Medical School Graduates Research Articles

Attractiveness and gender dynamics in surgical specialties: a comparative analysis of French medical graduates (2017–2022)

BackgroundFrench medical graduates undertake a national examination at the end of their studies with a subsequent national ranking. Specialty is then chosen by each candidate according to their ranking. This study aims to describe the attractiveness of surgical specialties and the evolution of the male-female distribution among French medical graduates (FMG) from 2017 to 2022.MethodsOur database included the candidates’ ranking, sex and choice of specialty from 2017 to 2022. It included all French medical graduates from 2017 to 2022 and all French medical schools. A linear regression was performed to predict future trends. Dependent variables were mean rankings and the percentage of women. The independent variable was year of application. A Pearson correlation was performed to examine any relationship with mean workweek.ResultsA total number of 5270 residents chose a surgical programme between 2017 and 2022. The number of residents who were assigned their desired surgical programme held stable at 878 surgical residents per year. Plastic and reconstructive surgery remained the most frequently chosen surgical programme. Thoracic and cardiovascular surgery was the least frequently chosen surgical programme between 2017 and 2022. The mean ranking for a candidate choosing a surgical programme rose significantly by 9% from 2017 to 2022 (p < 0.01). Neurosurgery exhibited the greatest fall as a surgical specialty as its rankings decreased by 163.6% (p < 0.01). Maxillo-facial surgery was the only specialty with a statistically significant increase in its rankings by 35.9% (p < 0.05). The overall proportion of women was 51.1%. Obstetrics-and-gynecology was the highest represented specialty among female candidates, with a mean of 83.9% of women. Orthopedic surgery was the lowest represented, being composed of a mean of 28.6% of women. The number of female surgical residents increased significantly over the six-year period, by 7.6% (p < 0.01).ConclusionsMore and more medical school graduates decide not to choose surgery for their residency programme. Some specialties continue to be attractive while many are losing their appeal. While there does appear to be progress towards gender equity, further investigation is necessary to assess its actual implementation.

The state of diversity among consultant neurologists in the United Kingdom

Equitable representation is key for successful clinical and research work. Inequalities in gender, skin colour, and education have been found among professionals in many medical, surgical and academic fields, but have not been examined yet in the current UK neurologists’ workforce. This cross-sectional study examined whether there are disparities in gender, perceived skin colour, education, academic productivity, and career progression among UK neurologists. The names of consultant neurologists working in the UK anytime between December 2021 and March 2022 were found via an online search. Online data were collected regarding education, research activity, academic productivity, impact and progression. A total of 1010 consultant neurologists were found to be working in the UK. There was predominance of men at consultant level, with a university affiliation, and with a full professor position. All 24 female full professors had white skin colour. There were no skin colour or gender disparities in currently being affiliated with a top university, obtaining a Master's degree, or duration between medical degree obtainment and becoming full professors. However, less black or brown neurologists had obtained a PhD, were consultants, andit took them a longer time from medical school graduation until becoming consultants.Less females were currently affiliated with a university and had obtained their medical degree from a top university. There were also skin colour and gender disparities in bibliometrics. In conclusion, this study revealed that there are gender, skin colour, education, academic productivity, and career progression gaps among UK consultant neurologists, which need to be addressed.

Addressing Barriers to Entry and Retention of Women in Interventional Vascular Specialties With Proposed Solutions: A Scientific Statement From the American Heart Association.

Representation of women in interventional vascular fields (interventional cardiology, interventional radiology, and vascular surgery) lags behind that in other specialties. With women representing half of all medical school graduates, encouraging parity of women in these fields needs to start in medical school. Barriers to pursuing careers in vascular intervention include insufficient exposure during core clerkships, early mentorship, visibility of women in the field, length of training, lifestyle considerations, work culture and environment, and concerns about radiation exposure. This scientific statement highlights potential solutions for both the real and perceived barriers that women may face in pursuing careers in vascular intervention, including streamlining of training (as both interventional radiology and vascular surgery have done with a resultant increase in percentage of women trainees), standardization of institutional promotion of women in leadership, and professional and industry partnerships for the retention and advancement of women.

