Career In Surgery Research Articles

A prospective cohort study on the role of surgical mentorship on medical students’ surgical experience and attitudes towards surgery

BackgroundExposure to surgery during medical school is limited. We ran a mentorship scheme pairing students at a medical school with local surgeons to improve undergraduate insight. We evaluated the effectiveness of mentorship in increasing surgical exposure and drivers for students seeking surgical mentorship.Methods35 surgeons across 7 specialties were recruited and matched with 37 students in years 2–4 for 7 months. Quantitative and qualitative evaluation was done with pre-, mid- and post-scheme questionnaires. Students rated confidence across pursuing a career in surgery, surgical exposure, career insight, understanding the application process, contacts, portfolio development, research knowledge and pursuing extra-curricular activities related to surgery using a 5-point Likert scale. Paired t-tests were performed to measure students’ confidence before and after the scheme.ResultsOf students that completed all 3 questionnaires (n = 21), conducting research/audit was most frequently selected as a main goal (81.0%), followed by theatre experience (66.7%) and career progression support (28.6%). The number of students that had assisted in theatre increased by 50.0%. Confidence ratings across all domains increased with 7/8 (87.5%) exhibiting a statistically significant improvement (p < 0.05). The greatest improvement was seen in having adequate contacts in surgery from 2.05 to 3.33 (p = 0.00). 95.2% would recommend the scheme.ConclusionsStudents gained significantly more surgical experience and were better equipped with the knowledge required to pursue a surgical career. Mentorship schemes are invaluable in supplementing the undergraduate curriculum and empowering students.Trial registrationEthical clearance granted by King’s College London Research Ethics Committee, Reference Number MRSU-22/23-34530. .

For the Love of the Game: Calculating the Premium Associated With Academic Surgical Practice.

We sought to determine the premium associated with a career in academic surgery, as measured by compensation normalized to the work relative value unit (wRVU). An academic surgical career embodying innovation and mentorship offers intrinsic rewards but is not well monetized. We know compensation for academic surgeons is less than their nonacademic counterparts, but the value of clinical effort, as normalized to the wRVU, between academic and nonacademic surgeons has not been well characterized. Thus, we analyzed the variations in the valuation of academic and nonacademic surgical work from 2010 to 2022. We utilized Medical Group Management Association Provider Compensation data from 2010, 2014, 2018, and 2022 to compare academic and nonacademic surgeons. We analyzed raw total cash compensation (TCC), wRVU, TCC per wRVU (TCC/wRVU), and TCC to collections (TCCtColl). We calculated collections per wRVU (Coll/wRVU). We adjusted TCC and TCCtColl for inflation using the Consumer Price Index. Linear modeling for trend analysis was performed. Compared with nonacademic, academic surgeons had lower TCC (2010: $500,415.0±23,666 vs $631,515.5±23,948.2, -21%; 2022: $564,789.8±23,993.9 vs $628,247.4±15,753.2, -10%), despite higher wRVUs (2022: 9109.4±474.9 vs 8062.7±252.7) and higher Coll/wRVU (2022: 76.68±8.15 vs 71.80±6.10). Trend analysis indicated that TCC will converge in 2038 at an estimated $660,931. In 2022, academic surgeons had more clinical activity and superior organizational revenue capture, despite less total and normalized clinical compensation. On the basis of TCC/wRVUs, academia charges a premium of 16% over nonacademic surgery. However, trend analysis suggests that TCC will converge within the next 20 years.

Control versus Choice in Deciding Career Pathway in Plastic Surgery: The Perfect Ratio.

The decisions and components of a career in medicine have changed. Historically, a career selection was often a decision between joining an institution or academic center versus the fiscal risks associated with private practice. This created a relatively simple risk versus reward equation: those in private practice made more money if it went well. The medical landscape has changed immensely, and priorities and remuneration have morphed, including concerns about promoting and sustaining well-being. The authors performed a systematic review of scholarly databases to identify relevant resources to the topic of study. Additionally, the authors relied on their own cumulative experience in the field, including the work of Dr. Wayne Sotile of the Sotile Center for Physician Resilience. The first installment of this article proposes a new model in opposition to the current standard of "risk versus reward" where the tradeoff is instead "control versus choice," where autonomy is the new risk. The five components that make up the majority of the ingredients in a plastic surgery career are clinical practice model, administrative duty, corporate support, academic involvement, and per diem or retainers. Much of finding or developing a practice model that suits the individual is figuring out an acceptable ratio of these ingredients. Inherent to this process is how much authority one has versus instituted control of any form, from hospital to university to insurance company.

