WHAT MAKES A MEDICAL STUDENT AVOID OR ENTER A CAREER IN UROLOGY? RESULTS OF AN INTERNATIONAL SURVEY

Abstract

To recruit the best and brightest medical students, it is crucial to understand what causes a medical student to pursue or avoid a career in urology. We performed a survey of 2 cohorts of residency applicants to elucidate these determinants. All 410 applicants to the 2003-2004 United States urology residency match and all 624 individuals who applied to a Boston-area emergency medicine (EM) residency program were invited to participate in the study. The on-line survey for the urology applicants asked the research question "What caused you to pursue the specialty of urology?" The EM applicant survey asked the research question "What caused you NOT to pursue a career in a surgical subspecialty, such as urology?" Qualitative responses were analyzed for themes by 2 researchers and independently coded. Sixty percent (248 of 410) of urology applicants and 40% (252 of 624) of EM applicants completed the survey. Thematic coding of the qualitative responses yielded an inter-rater agreement of 89% to 94%. Positive determinants cited by urology applicants included the mix of medicine/surgery, the diversity of urological procedures, and clinical exposure to the field. Negative determinants cited by EM applicants included the narrowness of the specialty, an unattractive lifestyle, and the demands of a surgical residency. No significant correlations were noted between themes cited and participants' genders, degrees or medical school nationalities. Ensuring that medical students have clinical exposure to urology, receive appropriate mentorship, and develop realistic perceptions of the specialty may substantially facilitate recruitment.