Emergency physician personnel crisis: a survey on attitudes of new generations in Slovenia

BackgroundEmergency departments globally are overburdened, and emergency medicine residency is losing popularity among students and physicians. This raises concerns about the collapse of a life-saving system. Our goal was to identify the key workforce reasoning and question medical staff employment behavior.MethodsThis was a prospective cross-sectional study. In December 2022, medical students and pre-residency doctors in Slovenia were invited to complete a web-based questionnaire. The data were analyzed using T-test, chi-square test, Mann‒Whitney-Wilcoxon tests, and principal component analysis. Open-ended questions were hand-categorized.ResultsThere were 686 participatns who clicked on the first page and 436 of those finished the survey. 4% of participants gave a clear positive response, while 11% responded positively regarding their decision to pursue emergency medicine residency. The popularity of emergency medicine decreases significantly among recent medical school graduates upon their initial employment. People who choose emergency medicine are less concerned about its complexity and pressure compared to others. Most respondents preferred 12-hour shift lengths. The preferred base salary range for residents was I$ 3623–4529, and for specialists, it was I$ 5435–6341. The sample’s primary personal priorities are achieving a satisfactory work-life balance, earning respect from colleagues, and engaging in academic activities. Factors that attract individuals to choose emergency medicine include high hourly wages, establishment of standards and norms, and reduced working hours.ConclusionsOur findings indicate that enhancing compensation, establishing achievable standards and norms, facilitating a beneficial work-life equilibrium, providing assistance with initial property acquisition, stimulating participation in deficit residency programs, fostering collegiality among peers, restricting the duration of shifts, and enabling pension accrual may be imperative in attracting more individuals to pursue emergency medicine residency.

Suggestion for the training policy of physician-scientists in Korea

Background: A physician-scientist refers to a person with dual Medical Doctor (MD) and Doctor of Philosophy (PhD) degrees, i.e., a physician who has acquired medical knowledge and skills as well as scientific knowledge and research abilities. This study examines the background and current status of physician-scientists in Korea and suggests policy directions to foster physician-scientists suitable for Korea.Current Concepts: With the start of the medical graduate school system in 2005, the MD-PhD dual degree program was implemented under the name of “medical scientist”. With the discontinuation of the medical graduate school system, the term “medical scientist” was replaced with “physician-scientist”. The importance of physician-scientists for the development of biomedical research and industry has been consistently emphasized. Therefore, the government has recently initiated a support policy to train physician-scientists.Discussion and Conclusion: To successfully foster physician-scientists in Korea, the following government policy aspects should be strengthened. First, sufficient economic support should be provided so that physician-scientists could immerse themselves in biomedical research. Second, to guarantee stable employment for physician-scientists, a national research institution such as the National Institute of Health in the United States should be established. Finally, the educational programs of the medical schools should be revised to strengthen the research-related knowledge and skills of the medical students.

Factors affecting young doctors' choice of medical specialty-A qualitative study.

Young doctors' choice of medical specialty is essential to maintaining a sufficient health workforce and developing a sustainable healthcare system. The choice of specialization is the result of numerous factors, including doctors' preferences, population needs, and the number of available residency slots. The aim of this article is to explore the factors taken into consideration by young Polish physicians in choosing their future specialty. We have conducted 30 structured interviews with randomly selected recent medical school graduates (17 female and 13 male). The study was conducted from December 2022 until February 2023 using online platforms. Data from in-depth interviews were coded using NVivo Release 1.6.1. Then thematic analysis was performed. Respondents indicated remuneration and career-associated factors as the main determinants, emphasizing that work-life balance, personal motivations, and the flexibility to choose the type of workplace (hospital vs. outpatient clinic) were even more important. Young doctors expect flexibility in working hours and better working conditions in future work, and these factors are important when choosing a medical specialty. Significant difficulties during the selection of medical specialty include limited residency slots in preferred specializations and lack of knowledge concerning the everyday aspects of work in a particular specialty. Factors and limitations influencing the choice of medical specialty should be taken into account by policymakers to address the shortages of doctors in deficit specialties. Knowledge about doctors' preferences regarding their medical specialty could support the development of targeted policies to increase the attractiveness of deficit specialties and reduce the uneven distribution of medical staff.