Enhancing Junior Doctors' Preparedness and Satisfaction in Trauma and Orthopaedics: A Quality Improvement Project With the Development of a Comprehensive Guidebook.

Junior doctors often feel underprepared for their trauma and orthopaedics (T&O) rotation due to limited exposure during medical school and inadequate support. This project aimed to enhance junior doctors' preparedness and satisfaction during their T&O rotation by developing a comprehensive guidebook that addresses key orthopaedic knowledge and logistical challenges. A quality improvement project (QIP) was conducted at Ysbyty Gwynedd Hospital. Initial surveys identified factors contributing to poor experiences during the trauma and orthopaedics rotation, including limited knowledge of orthopaedic emergencies and a lack of useful reference resources. A guidebook was developed and refined through multiple plan-do-study-act (PDSA) cycles. The guidebook covered topics such as orthopaedic emergencies, common injuries, referral pathways, and hospital logistics, presented in an accessible flowchart format. The primary objective of achieving 75% satisfaction among junior doctors was successfully met, with satisfaction increasing from four (40%) to eight (80%) doctors in the most recent survey. Secondary outcomes included a marked improvement in the understanding of quality improvement projects, rising from three (30%) to eight (80%) doctors. Orthopaedic knowledge also saw a significant enhancement, increasing from four (40%) to nine (90%) doctors. Confidence in handling night on-call duties improved dramatically, with all 10 doctors (100%) reporting increased confidence, compared to four (40%) doctors initially.Additionally, seven doctors (70%) expressed a greater interest in pursuing a career in orthopaedic surgery. The comprehensive guidebook significantly improved junior doctors' preparedness and satisfaction during their T&O rotation. While the guidebook is a valuable resource, ongoing mentorship and hands-on experience remain essential for long-term success. Replication of this project across other departments and hospitals is recommended to assess its broader applicability and impact.

Divorce Among Surgeons and Other Physicians in the United States.

To compare divorce prevalence among surgeons with that of non-surgeon physicians. The demanding nature of a career in surgery uniquely challenges the social wellbeing of a surgeon; however, its impact on marital health has not yet been well described. A cross-sectional study was conducted using publicly available U.S. Census data from 2017-2021 to investigate prevalence of divorce across different occupations. Survey respondents were divided into two groups, surgeons and non-surgeon physicians, with the remaining Census participants as a control. All participants under the age of 18 were excluded to focus on the U.S. adult population. Lifetime prevalence of divorce was measured across occupations and multivariable logistic regression analyses were performed to identify factors independently associated with divorce. Secondarily, the occurrence of more than one marriage was used to supplement understanding of marital health. A total of 3,171 surgeons and 51,660 non-surgeon physicians were identified, with both groups similarly aged (51.6 and 50.2y, respectively) and predominately male (82.9% and 61.9%, respectively). In unadjusted analysis, 21.3% (676/3,171) of surgeons had undergone a divorce compared to only 17.9% (9,252/51,660) of non-surgeon physicians, a 19% increase in risk of divorce (Risk ratio [RR]=1.19; 95% confidence interval [95% CI], 1.11-1.28). Both surgeons and non-surgeon physicians were significantly less likely to report being divorced compared with the general population. The increased divorce prevalence among surgeons persisted in multivariable analysis that adjusted for age, age at time of marriage, sex, race, income, hours worked per week, and number of children in the household, with surgeons experiencing a 22% increased prevalence of divorce over non-surgical physicians (adjusted divorce prevalence of 21.8% vs. 18.7%, respectively; odds ratio [OR]=1.22; 95% CI, 1.09-1.35). In subgroup analysis, the finding of higher divorce prevalence for surgeons over non-surgeon physicians was concentrated among men (adjusted divorce prevalence: 22.6% of male surgeons vs. 18.9% of male non-surgeon physicians; adjusted OR 1.26, 95% CI, 1.11-1.42), White (adjusted divorce prevalence: 22.4% of white surgeons vs. 19.1% of white non-surgeons; adjusted OR 1.22, 95% CI, 1.09-1.38) and Asian surgeons (adjusted divorce prevalence: 12.0% of Asian surgeons vs. 8.1% of Asian non-surgeons; adjusted OR 1.55, 95% CI, 1.06-2.26), with the effect not present in other measured subgroups. Both surgeons and physicians have lower divorce prevalence than the general population. Surgeons exhibit higher prevalence of divorce compared with non-surgeon physicians, with measured demographic and work characteristics insufficient to explain this difference.

