suma Sangisetty
- Department of Surgery, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA
| | - Patrick M Mulvaney
- The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI USA
| | - Beth A Ryder
- Department of Surgery, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA
| | - William G Cioffi
- Department of Surgery, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA
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Porcine wet lab improves surgical skills in third year medical students. J Surg Res 2013; 184:19-25. [DOI: 10.1016/j.jss.2013.06.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 05/23/2013] [Accepted: 06/05/2013] [Indexed: 11/20/2022]
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Gawad N, Moussa F, Christakis GT, Rutka JT. Planting the 'SEAD': early comprehensive exposure to surgery for medical students. JOURNAL OF SURGICAL EDUCATION 2013; 70:487-494. [PMID: 23725936 DOI: 10.1016/j.jsurg.2013.03.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 02/22/2013] [Accepted: 03/11/2013] [Indexed: 06/02/2023]
Abstract
INTRODUCTION The popularity of surgical specialties is declining amongst Canadian medical students. Limited early exposure of students to surgery and minor involvement of surgeons in preclerkship education are barriers to creating interest in the field. Although many informal observerships and interest groups exist, there are no structured programs in Canada that offer preclerkship medical students a comprehensive exposure to surgery. METHODS Twenty first-year medical students participated in the Surgical Exploration and Discovery (SEAD) Program. SEAD is a pilot project at the University of Toronto providing a unique combination of (1) observerships, (2) informal discussions on surgical careers, and (3) hands-on simulation workshops across all 7 direct-entry specialties within the Department of Surgery. All participants underwent pretraining and posttraining evaluation of learning through a paper-based knowledge test and all completed a structured survey on the benefit of the course. RESULTS Comparison of test scores revealed an overall significant improvement in learning (p<0.0001). The improvement in test scores was seen in the knowledge of all 3 components of the course (p<0.0001). Qualitative evaluation revealed a positive student experience, with 100% of students indicating that SEAD helped them identify new interests in surgical subspecialties. Finally, 100% of students stated that they would recommend the program to incoming medical students. CONCLUSION The SEAD Program successfully improves preclerkship students' knowledge of surgical principles, understanding of a career in surgery, and basic surgical skills. Participation in the program also positively influenced their interest in pursuing a career in surgery. Programs such as SEAD may be offered to preclerkship medical students to improve their exposure to surgery at this level of training and to enhance perspectives toward surgical careers.
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Affiliation(s)
- Nada Gawad
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
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Galiñanes EL, Shirshenkan JR, Doty J, Wakefield MR, Ramaswamy A. Standardized laparoscopic simulation positively affects a student's surgical experience. JOURNAL OF SURGICAL EDUCATION 2013; 70:508-513. [PMID: 23725939 DOI: 10.1016/j.jsurg.2013.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 01/05/2013] [Accepted: 03/10/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE The aim of the study was to determine whether a standardized orientation to basic laparoscopy makes a positive effect on the experience of third-year medical students. STUDY DESIGN Fifty-three third-year medical students at the University of Missouri, Columbia were randomly divided into 2 groups during their clerkship orientation. Both groups received a 40-minute laparoscopic hands-on training simulation guided by instructors. However, only 1 group was given a 20-minute multimedia presentation on introduction to laparoscopy that covered equipment, set up, troubleshooting, and different methods of access into the abdomen. Both groups were given a preclerkship and postclerkship survey where students were asked to rate their experience, comfort, and interest in surgery on a 10-point Likert scale. RESULTS Hundred percent of the students receiving the combined hands-on training simulation and the 20-minute presentation felt that the experience helped during their clerkship (p = 0.002) and 92% felt it had a positive effect (p = 0.501). In contrast, only 72% of the group that received the hands-on training simulation alone found it helpful (p = 0.029) and 86% thought it had a positive effect (p = 0.508). There was no statistical difference between either group with regard to their perceived comfort with assistance in the operating room and with laparoscopy. Neither experience had a statistical effect on a students' interest in surgery as a career. CONCLUSIONS Our results demonstrate how a standardized orientation to basic laparoscopy can make a positive effect on a student's experience; however, it fails to transition into a student's interest in surgery as a profession or in their perceived comfort level in the operating room. Our study suggests that a student's surgical interest is highly variable and composed of multiple experiences that occur during their clerkship that ultimately affects their perception of surgery as a field and profession.
