Why do students choose careers in surgery?

Abstract

Background: Recent changes in medical education have emphasized primary care careers. This could have a negative impact on the number of applicants to surgical residencies. We sought to determine what factors influenced medical students in choosing surgical careers. Methods: Third year medical students who completed their surgical clerkship in the 2001–2002 academic year (n = 83) were surveyed pre-and post- surgical clerkship. Responses were analyzed and correlated to the 2003 match results. Results: The response rate of students surveyed was 98%. Pre-clerkship, 6/82 students (7%) expressed an interest in surgery or surgical subspecialty careers. Post-clerkship, 34/84 students (40%) expressed an increased interest in a surgical career; 13/84 (15%)expressed a decreased interest, and 37% of students expressed no change in career interest. Of those students expressing an increased interest in surgery, the clerkship experiences most noted to be influential were (1) number of cases participated/scrubbed (95%), (2) resident interaction (85%), (3) faculty interaction (80%), and (4) number of cases observed (65%) (p < 0.05). The number of hours spent on rotation (call, rounds) was the leading experience associated with a decreased interest in a surgical career (p < 0.05). 12/83 students surveyed (14%) ultimately matched into a surgical program (NRMP 2003 match results). Conclusions: These data suggest that operative exposure and interaction with residents and faculty have a positive influence in students’ choice of a surgical career. Although only 6% of students expressed an interest in surgery pre-clerkship, a two-fold increase in this number was noted in choice of residency (14%). Work hours were the primary negative indicator for surgery residency. As medical curriculum is restructured and surgical exposure decreased, these data underscore the importance of quality exposure to both procedures and role models during the 3rd year surgical clerkship.