FP5.7 - Why I don’t want a career in surgery? - Uncovering obstacles and investigating barriers among year 3 UK medical students: A thematic analysis

Abstract Aims Surgical training and placements can be stereotyped negatively by medical students. Our study aimed to identify barriers to pursuing a surgical career amongst UK year 3 medical students, to improve surgical educational policies. Methods An optional, anonymous, single-question, open-text survey was administered to 190, year 3 UK medical student, after they had completed an 11 week surgical clinical placement, comprising Breast, Emergency Department, Interventional Radiology, Orthopaedics, Peri-op anaesthetics, Plastics, Vascular, Upper/Lower GI and Urology. The specific question asked was, 'Would you contemplate pursuing a career in surgery?' Responses from students NOT considering a surgical career were analysed qualitatively using a thematic approach to identify perceived barriers to a surgical career. Results 102 responses were received of which 35 were not suitable for analysis. Of the remaining 67 students, 30 (44.8%) demonstrated a negative view towards a surgical career. Following thematic analysis four main themes were identified:Pre-existing interest in another specialty.Nature of surgical training (long duration, competitive, poor work-life balance).Stressful clinical workload, high emotional pressure and burnout.Negative, masculine culture within surgical teams. Positively, despite not planning to pursue surgery - some students reported surgery was not as intimidating as they had expected it to be and surgeons did not meet stereotypes they were expecting. Conclusions Medical students continue to comment on negative surgical working environment experiences. Our study highlights areas that high pressure surgical training placements, need to actively improve in order to ensure a positive working and teaching surgical environment for our future medical workforce.

Factors Influencing Medical Students' Decision in Choosing a Surgical Specialty.

The decision to pursue a career in surgery among medical students is influenced by various factors, including personal preferences, perceptions of the specialty, and educational experiences. Understanding these factors is crucial for addressing challenges and fostering interest in surgical specialties. This study analyzed data from 889 medical students to explore demographic characteristics and factors influencing their decisionregarding pursuing a surgical career. Participants completed surveys regarding their gender, academic year, GPA, and intentions regarding surgical careers. Factors influencing career were assessed using closed-ended questions, with both deterrents and motivators considered. The study found a higher proportion of female participants (63.1%) compared to male participants (36.9%). Factors influencing participants' decisionnot to pursue a surgical career included a preference for other specialties (61.8%), a dislike for the lifestyle of surgeons (51.3%), and perceptions of long training durations (33.7%). Conversely, interest in the specialty (71.0%) and a preference for hands-on work (55.6%) were significant motivators for pursuing a surgical career. Additional factors such as concerns about the competitive environment, dislike for hands-on work, and perceptions regarding salary and work environment also emerged as notable considerations. The findings highlight the importance of addressing misconceptions, providing mentorship, and promoting diversity within surgical specialties to encourage interest and diversify the surgical workforce. The study found a high interest in surgical specialty among Saudi medical students; however, some barriers were identified, particularly work-home relations, gender disparity, and pressure put on surgeries.

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

Background and objectivesConsidering 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.

Careers in Skull Base and Open Cerebrovascular Surgery: Factors Associated with Academic Job Placement