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Lou X, Enter D, Sheen L, Adams K, Reed CE, McCarthy PM, Calhoon JH, Verrier ED, Lee R. Sustained Supervised Practice on a Coronary Anastomosis Simulator Increases Medical Student Interest in Surgery, Unsupervised Practice Does Not. Ann Thorac Surg 2013; 95:2057-63. [DOI: 10.1016/j.athoracsur.2013.02.045] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 01/30/2013] [Accepted: 02/04/2013] [Indexed: 11/29/2022]
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Fitzgerald JEF, Tang SW, Ravindra P, Maxwell-Armstrong CA. Gender-related perceptions of careers in surgery among new medical graduates: results of a cross-sectional study. Am J Surg 2012; 206:112-9. [PMID: 22902099 DOI: 10.1016/j.amjsurg.2012.04.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 04/01/2012] [Accepted: 04/01/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Despite promotional measures at a national level, female surgeons account for only 10% of the consultant workforce in the United Kingdom. With rising proportions of female medical graduates, it is important that surgery continues to recruit the most able candidates regardless of sex. This study investigates the differing perceptions of surgical careers among recent medical school graduates and identifies factors discouraging female doctors from pursuing a career in surgery. METHODS Newly qualified graduates from the University of Nottingham Medical School, Nottingham, UK, were invited to complete a nonmandatory questionnaire investigating career intentions and factors influencing this. RESULTS Two hundred and eight questionnaires were returned (a 66% response rate). Male respondents were significantly more likely to rate surgery as an attractive or very attractive career (P = .0116). Overall, only 33 (25%) female doctors expressed interest in a surgical career as opposed to 33 (42%) male doctors (P = .010). Frequently cited reasons included no interest in surgery itself (21%) and negative attitudes toward women in surgery among the surgical teams (18%). Irrespective of career interests, 59% of male and 68% of female respondents believed surgery was not a career welcoming women (P = .186). Reasons included difficulty maintaining family life, limited flexible training, and lack of role models. CONCLUSIONS This study identifies significant sex differences in the perception of surgical careers. The majority believes surgery does not welcome female trainees. Future strategies to promote surgery must address attitudes and behaviors in both sexes while taking active steps to support female surgeons during their training and in the workplace.
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Affiliation(s)
- J Edward F Fitzgerald
- Department of Gastrointestinal Surgery, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom NG7 2UH.
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Baldwin K, Namdari S, Bowers A, Keenan MA, Levin LS, Ahn J. Factors affecting interest in orthopedics among female medical students: a prospective analysis. Orthopedics 2011; 34:e919-32. [PMID: 22146211 DOI: 10.3928/01477447-20111021-17] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The field of orthopedics has a limited ability to recruit high-quality female applicants. The purpose of this study was to determine whether early exposure to the field affects a woman's decision to pursue orthopedics. We performed a prospective, nonrandomized cohort study between academic years 2005 and 2009 and compared interest in orthopedic surgery among female (n=271) and male (n=71) medical students at 2 urban teaching institutions. Elective lectures and orthopedic literature were distributed via e-mail to the study participants. These materials included articles published in the medical literature, materials produced and distributed by the American Academy of Orthopaedic Surgeons, and Web sites providing educational materials. The primary outcome was the likelihood of application for orthopedic residency. We studied the influence of demographics, exposure, and attitudes on interest in pursuing an orthopedic career. Men had a significantly higher baseline level of interest in orthopedic surgery than women (P=.005). Younger age (P<.001) and personal (P<.001), independent (P<.001), and school (P=.023) exposures to orthopedics were significantly related to interest among women. At final follow-up, total personal exposures (P=.003) and total independent exposures (P<.001) in the form of our literature and lectures were correlated with final interest in women. Female interest was decreased by the long hours, physical demands, and predominantly male nature of the field. Early exposure to orthopedic educational resources may be useful in generating female interest. Perceptions and attitudes regarding orthopedic surgery must to be changed to attract the best and brightest minds, regardless of sex.
