An integrated vascular surgery residency program would increase interest among Saudi medical students in a career in vascular surgery

BACKGROUND AND OBJECTIVES

Considering the absence of integrated vascular surgery residency programs in Saudi Arabia, and the need for planning training pathways, we aim to identify how many medical students are interested in vascular surgery, and the factors affecting students' opinions on pursuing vascular surgery.

MATERIALS AND METHODS

A cross-sectional study was conducted using an online questionnaire that was distributed to medical students nationwide via social media and email. Data were collected from 13 February 2022 to 1 March 2022.

RESULTS

A total of 408 students participated. Among them, 152 students were interested in general surgery, of which 103 were considering vascular surgery as a possible future fellowship. However, only 29 out of 408 (7.1%) students picked vascular surgery as their 1st choice. The main motivating factors for students to pursue vascular surgery as a career were: an interest in vascular cases (cardiovascular science), the use of emerging technologies, and the endovascular capabilities of vascular surgeons. The negative factors were simply a preference for another specialty, followed by a lack of experience in vascular surgery.

CONCLUSION

This study reveals that only 7.1% of students consider vascular surgery their first choice. Both the lack of vascular surgeons and students' experience in vascular surgery affected awareness levels. Interaction with vascular surgeons through virtual rotations for under-served medical schools and the introduction of vascular sciences within the cardiology blocks during basic science years are recommended strategies.

Fourth-Year Medical Students' Perceptions of Vascular Surgery: Can We Improve the Pipeline?

BACKGROUND

Since their inception, Integrated Vascular Surgery Residency (IVSR) programs have expanded widely and attracted highly competitive medical students by offering a more focused approach to learning both open surgical and endovascular techniques. However, despite substantial modifications to the training paradigm, a shortage of vascular surgeons is still projected through 2050. We aimed to gather and analyze fourth-year medical students' knowledge and perceptions of vascular surgery (VS) to further inform strategies for recruiting future vascular surgeons.

METHODS

We sent anonymous electronic questionnaires to fourth-year medical students at 7 allopathic and 3 osteopathic medical schools, with questions detailing demographics, specialty preferences, and exposure to and perceptions of VS. Descriptive statistics were obtained, and responses were compared between students applying to surgical specialties (SS) and nonsurgical specialties (NSS).

RESULTS

Two hundred eleven of 1,764 (12%) participants responded (56% female). 56% reported VS exposure, most commonly during the third year. 64 (30%) planned to apply to SS. 57% of respondents reported knowledge of the management of vascular disease, and 56% understood procedures performed by vascular surgeons. Ranking the importance of factors in choosing specialties, SS selected "experiences gained during medical school rotations" (P < 0.05), "types and/or variety of treatment modalities used in this field" (P < 0.001), and "interest in the pathology or disease processes treated" (P < 0.05) as highest priorities. NSS preferred "lifestyle (work-life balance) as an attending" (P < 0.001). Only 7% of all respondents believed vascular surgeons have a good work-life balance, with a larger percentage of SS (P < 0.001) agreeing. Stratified by gender, female students rated "limited ability of childbirth during residency and/or postponement of family plans" (P < 0.05), "gender-related concerns, such as discrimination at work or unfair career possibilities" (P < 0.001), and "fear of unfair competition" (P < 0.05) as potential negative aspects of VS careers. 55% of respondents believed the IVSR makes VS more appealing.

CONCLUSIONS

Medical students perceive poor quality of life and work-life balance as deterring factors to a career in VS. Opportunities exist to educate students on the pathologies treated, procedures performed, and attainable quality of life available in our field. We should also continue to develop recruitment strategies to stimulate student interest and increase early exposure in VS.

A scoping review of vascular surgery education in the medical school curriculum

OBJECTIVE

Despite the high burden of vascular disease that is assessed, investigated, and managed by generalists, no specific medical school curriculum is in use for vascular surgery (VS). In the present scoping review, we aimed to map the available evidence on the provision of VS education in the medical school curriculum worldwide.

METHODS

The present review was conducted in accordance with the PRISMA (preferred reporting items for systematic reviews and meta-analysis) extension for scoping reviews. The inclusion criterion was reported research studies on VS education in the medical curriculum.

RESULTS

A total of 20 studies were included. Three main themes were identified. VS was perceived as an essential part of the general medical student curriculum by VS applicants. Exposure to VS varied considerably, and students generally expressed a need for an increase in VS coverage. The most important positive determinants when choosing VS as a career were having a VS mentor, the technical aspects of VS, and participation in a VS rotation. Frequently cited deterrents were the long training time and demanding lifestyle potentially compromising family life.