Abstract Introduction Fellowship training has become increasingly sought after by neurosurgeons aiming for academic careers over the last two decades. This study assesses American Board of Neurological Surgeons board-certified neurosurgeons specializing in skull base or open cerebrovascular surgery between 2013 and 2023, focusing on identifying academic career predictors through demographic and academic outputs. Methods The study utilized the American Association of Neurological Surgeons Neurosurgical Fellowship Training Program Directory to identify neurosurgeons certified from 2013 to 2023, gathering demographic details and academic productivity from Scopus. Results Among 173 neurosurgeons, 87.86% were male, 36.36% were graduates from top 40 National Institutes of Health-funded medical schools, and 49.42% completed their residency in highly ranked departments. In univariate analysis, predictors for an academic career included publishing in the field before residency (p = 0.03054), a higher h-index before and after residency (p = 0.03976 and 0.0003101), and increased publication volume during and up to 3 years post-fellowship (2.284e-06). Multivariate analysis found that publication volume during and up to 3 years post-fellowship (odds ratio [OR] = 4.98, 95% confidence interval [CI]: 2.07–11.9, p = 0.0003) and basic science publications (OR = 2.4, 95% CI: 1.05–5.49, p = 0.038) were the most significant predictors of academic career placement. Conclusion The study underscores the strong link between the academic career success of neurosurgeons trained in skull base and open cerebrovascular surgery and their research productivity, particularly publication volume during key career stages and involvement in basic science research. This highlight sustained research activity as a critical determinant of academic career achievement, surpassing the influence of training institution prestige.

Roles, Responsibilities, and Expectations of Medical Students on Surgical Subinternships: A Modified Delphi Consensus Study.

Surgical subinternships are important rotations for students preparing for a career in general surgery; however, these rotations often vary by institution and service. This modified Delphi study was conducted to reach a consensus set of roles, responsibilities, and expectations of fourth-year medical students on their surgical subinternships. Candidate statements on roles, responsibilities, and expectations of subinterns were categorized into 7 domains: rotation structure, rounding and patient care, operating room conduct, technical skills, knowledge base, clinic, and professionalism. Expert panels were assembled of key stakeholders: program directors, clerkship directors, other education faculty, trainees, and recent subinterns. Three Delphi rounds were conducted from January to April 2023 to reach consensus defined a priori as a Cronbach α ≥ 0.8 and 80% or greater panel agreement. Forty-six expert panelists were recruited to participate in Delphi rounds, with 100%, 95.7%, and 97.8% response rates in the first, second, and third rounds, respectively. By the third round, 67 statements reached consensus as essential roles, responsibilities, and expectations of surgical subinterns. Key themes from these 67 statements included subinterns approximating the role of an intern with respect to work hours, patient care responsibilities, basic technical skills, and knowledge base. Panelists rated rounding and patient care as the most important domain, followed closely by professionalism. Additional key domains for evaluation in descending order were knowledge base, operating room conduct, clinic, and technical skills. By the third round, notable disagreements in the Delphi process included technical skills and rounding and patient care (93.3% and 88.9% agreement, respectively). This study provides a national consensus on core roles, responsibilities, and expectations for medical students completing surgical subinternships. Students can use these recommendations to prepare for subinternships, whereas faculty as well as residents and fellows can use them to evaluate applicants for general surgery residency positions.

Attitude of aspiring orthopaedic surgeons towards artificial intelligence: a multinational cross-sectional survey study

IntroductionThe purpose of this study was to evaluate the perspectives of aspiring orthopaedic surgeons on artificial intelligence (AI), analysing how gender, AI knowledge, and technical inclination influence views on AI. Additionally, the extent to which recent AI advancements sway career decisions was assessed.Materials and methodsA digital survey was distributed to student members of orthopaedic societies across Germany, Switzerland, and Austria. Subgroup analyses explored how gender, AI knowledge, and technical inclination shape attitudes towards AI.ResultsOf 174 total respondents, 86.2% (n = 150) intended to pursue a career in orthopaedic surgery and were included in the analysis. The majority (74.5%) reported ‘basic’ or ‘no’ knowledge about AI. Approximately 29.3% believed AI would significantly impact orthopaedics within 5 years, with another 35.3% projecting 5–10 years. AI was predominantly seen as an assistive tool (77.8%), without significant fear of job displacement. The most valued AI applications were identified as preoperative implant planning (85.3%), administrative tasks (84%), and image analysis (81.3%). Concerns arose regarding skill atrophy due to overreliance (69.3%), liability (68%), and diminished patient interaction (56%). The majority maintained a ‘neutral’ view on AI (53%), though 32.9% were ‘enthusiastic’. A stronger focus on AI in medical education was requested by 81.9%. Most participants (72.8%) felt recent AI advancements did not alter their career decisions towards or away from the orthopaedic specialty. Statistical analysis revealed a significant association between AI literacy (p = 0.015) and technical inclination (p = 0.003). AI literacy did not increase significantly during medical education (p = 0.091).ConclusionsFuture orthopaedic surgeons exhibit a favourable outlook on AI, foreseeing its significant influence in the near future. AI literacy remains relatively low and showed no improvement during medical school. There is notable demand for improved AI-related education. The choice of orthopaedics as a specialty appears to be robust against the sway of recent AI advancements.Level of evidenceCross-sectional survey study; level IV.