Gender differences among shoulder arthroplasty surgeons: past, present, and future

Reducing differences in the gender representation of shoulder arthroplasty surgeons may help optimize patient care. This work aims to determine (a) the current gender distribution of surgeons performing shoulder arthroplasty, (b) how gender relates to practice patterns among shoulder arthroplasty surgeons, and (c) how gender distribution has been changing over time. The Medicare Provider Utilization and Payment Data for years 2012-2020 was utilized to identify orthopedic surgeons performing anatomic and reverse total shoulder arthroplasty (current procedural terminology [CPT] code 23472). The dataset provides self-reported gender, credentials, national provider identifier (NPI), annual volume for all procedures (based upon CPT) that were performed at least 11 times in the calendar year, and location for all included providers. The dataset was linked to the Medicare physician compare dataset using NPI numbers to determine hospital affiliations, year of medical school graduation, and graduating medical school. All included hospitals were queried to determine academic status (affiliated orthopedic residency or fellowship program). The American Shoulder and Elbow Surgeons (ASES) directory was reviewed to determine gender breakdown of current members. The number of surgeons performing at least 11 shoulder arthroplasty annually increased from 821 (13 females; 1.6%) in 2012 to 1,840 (53/1,840 females; 2.9%; p=0.05) in 2019. One female ranked in the top 100 surgeons by shoulder arthroplasty volume in 2012 and in 2020. Female surgeons graduated more recently from medical school (mean: 2005) compared to male surgeons (mean: 1997; p<0.001). About 10% of female (10.8%, 12/111) and male surgeons (9.1%, 229/2528) practiced at hospitals with orthopedic residents (p=0.50). Female surgeons performing shoulder arthroplasty were less likely than males to perform total knee arthroplasty (29.4% versus 54.1%; p<0.001) and total hip arthroplasty (12.6% versus 34.7%; p<0.001). There were 86 female members of the ASES (6.7%; 86/1275), with a significant difference in the proportion of women in differing membership categories (p=0.017). A diverse cohort of high-volume shoulder replacement surgeons is integral to delivering high-quality shoulder arthroplasty. Currently, the proportion of women performing high volume shoulder replacement in the US is small, with little improvement in recent years. However, women performing shoulder arthroplasty are younger, often involved in academic practices, and the membership of the ASES is increasingly female. Continued efforts to promote orthopedics, and mentor women residents and medical students interested in shoulder surgery, may bring real change to the gender differences among shoulder replacement surgeons over the coming years.

Assessing the debt and current state of financial literacy in a cohort of diagnostic & interventional radiology residents

Rationale and objectivesThe purpose of this study is to assess diagnostic and interventional radiology resident physicians' knowledge of core facets of financial literacy: loans, real estate, investments and retirement, and insurance, with the goal of determining the need for formal financial literacy education within radiology residency programs. MethodsFrom May 2021 to March 2022, surveys were sent to 196 diagnostic and 90 interventional radiology residency programs. Residents were asked 10 knowledge multiple choice questions to assess areas of financial literacy. Custom R programming was used to evaluate responses. ResultsA total of 149 diagnostic radiology residents and 49 interventional radiology residents responded to portions of the survey, for a total of 198 respondents. Of the cohort with demographic data collected, 84 out of 141 residents (60 %) had over $100,000 of debt following medical school graduation, with 115 out of 146 DR residents (79 %) and 41 out of 47 (87 %) IR residents reporting no coursework in finance. ConclusionsMany radiology resident physicians have a significant debt burden, no official financial education, and clear knowledge gaps in areas of financial literacy. A structured financial education curriculum could better prepare residents for the financial realities of post-residency life.

Examining Racial and Gender Diversity in the Plastic Surgery Pipeline: Where is the Leak?

There is limited information about minority representation throughout the plastic and reconstructive surgery (PRS) pipeline. The aim of this study was to examine trends in representation among minorities at different stages of the PRS training pathway, starting with potential candidates in high school through practicing physicians. The PRS pipeline was defined as high school; college; medical school applicants, matriculants, and graduates; PRS residency applicants, matriculants, and active residents; and PRS practicing physicians. Racial data for each stage were obtained from the US Census and Association of American Medical Colleges. The proportion of races at each stage were divided by their US population counterpart proportions to produce representation quotients (RQs). Medians and interquartile ranges (IQRs) are reported. Mann-Whitney U tests compared RQ values within identities between successive stages. Black students had high representation in high school (RQ = 1.26 [IQR: 1.21-1.29]) but had significant, stepwise decreases in representation in subsequent stages. A similar trend was observed for Hispanic individuals, who had their highest representation in high school (1.43 [1.37-1.50]), followed by significant decreases in RQ at nearly every subsequent stage up to and including practicing physicians (0.30 [0.28-0.31). Asian individuals were overrepresented at every stage (high school RQ: 1.01 [1.00-1.03]; practicing physician RQ: 2.30 [2.27-2.32]). White individuals were underrepresented before residency but had an RQ that approximated 1 in subsequent stages. Racial minorities experienced decreases in representation at each successive stage in the PRS pipeline following high school. Ongoing diversity efforts should focus on premedical recruitment and professional support for minority students.

