Combine Promotion of Surgical Role Models with Other Initiatives: Reply

Abstract

To the Editor, We read with interest the comments by Ali about our recent article defining the ideal qualities of a surgical role model and the influence on career choice of identifying such an individual [1]. Students interested in any medical specialty may actively seek out inspirational role models. Equally, inspirational role models can lead students to initiate new career interests. In what proportions this occurs we can only speculate. However, whether doctors wishing to do surgery are more likely to remember potential role models is open for debate; cause and effect can be subjective. Overall, we would suggest that individuals remember an inspiring role model regardless of intended career choice. Nonetheless, we acknowledge that recall bias may color the findings of any study sharing a retrospective recall design in common with our methodology, which includes those findings cited in the correspondence. Recall bias, if it exists in the form suggested, may lead to an over-emphasis on the importance of role models in career choice selection. Yet we are not alone in reporting the importance of role models in influencing career choices across medical specialties, and little doubt exists regarding their importance [2]. Most recently, we note a study investigating factors influencing career choice after initial postgraduate surgical training in Ireland. The influence of role models was the most commonly cited factor affecting candidates in choosing to commence surgical training [3]. The correspondent is erroneous in interpreting our article as suggesting that the drive to increase interest in surgery should be focused on increasing the number of surgical role models. As stated in our conclusions, such a tactic is simply one way of promoting interest. However, there is a wealth of published literature indicating that the self-reported factors leading doctors to select or reject a career in surgery are multi-factorial. These include lack of controllable lifestyle, working hours, intellectual challenge, undergraduate experience, and career opportunities [4, 5]. We suggest that promoting surgical role models may have a part in promoting surgical careers, but this influence must be in combination with other initiatives. In general, we support the suggestion that medical students should receive as much exposure to surgery as possible while in medical school. However, the pressures on medical school curricula to be comprehensive make further increases in surgical exposure unlikely. In addition, it would be wrong to solely target medical students rather than postgraduate trainees, given the majority of medical students will change their career intentions [6]. Initiatives such as the Women in Surgery (WinS) network (http://surgicalcareers.rcseng.ac.uk/wins) and the Association of Surgeons in Training (http://www.asit.org/) are already undertaking work to promote careers in surgery in the United Kingdom. Our study supports promoting role models as part of these. P. Ravindra (&) Division of Gastrointestinal Surgery, School of Graduate Entry Medicine and Health, University of Nottingham Medical School Derby, Royal Derby Hospital, Uttoxeter Road, Derby DE22 3DT, UK e-mail: pravisharavindra@doctors.org.uk