Gender more than ethnicity or disability influences the choice of a career in cardiothoracic surgery by United Kingdom medical students

ObjectivesCardiothoracic surgery has reported poor equality, diversity, and inclusion amongst its faculty [1–3]. We explored how gender, ethnicity, and disability influence medical students’ interest in cardiothoracic surgery as a career choice, as well as overall exposure to cardiothoracic surgery in the undergraduate curriculum. MethodsWe distributed a 26-item Google Forms online survey to student members of a medical education group from all 37 UK medical schools via social media. Respondents were asked to rank different ‘factors of interest’ on a 1–5 Likert scale (1 ​= ​not important at all, 5 ​= ​very important) and were encouraged to add free-text comments. Quantitative data were analysed using SPSS. ResultsThere were 258 respondents, 62% identifying as female and 38% male. Respondents' ethnicities were 45% White, 44% Asian or Asian British, and 11% from other ethnic groups. 11% of respondents confirmed ‘long-standing illness or disability’.Men were almost twice as likely to consider a career in cardiothoracic surgery than women (33% vs 19%; p ​< ​0.001). Women were more likely than men to feel that their gender, lack of a similarly gendered mentor, and long working hours were important factors when considering cardiothoracic surgery as a career.Ethnicity of the respondent did not appear to affect how they perceived the challenges of a career in cardiothoracic surgery. Interestingly, ‘long-standing illness or disability’ did not significantly affect the decision making to consider this specialty as a career.Overall, 73% of respondents reported not having adequate exposure to cardiothoracic surgery at medical school and agreed they would benefit from more time. ConclusionsFemale medical students felt their gender, lack of same-sex role models, and perceived long working hours were barriers in considering cardiothoracic surgery as a career. All students felt the need for more exposure to Cardiothoracic Surgery in the undergraduate curriculum.

165 Schools Engagement Will Improve Equality and Diversity Within Orthopaedics and Surgery

Abstract Aim Inclusivity and diversity of individuals from lower socioeconomic backgrounds is unequal within surgery. Diversification of the workforce is a requirement for the future of surgery to ensure high quality patient care is provided (Hassan, 2023). The School’s Engagement Session, originating with the British Hip Society and replicated with British Orthopaedic Association (BOA), aimed to introduce the idea of a career in medicine or surgery to children from non-selective state schools. Method Three school groups, twenty-four students and three staff members, attended day three of the annual BOA conference. Highly engaging medical student presentations, industry stand activities, and hands-on consultant led surgical based stations sparked interest and provided ‘work-experience’ opportunities; an increasingly challenging pre-requisite for applicants to acquire. Resources, lunch, and room availability were all supported by the BOA. Results Directly addressing students from lower socioeconomic backgrounds about a career in surgery, which many had not previously considered, stimulated their interest in this as a career. Feedback from accompanying educators, acknowledged their lack of insight regarding accessibility, and students explicitly demonstrated the positive impact of these in-person engagement events. Many students explained how this newly acquired knowledge had empowered the possibility of pursuing a medical career. Conclusions Replication of this highly successful event demonstrated the impact of engagement with individuals from diverse backgrounds upon future surgical diversity. Nationwide reproducible events are therefore warranted to reduce inequality in medicine and surgery. Medical student through to consultant involvement with future engagement work will diversify and sustain the surgical workforce within the UK.