Associations Between Secondary School Background, Academic Performance and Subsequent Career Achievements for Medical School Graduates in Sudan

Associations Between Secondary School Background, Academic Performance and Subsequent Career Achievements for Medical School Graduates in Sudan

Role of neodymium laser in surgery: stimulation of postoperative surgical wounds healing. Results of clinical studies

To prove the effectiveness of the low-intensity laser radiation application in the treatment of wounds of different origin. The clinical study involved 110 persons, divided into 55 subjects in both the study and control groups. The patients of the study group were exposed to the long-wave short-pulse neodymium laser immediately and within 35 days after interventions with a skin incision using it, in a way that wound treated with laser received low-level laser therapy. The control group patients' wounds were treated with standard methods by the means of topical drugs corresponding to the clinical manifestations of the wound process in each particular case. The study was carried out in the hospital of the department of maxillofacial and plastic surgery of the dental complex of the «Russian University of Medicine» from 2019 to 2022, and further conservative treatment was conducted in the department of dermatology and cosmetology of the University Hospital of the Medical Graduate School (Institute) of the RSSU. All wounds were classified into three groups for the convenience of systematization and formation of a generalized treatment protocol for postoperative surgical wounds. The objectivity and optimality of the chosen by us actions were confirmed in the conducted work. The formed scars were visually assessed on the POSAS scale at the end of the treatment by patients and 4 independent doctors, as well as each scar was visually assessed by four independent doctors and patients. At the end of the study we formed and proposed an algorithm for the treatment of surgical wounds of various origins. The parameters of the Aerolase Neo Light Pod neodymium laser for the treatment of patients with different types of skin wounds were clinically determined. Experimentally proven properties of the Aerolase Neo Light Pod neodymium laser on accelerating the healing process of surgical wounds through photobiomodulation mechanism support their regeneration with the formation of negligible normotrophic scars, as well as reduce the length of patients' treatment in surgical hospitals, as compared to patients receiving standard external drugs.

Defining Medical AI Competencies for Medical School Graduates: Outcomes of a Delphi Survey and Medical Student/Educator Questionnaire of South Korean Medical Schools.

Given the increasing significance and potential impact of artificial intelligence (AI) technology on health care delivery, there is an increasing demand to integrate AI into medical school curricula. This study aimed to define medical AI competencies and identify the essential competencies for medical graduates in South Korea. An initial Delphi survey conducted in 2022 involving 4 groups of medical AI experts (n = 28) yielded 42 competency items. Subsequently, an online questionnaire survey was carried out with 1,955 participants (1,174 students and 781 professors) from medical schools across South Korea, utilizing the list of 42 competencies developed from the first Delphi round. A subsequent Delphi survey was conducted with 33 medical educators from 21 medical schools to differentiate the essential AI competences from the optional ones. The study identified 6 domains encompassing 36 AI competencies essential for medical graduates: (1) understanding digital health and changes driven by AI; (2) fundamental knowledge and skills in medical AI; (3) ethics and legal aspects in the use of medical AI; (4) medical AI application in clinical practice; (5) processing, analyzing, and evaluating medical data; and (6) research and development of medical AI, as well as subcompetencies within each domain. While numerous competencies within the first 4 domains were deemed essential, a higher percentage of experts indicated responses in the last 2 domains, data science and medical AI research and development, were optional. This medical AI framework of 6 competencies and their subcompetencies for medical graduates exhibits promising potential for guiding the integration of AI into medical curricula. Further studies conducted in diverse contexts and countries are necessary to validate and confirm the applicability of these findings. Additional research is imperative for developing specific and feasible educational models to integrate these proposed competencies into pre-existing curricula.

Medical Students' Perception of Interprofessional Education: A Cross-Sectional Study.