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Affiliation(s)
- Keith Baldwin
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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McHugh SM, Corrigan MA, Sheikh A, Lehane E, Broe P, Hill ADK. A study of the factors influencing school-going students considering medical careers. Surgeon 2011; 9:191-4. [PMID: 21672658 DOI: 10.1016/j.surge.2010.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Revised: 09/09/2010] [Accepted: 09/09/2010] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Obtaining a place in an Irish medical school is extremely competitive, a situation mirrored in many other countries. We aimed to determine the factors influencing school students in deciding to study medicine in university. We further determined what level of interest exists in pursuing a surgical career after completion of medical school. METHODS The Royal College of Surgeons in Ireland hosts an annual "Introduction to Medicine" programme for senior school children. Attendees were surveyed using a Likert scale to examine the factors influencing the group in choosing to study medicine, and pursue surgery as their ultimate career choice. RESULTS A total of 128 completed the survey, giving a response rate of 100%. The opportunity to help others was most the most influential factors cited by students (97%). Males were significantly more likely to have an interest in a career in surgery rather than medicine (p = 0.003), and ranked "financial reward" (p = 0.036) as a more significant factors in influencing career choice than did females. CONCLUSIONS A clear understanding of these factors influencing our students in their career choices and a strategy of recruitment based on these is imperative in order to optimize recruitment of students most suited to working as doctors.
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Affiliation(s)
- S M McHugh
- Department of Surgery, Beaumont Hospital, Dublin, Ireland; Royal College of Surgeons in Ireland, Dublin, Ireland.
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Tesche LJ, Feins RH, Dedmon MM, Newton KN, Egan TM, Haithcock BE, Veeramachaneni NK, Bowdish ME. Simulation Experience Enhances Medical Students' Interest in Cardiothoracic Surgery. Ann Thorac Surg 2010; 90:1967-73; discussion 1973-4. [DOI: 10.1016/j.athoracsur.2010.06.117] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2010] [Revised: 06/23/2010] [Accepted: 06/29/2010] [Indexed: 10/18/2022]
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Are C, Stoddard HA, Thompson JS, Todd GL. The influence of surgical demonstrations during an anatomy course on the perceptions of first-year medical students toward surgeons and a surgical career. JOURNAL OF SURGICAL EDUCATION 2010; 67:320-324. [PMID: 21035773 DOI: 10.1016/j.jsurg.2010.07.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Accepted: 07/28/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE We previously have demonstrated the educational benefits of surgical demonstrations to first-year medical students. The aim of this current study was to analyze the influence of these demonstrations on the perceptions of students toward surgeons and a possible career in surgery. METHODS A faculty member from the Department of Surgery provided an instruction on pancreatic malignancies and management to first-year medical students during their gross anatomy course. After this instruction, using a lightly embalmed cadaver, the clinically relevant anatomy was detailed and a pancreaticoduodenectomy was performed on the cadaver. Immediately after the demonstration, a brief survey was conducted to obtain feedback from the students about the experience. RESULTS A total of 170 students over 2 years returned the survey for a response rate of 69%. The demonstration provided 77% of students with a favorable impression of surgeons, and 90% of the students felt that this exposure gave them an understanding of the knowledge, skills, and qualities needed to become a surgeon. Additionally, 57% of respondents stated that watching the demonstration increased the likelihood of them pursuing a surgical career. For the 67% of students who were considering a surgery career, the demonstration reinforced their interest; however, for the students who were not interested in surgery, the demonstration did not alter their opinion. CONCLUSION The results of this study showed that surgical demonstrations to first-year medical students can influence their perceptions favorably about surgeons and a surgical career. This interaction provided students with information and motivation to pursue a career in surgery and also may counteract any negative stereotypes of the field that first-year students may have had.