599 From Classroom to Theatre: Analysis of an Undergraduate Surgical Mentorship Scheme to Support Tomorrow’s Surgeons

Abstract Aim Exposure to surgery during medical school is limited. We ran a mentorship scheme pairing students at a medical school with local surgeons to improve undergraduate insight. We evaluated the effectiveness of mentorship in increasing surgical exposure and drivers for students seeking surgical mentorship. Method 35 surgeons across 7 specialties were recruited and matched with 37 students in years 2-4 for 7 months. Quantitative and qualitative evaluation was done with pre-, mid-and post-scheme questionnaires. Students rated confidence across pursuing a career in surgery, surgical exposure, career insight, understanding the application process, contacts, portfolio development, research knowledge and pursuing extra-curricular activities related to surgery using a 5-point Likert scale. Paired t-tests were performed to measure students’ confidence before and after the scheme. Results Of students that completed all 3 questionnaires (n=21), conducting research/audit was most frequently selected as a main goal (81.0%), followed by theatre experience (66.7%) and career progression support (28.6%). The number of students that had assisted in theatre increased by 50%. There was a statistically significant improvement (p&amp;lt;0.05) in confidence ratings across all domains. The greatest improvement was seen in understanding of the application process from 2.33 to 3.52 (p=0.00). 95.2% would recommend the scheme. Conclusions Students seek mentorship to develop their clinical and academic skills. Students gained significantly more surgical experience and were better equipped with the knowledge required to pursue a surgical career. Mentorship schemes are invaluable in supplementing the undergraduate curriculum and empowering students.

821 Impact of a One-Day Conference on Perceptions and Understanding of T&amp;O - Outcomes of the South West Orthopaedic Conference 2023

Abstract Aim This study aimed to evaluate the effects of a student-organised conference on delegates’ motivation and understanding of orthopaedic surgery. Method This was a conference organised by students with the support of consultants from the Princess Elizabeth Orthopaedic Centre in The Royal Devon and Exeter Hospital. Identical questionnaires were completed immediately before and after the conference on google forms. The google forms were distributed to the delegates via their registered email address. The pre- and post-conference questionnaire had three sections comprising of understanding, motivations, and barriers to pursing orthopaedic surgery. Pre- and post-conference responses which were recorded on a Likert scale and were compared using Wilcoxon signed rank test. All data analysis performed was using IBM SPSS (v.28, USA). Results 62 delegates completed the questionnaires, the majority of which were medical students with 4 junior doctors. Understanding of orthopaedics showed a significant increase in the majority of questions (p&amp;lt;0.001), except the intention to pursue orthopaedics which showed no significant difference. Delegates were attracted to orthopaedics due to the work-life balance, prestige and salary (p&amp;lt;0.001), however they showed a reduced interest in case variety and private practice. There was no difference in the barriers to pursuing orthopaedic surgery, except lack of patient contact which showed a significant increase (p&amp;lt;0.001). Conclusions Orthopaedic conferences improve delegates understanding, perceptions and motivations to pursue a career in orthopaedic surgery. We therefore encourage orthopaedic surgeons and educationalists to increase exposure to orthopaedics for undergraduates by supporting more student-led initiatives to promote recruitment into orthopaedic surgery.

Can astrology determine a career in medical surgery? An in-depth study of celestial markers and natal chart indicators for medical surgeons (Part-1)

Can astrology determine a career in medical surgery? An in-depth study of celestial markers and natal chart indicators for medical surgeons (Part-1)

Evolution of Medical Students' Interest in Orthopaedic Surgery Careers from Matriculation to Graduation.

Little is known about risk factors for changes in students' interest in orthopaedics during medical school. We aimed to identify variables associated with diminished (vs. sustained) and emerging (vs. no) plans to become board certified in orthopaedic surgery. We conducted a retrospective national-cohort study of students who matriculated in US MD-granting medical schools in academic years 1993 to 1994 through 2000 to 2001. The outcome measure was the evolution of students' board-certification plans in orthopaedic surgery from matriculation to graduation using responses on the Association of American Medical Colleges' Matriculating Student Questionnaire and Graduation Questionnaire. Covariates included demographic, attitudinal, experiential, and career intention variables. Of 53,560 graduates with complete data, 2,765 students reported diminished interest in becoming board certified in orthopaedics, 1,345 reported emerging interest, and 1,327 reported sustained interest. In multivariable logistic regression models, students who were female (adjusted odds ratio [aOR] 1.83, 95% confidence interval [CI] 1.43-2.34), Asian (aOR 1.46, 95% CI 1.18-1.82), reported greater importance of social responsibility (aOR 1.16, 95% CI 1.02-1.33) and prestige (aOR 1.20, 95% CI 1.10-1.30) in choosing a medicine career, and planned full-time university faculty careers (aOR 1.58, 95% CI 1.33-1.89) at graduation were independently more likely to have diminished (vs. sustained) interest. Students who participated in research and/or authorship electives (aOR 3.50, 95% CI 3.00-4.07) and who attended private institutions (aOR 1.23, 95% CI 1.10-1.39) were more likely to have emerging (vs. no) interest. Twice as many students lost interest than gained interest in orthopaedics during medical school, and the cohort of students interested in orthopaedics became less diverse over the course of medical school. Several risk factors amenable to change were identified. Interventions that target these risk factors are warranted to increase the diversity of the orthopaedic surgery workforce.