Background and objective Interprofessional education (IPE) involves learners from multiple health professions learning collaboratively to improve patient care. This study assessed medical students' perceptions of IPE at Taibah University in Saudi Arabia. Methods In this cross-sectional study, 319 medical students in years two to six of graduate medical school and internships completed the Readiness for Interprofessional Learning Scale (RIPLS) questionnaire between April 2022 and July 2022. RIPLS consists of 19 items measuring teamwork/collaboration, negative/positive professional identity, and roles/responsibilities. Comparisons were made based on gender and academic level by using the Mann-Whitney U and Kruskal-Wallis tests. Results Students generally expressed positive attitudes towards IPE. The majority agreed that IPE improves teamwork, communication, and patient care. In our cohort, 148 students (46.4%)strongly agreed and 140(43.9%) agreed that shared learning enhances understanding of clinical problems. However, 186 students (60%) disagreed that clinical problem-solving is profession-specific. On the teamwork/collaboration subscale, 279 students (87.7%) strongly agreed that learning with others makes them more effective team members. Regarding negative identity, 186 students (58.3%) disagreed that learning with other students wastes time. By gender, males had lower ranks for negative identity (p=0.03) and positive identity (p=0.03) versus females. As for academic level, clinical students and interns had higher and lower ranks, respectively, for negative identity (p<0.01). Conclusion Based on our findings, medical students generally hold favorable views toward IPE and recognize its benefits for collaboration, communication, and patient care. Incorporating IPE throughout medical training may further improve attitudes and interprofessional skills.

Maxine Deborrah Hyde: First Female Graduate of Case Western Reserve University's Neurologic Surgery Residency Program and Second Black Female Neurosurgeon in the United States

The historical diversity gap in the neurosurgical workforce persists to this day. Women, despite constituting over half of the yearly total of medical school graduates, comprise only 6% of certified practicing neurosurgeons in the United States. Furthermore, Black Americans make up under 4% of U.S. neurosurgeons, despite making up around 14% of the national population. The purpose of this account is to highlight the life and career of Dr. Maxine Deborrah Hyde and illustrate the importance and necessity of diversity and inclusivity in advancing the field of neurosurgery. Through this paper, we aspire to encourage the development of new diversity initiatives. Original scientific and bibliographic materials of Hyde were examined, and an extensive analysis of her life was compiled. Despite growing up during the era of Jim Crow, Dr. Hyde persevered and became the valedictorian of Oak Park High School. As a first-generation college student at Tougaloo College, she later earned her MS from Cleveland State University. Dr. Hyde graduated with honors from Case Western Reserve University School of Medicine in 1977. Thereafter, she became the first female and first Black graduate of Case Western's neurosurgery residency and the second Black woman to receive certification from the American Board of Neurological Surgery. Later in life, Dr. Hyde established the Beacon of Hope Scholarship Foundation to assist disadvantaged students in overcoming educational barriers. Dr. Hyde was a trailblazer who overcame systematic barriers and paved the way for future generations of aspiring neurosurgeons.

Gender gap-Gender-specific development in the field of obstetrics and gynecology in Germany in the last 20 years.

Gender Gap refers to differences between men and women in terms of access to medical education, career development, and leadership positions in medical practice and research. Although women now make up most medical school graduates in many countries, they are often underrepresented in higher positions. The aim of this study is therefore to analyze the gender-specific development in the field of Obstetrics and Gynecology in Germany over the past 20 years and to survey the current status quo. An narrative review was carried out on the development of female graduates of human medicine, the proportion of women in contract medical care and clinical care, as well as the gender-specific evaluation of obtaining a gynecological/obstetric additional qualification. habilitation figures in the field of Obstetrics and Gynecology were evaluated about gender distribution. All data were received from federal institutes. A total of 46.7% (n = 95,234) of all inpatient doctors were female. A total of 46.7% (n = 95,234) of the physicians in hospitals were female. A total of 46% (1,832/3,958) were the portion of females as assistant physicians, 39.8% (n = 45.551) as specialists, 35.3% (n = 18789) as senior physicians, 25.1% (n = 2394) as first senior physicians and 25% (n = 10) as chief physicians in hospital. A total of 64.6% (n = 3958) of the physicians in Obstetrics and Gynecology were female. A total of 46% (1,832/3,958) were the portion of females as assistant physicians, 64.6% (n = 3958) as specialists, 65.0% (n = 1919) as senior physicians, 26.4% (n = 207) first senior physicians and 25% (n = 10) as chief physicians in Obstetrics and Gynecology. The problem with the gender gap in medicine, does not seem to be access to teaching or starting a residency. But in the functions with increasing responsibility and management functions, e.g., as senior physicians, women are already rarely seen. In Obstetrics and Gynecology, too, there is a shortage of women in leading positions, despite the relatively high numbers, for example as senior physicians. Factors like maternity and establishing a family are points mentioned therefore, but also stereotypes seem to be considerable facts. However, it is important to recognize the need for more women in higher positions in medicine and actively work to encourage more women to choose a career in medicine.