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Affiliation(s)
- Chandrakanth Are
- Department of Surgery, University of Nebraska Medical Center College of Medicine, Omaha, Nebraska 68198, USA.
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Pico K, Gioe TJ, VanHeest A, Tatman PJ. Do men outperform women during orthopaedic residency training? Clin Orthop Relat Res 2010; 468:1804-8. [PMID: 20333491 PMCID: PMC2881995 DOI: 10.1007/s11999-010-1318-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Orthopaedic surgery residency has one of the lowest percentages of women (13.1%) of all primary surgical specialties. There are many possible reasons for this, including bias during the selection process. QUESTIONS/PURPOSES We therefore asked whether performance during residency might adversely bias the selection of future female orthopaedic residents by researching whether males and females perform equally in orthopaedic surgery residency. METHODS Ninety-seven residents enrolled in our residency between 1999 and 2009; six males and one female left the program, leaving 90 residents (73 males, 17 females) as the study cohort. Resident performance was compared for OITE scores, ABOS results, faculty evaluations, and in a resident graduate survey. RESULTS Males and females had similar faculty evaluations in all ACGME competency areas. Males and females had similar mean OITE scores for Years 2-5 of residency, although males had higher mean scores at Years 3 through 5. Males and females had similar mean ABOS Part 1 scores and ABOS Part 1 pass rates; however, fewer males than females took more than one attempt to pass. Males and females had similar Part 2 pass rates or attempts. For the 45 resident graduates surveyed, females pursued fellowships equally to males, worked slightly less hours in practice, and reported higher satisfaction with their career choice. CONCLUSIONS For the 90 residents at one residency program, we observed no differences between males' and females' performance. Although females pursue orthopaedic residency less frequently than males, performance during residency should not bias their future selection.
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Affiliation(s)
- Katharine Pico
- Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue, Suite R200, Minneapolis, MN 55454 USA
| | - Terence J. Gioe
- Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue, Suite R200, Minneapolis, MN 55454 USA ,Minneapolis Veterans Affairs Medical Center, Minneapolis, MN USA
| | - Ann VanHeest
- Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue, Suite R200, Minneapolis, MN 55454 USA
| | - Penny J. Tatman
- HealthEast Education and Research Department, St Paul, MN USA
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Fox BD, Amhaz HH, Patel AJ, Fulkerson DH, Suki D, Jea A, Sawaya RE. Neurosurgical rotations or clerkships in US medical schools. J Neurosurg 2010; 114:27-33. [PMID: 20560724 DOI: 10.3171/2010.5.jns10245] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Medical student exposure to neurosurgery is limited. To improve the educational interactions between neurosurgeons and medical students as well as neurosurgical medical student rotations or clerkships (NSCs) we must first understand the current status. METHODS Two questionnaires were sent, one to every neurosurgery course coordinator or director at each US neurosurgery residency program (99 questionnaires) and one to the associated parent medical school dean's office (91 questionnaires), to assess the current status of NSCs and the involvement of neurosurgeons at their respective institutions. RESULTS We received responses from 86 (87%) of 99 neurosurgery course coordinators or directors and 64 (70%) of 91 medical school deans' offices. Most NSCs do not have didactic lectures (53 [62%] of 86 NSCs), provide their medical students with a syllabus or educational handouts (53 [62%] of 86), or have a recommended/required textbook (77 [90%] of 86). The most common method of evaluating students in NSCs is a subjective performance evaluation. Of 64 medical school deans, 38 (59%) felt that neurosurgery should not be a required rotation. Neurosurgical rotations or clerkships are primarily offered to students in their 4th year of medical school, which may be too late for appropriate timing of residency applications. Only 21 (33%) of 64 NSCs offer neurosurgery rotations to 3rd-year students. CONCLUSIONS There is significant room for improvement in the neurosurgeon-to-medical student interactions in both the NSCs and during the didactic years of medical school.
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Affiliation(s)
- Benjamin D Fox
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas 77030, USA
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