Concerns, Perceptions, and Career Considerations of Female Medical Students Interested in Neurosurgery: A Qualitative Case Study

Neurosurgery exhibits notably lower representation of Black, Hispanic, and female surgeons compared to various other medical and surgical specialties. Existing research focuses on medical students' views on surgeons, factors influencing female medical students' preferences in surgical fields, and the perceived interests and concerns of students contemplating a career in neurosurgery. However, there is a significant gap in understanding the unique concerns and perspectives of female medical students interested in neurosurgery. Semistructured interviews with female medical students were recruited from medical schools in the District of Columbia area. Interview questions were based on Lent and Brown's Social Cognitive Career Theory. Transcripts were analyzed thematically into codes. In total, 8 female medical students from our institution participated. We identified 3 major themes that influenced medical students decision-making: sense of belonging (diversity, mentorship, and passionate), self-efficacy (ambitious/"gunner," intense/competitive), and outcome expectations (innovation/research, immediate impact, procedural/surgical aspect, salary, and work-life balance). Female medical students face distinct challenges and factors to consider when choosing a career in neurological surgery. The biggest concern for female students was a sense of belonging. It is imperative to enhance the diversity within the neurosurgical specialty and boost the representation of female neurosurgeons. Early interventions designed to tackle and alleviate their specific concerns are pivotal in achieving this goal.

Assessing Diversity of Invited Speakers at the AAOS Annual Meeting

Introduction Orthopaedic surgery remains one of the least diverse fields in medicine, particularly in the higher levels of academic medicine. There is limited literature examining representation of females as speakers and presenters at national meetings, although this is a common stepping stone in an academic career. Purpose The purpose of this study is to assess gender diversity among invited speakers at the AAOS Annual Meeting between 2015 and 2022 to determine if this increased over time. Methods The AAOS Annual Meeting final programs from 2015 to 2022 were reviewed to collect the names of all invited speakers (paper presentation session moderators, Ask an Expert session moderators, ICL moderators, and ICL presenters). An internet search of publicly available websites was conducted to determine the gender of each speaker. We then determined the percentage of female speakers in each category each year and compared these across years. Results There were non-significant positive trends in the percentage of female ICL presenters, paper presentation sessions moderators, and Ask an Expert sessions moderators, there was a significant positive trend in the percentage of female ICL moderators between 2015 and 2022. Conclusions Speaking at national meetings is an important component of advancing one’s career in academic surgery and can also provide crucial role models to aspiring young surgeons. However, despite various efforts to increase gender diversity in orthopaedic surgery, there have been few significant changes in the representation of female invited speakers at the AAOS annual meeting since 2015.

Pathway to cardiothoracic surgery: A primer for aspiring students

ObjectiveThe pathway to cardiothoracic surgery is often obscure for premedical students and aspiring applicants and requires navigating various known and unknown obstacles. Recognizing the challenges encountered on the path to a career in cardiothoracic surgery in the United States, we present this guide for students interested in the field to maximize success in their premedical, preclinical, and preresidency years. MethodsThis is a joint collaboration between the Thoracic Surgery Residents Association and the Thoracic Surgery Medical Student Association. Drawing from firsthand experiences and insights gathered from numerous student applicants and current surgical residents, a comprehensive guide was constructed for students from the point of undergraduate school to advanced training options, including super-fellowship training. ResultsSeveral intricacies to cardiothoracic surgery career planning were discussed, including differences between traditional and integrated/fast-track pathways, college and medical school selection, networking, performing during clinical rotations, extracurricular and research activities, building mentorship relationships, and pursuing alternate career and advanced training opportunities. ConclusionsFor premedical students and aspiring applicants, the road to cardiothoracic surgery requires meticulous planning, grit, and thoughtful dedication. This document consolidates firsthand insights and advice from numerous aspiring and matched applicants to serve as a comprehensive guide for students seeking a career in cardiovascular and thoracic surgery.