Perceptions of mistreatment: a comparison of students at two geographically and culturally distinct graduate medical schools

Perceptions of mistreatment: a comparison of students at two geographically and culturally distinct graduate medical schools

Medical student specialty decision-making and perceptions of neurosurgery. Part 2: Role of race/ethnicity.

Although individuals underrepresented in medicine (URM) make up 33% of the United States population, only 12.6% of medical school graduates identify as URM; the same percentage of URM students comprises neurosurgery residency applicants. More information is needed to understand how URM students are making specialty decisions and their perceptions of neurosurgery. The authors aimed to evaluate the differences between URM and non-URM medical students and residents in terms of the factors that contribute to specialty decision-making and perceptions of neurosurgery. A survey was administered to all medical students and resident physicians at a single Midwestern institution to assess factors influencing medical student specialty decision-making and perceptions of neurosurgery. Likert scale responses converted to numerical values on a 5-point scale (strongly agree was the high score of 5) were analyzed with the Mann-Whitney U-test. The chi-square test was performed on the binary responses to examine associations between categorical variables. Semistructured interviews were conducted and analyzed using the grounded theory method. Of 272 respondents, 49.2% were medical students, 51.8% were residents, and 11.0% identified as URM. URM medical students considered research opportunities more than non-URM medical students in specialty decision-making (p = 0.023). When specialty decision-making factors were assessed, URM residents less strongly considered the technical skill required (p = 0.023), their perceived fit in the field (p < 0.001), and seeing people like them in the field (p = 0.010) than their non-URM counterparts when making specialty decisions. Within both medical student and resident respondent cohorts, the authors found no significant differences between URM and non-URM respondents in terms of their specialty decision-making being affected by medical school experiences such as shadowing, elective rotations, family exposure, or having a mentor in the field. URM residents were more concerned about the opportunity to work on health equity issues in neurosurgery than non-URM residents (p = 0.005). The predominant theme that emerged from interviews was the need for more intentional efforts to recruit and retain URM individuals in medicine and specifically neurosurgery. URM students may make specialty decisions differently than non-URM students. URM students were more hesitant toward neurosurgery due to their perceived lack of opportunity for health equity work in neurosurgery. These findings further inform optimization of both new and existing initiatives to improve URM student recruitment and retention in neurosurgery.

Medical student specialty decision-making and perceptions of neurosurgery. Part 1: Role of gender.

Although women account for 50% of medical school graduates, less than 30% of neurosurgery residency applicants and less than 10% of neurosurgeons are female. In order to diversify the field of neurosurgery and recruit more women, it is necessary to understand why there is a disproportionately low entry rate into neurosurgery by female medical students. Factors contributing to specialty decision-making and perceptions of neurosurgery among medical students and residents, specifically differences by gender, have not been studied. The authors aimed to investigate these differences using quantitative and qualitative methods. A Qualtrics survey was administered at the authors' institution to all medical students and resident physicians to assess factors influencing medical specialty decision-making and perceptions of neurosurgery. Likert scale responses converted to numerical values on a 5-point scale were analyzed with the Mann-Whitney U-test. The chi-square test was performed on binary responses. Semistructured interviews were conducted in a subset of survey respondents and were analyzed by using the grounded theory method. Of the 272 survey respondents, 48.2% were medical students and 61.0% were female. When making specialty decisions, female medical students considered maternity/paternity leave more (p = 0.028) than their male counterparts. Female medical students were more hesitant toward neurosurgery due to maternity/paternity needs (p = 0.031) and the technical skill required (p = 0.020) than male medical students. Across both genders, the majority of medical students were hesitant toward neurosurgery due to opportunities for work/life integration (93%), length of training (88%), malignancy of the field (76%), and perceived happiness of the people in the field (76%). Female residents indicated they were more likely than male residents to consider the perceived happiness of the people in the field (p = 0.003), shadowing experiences (p = 0.019), and elective rotations (p = 0.004) when making specialty decisions. Two major themes emerged from the semistructured interviews: 1) maternity needs were more of a concern for women and 2) length of training was a concern for many individuals. Compared with their male counterparts, female students and residents consider different factors and experiences when choosing a medical specialty and have different perceptions of neurosurgery. Exposure to and education within neurosurgery, specifically maternity needs, may help address hesitancy in pursuing a neurosurgical career among female medical students. However, cultural and structural factors may need to be addressed within neurosurgery in order to ultimately increase representation of women.