CONCLUSIONS

The present scoping review has provided a starting point to better understand the provision of VS education in medical schools across the world. Our review has demonstrated the variability in VS exposure at medical school and described students' sentiments toward VS. We have highlighted the need to determine whether the current curricula are adequate from the perspective of multiple stakeholders (eg, vascular surgeons, educators, general practitioners, a variety of specialists) with a crucial role in the treatment of patients with vascular conditions.

Factors Affecting the Interest in a Surgical Career among Medical Students at a Nonurban, Tertiary Care Academic Institution

BACKGROUND

Present day medical students are inherently different from those in the past by growing up in a uniquely different environment that shapes their personal and professional values which affects their career decisions. Vascular surgery (VS) task force is facing a shortage in the near future. The purpose of this analysis is to gain a better understanding of the medical students' perceptions about surgery in general and VS in particular. Our institution is a large, tertiary care medical center, which is in a nonurban location. Our goal was to identify any barriers in the recruitment of prospective students to VS and to implement directives to address such barriers.

METHODS

An online questionnaire was distributed to Penn State Hershey College of Medicine medical students. Our institution has an established 0 + 5 VS residency program and a VS interest group. It was designed to understand potential barriers in the recruitment of medical students choosing VS as a career. Survey consisted of 23 questions, which were carefully designed to collect information about student demographics, interest in medical profession in general, opinions about the field of surgery, and reasons for having an interest or no interest in VS.

RESULTS

Five hundred sixty medical students at Penn State Hershey College of Medicine were surveyed, of whom 143 (26%) completed the survey. About 58.7% were females and two-thirds of the respondents were in the age range of 21-25 years. The following factors were significantly associated with pursing surgical career: Medical Student Year III (odds ratio [OR] 0.36, confidence interval [CI] 0.19-0.69), surgical mentorship (OR 6.01, CI 1.30-28), wanting more exposure to VS (OR 6.15, CI 2.07-18.23), and opportunity to complete training within 5 years (OR 1.14, CI 1.03-1.25) (all P < 0.05). Specifically, for VS, following factors were found to be associated with increased likelihood of choosing a VS career: variety of operative cases, ability to operate on multiple anatomic areas of the body, and opportunity to complete training within 5 years (all P < 0.05). Following factors were associated with not choosing a VS career: surgical career not for me, long duration of surgical training, financial aid burden, marital status, and complexity of operations (all P < 0.05). Students cited following concerns for choosing a surgical career: burnout (61%), stress (12.8%), work hours (12.1%), and stressful life style (5.7%).

CONCLUSIONS

Potential barriers of students in choosing a surgical career are fundamentally grounded in their overall perception of surgery but are independently associated with their level of education (medical student-III versus others), strong surgical mentorship, the desire to be exposed to VS, and the opportunity to complete subspecialty surgical training within 5 years. For VS, attractive factors were variety of operative cases, ability to operate on multiple anatomic areas of the body, and opportunity to complete training within 5 years. Overall, burnout associated with surgical career is the most common concern for medical students.

Vascular surgery: What increases the flow of students to the speciality?

OBJECTIVES

Vascular surgery is in increasing demand due to the higher prevalence of cardiovascular disease in the general population. Meanwhile, applications to join the speciality have been in decline in the last few years. St George's Surgical Society held a one-day conference to expose undergraduates to the speciality in the hope that this will inspire more undergraduates to pursue it as a career.

METHODS

The conference consisted of introductory lectures delivered by a consultant vascular surgeon, followed by practical skills workshops simulating aortic anastomosis on porcine aortas. Pre-course and post-course questionnaires assessed positive and negative perceptions of vascular surgery, knowledge of and self-reported confidence in practical surgical skills and utility of the course in their decision to potentially pursue a career in vascular surgery.

RESULTS

There was a significant increase of 27% ( p = 0.03) in the positive perception that vascular surgery includes a diverse range of procedures and subspecialties. Attendees reported a 27% significant increase ( p = 0.02) in the perception that vascular surgery had a wide array of opportunity for academic/research work. Finally, there was an 18% decrease ( p = 0.03) in the negative perception that vascular surgery is somehow female-unfriendly or discriminatory against females. There was also a significant rise in both interest (33%) and understanding (73%) of vascular surgery.

CONCLUSIONS

A one-day conference can significantly impact students' perception especially when there is a lack of exposure within the undergraduate curriculum. This course helped to increase positive perception and dispute negative misconceptions about the speciality. The simulation workshops held at this conference increased students' confidence and awareness of relevant surgical skills. This conference provided a unique experience that positively impacted and inspired students and thus served as an important supplement to core medical curriculum.