A national perspective on exposure to essential surgical procedures among medical trainees in Nigeria: a cross-sectional survey and recommendations

BackgroundIn sub-Saharan Africa, recent graduates from medical school provide more direct surgical and procedural care to patients than their counterparts from the Global North. Nigeria has no nationally representative data on the procedures performed by trainees before graduation from medical school and their confidence in performing these procedures upon graduation has also not been evaluated.MethodsWe performed an internet-based, cross-sectional survey of recent medical school graduates from 15 accredited Federal, State, and private Nigerian medical schools spanning six geopolitical zones. Essential surgical procedures, bedside interventions and three Bellwether procedures were incorporated into the survey. Self-reported confidence immediately after graduation was calculated and compared using cumulative confidence scores with subgroup analysis of results by type and location of institution. Qualitative analysis of free text recommendations by participants was performed using the constant comparative method in grounded theory.ResultsFour hundred ninety-nine recent graduates from 6 geopolitical zones participated, representing 15 out of a total of 44 medical schools in Nigeria. Male to female ratio was 2:1, and most respondents (59%) graduated from Federal institutions. Students had greatest practical mean exposure to bedside procedures like intravenous access and passing urethral foley catheters and were most confident performing these. Less than 23% had performed over 10 of any of the assessed procedures.They had least exposures to chest tube insertion (0.24/person), caesarean Sect. (0.12/person), and laparotomy (0.09/person). Recent graduates from Federal institutions had less procedural exposure in urethral catheterization (p < 0.001), reduction (p = 0.035), and debridement (p < 0.035).Respondents that studied in the underserved North-East and North-West performed the highest median number of procedures prior to graduation. Cumulative confidence scores were low across all graduates (maximum 25/60), but highest in graduates from Northern Nigeria and private institutions. Graduates recommended prioritizing medical students over senior trainees, using simulation-based training and constructive individualized non-toxic feedback from faculty.ConclusionNigerian medical students have poor exposure to procedures and low confidence in performing basic procedures after graduation. More attention should be placed on training for essential surgeries and procedures in medical schools.

The need for hands-on training and supervision for entry-level physicians in a country with low surgical staffing density: a nationwide survey in Ghana

BackgroundDespite the largely unmet need, relatively few medical school graduates enrol in surgical residency and fewer surgical specialists work rurally in low- and middle-income countries. Surgical housemanship is the only formal training for medical graduates who will become the main surgical care providers in underserved areas. This study aimed to evaluate Ghanaian surgical housemanship (internship) and its impact on independent medical practice.MethodsA nationwide questionnaire survey of surgical trainees from seven teaching or regional-level hospitals ascertained the experience and self-confidence levels for 35 training objectives set by the Medical and Dental Council of Ghana, and suggestions to improve surgical training quality.ResultsOf 310 respondents, 59.7% experienced ≤ 10 cases for each topic, and 24.8% reported self-confidence as ≤ 2 points (out of 5). More than 90% of respondents experienced ≤ 10 cases for gastric, colorectal and liver cancer management. Teaching hospital trainees had lower proportions of those experiencing > 10 cases (36.6% versus 43.7%) and reporting self-confidence ≥ 4 (46.5% versus 55.8%), respectively, compared with those from regional/other-level hospitals. 40% of respondents were not confident about their surgical skills, and 70.5% requested better-supervised and practical surgical skills training. The proportion of respondents who reported limited supervision was higher among those from teaching hospitals, reported self-confidence scores < 4, and experienced ≤ 10 cases for each topic. 67% of respondents were satisfied with their surgical housemanship and 75.8% perceived surgical rotation as relevant to their future work.ConclusionsMost surgical trainees are concerned about their surgical skills. A structured curriculum with specific goals and better-supervised surgical skills training should be established. Inclusion of regional/other-level hospitals in surgical training may reduce the supervisory burden in teaching hospitals.