EducationBrief intervention by surgeons can influence students toward a career in surgery1
Introduction
Over the past few years, there has been an alarming decrease in the number of medical students matching in general surgery programs [1]. Additionally, this trend is predicted to result in a major shortage in the general surgical workforce [2]. Interest in surgery as a career peaked in 1981, with 12.1% of senior medical students matching in general surgery. Since then, however, there has been a gradual decline over the past two decades, plummeting to just 6.1% in 2001 and 5.3% in 2002 3, 4. In contrast, the surgical subspecialties of orthopedics, urology, and otolaryngology have maintained a stable applicant pool, and such specialties as radiology, anesthesia, and emergency medicine have experienced impressive increases in applicants [5]. Lifestyle issues have emerged as important contributing factors to the decline in students pursuing surgery as a career choice 6, 7. Although changes are being made in residency work hours for all residents, this may not be enough.
Attention has primarily focused on the perceptions of graduating medical students [8], but little is known about perceptions of entering students. The purpose of the current study was 2-fold: first, to understand the perceptions of first-year medical students about the field of surgery and two, to determine whether exposing these students to the discipline of surgery through a brief intervention early in their medical education could influence their perceptions toward surgery as a career choice.
Section snippets
Materials and methods
First-year medical students at the University of Texas-Houston School of Medicine were asked to voluntarily participate in a brief presentation by the Department of Surgery. The format consisted of a preintervention survey, a 1-h intervention, a postintervention survey, and then an informal, small group question-and-answer period. Students were asked to rank 19 items coded on a Likert-type scale from 1 (not important) to 8 (very important) regarding their beliefs about surgery as a career as
Results
Of 210 first year students, 121 (58%, 66 male, 50 female, and 5 not specified) completed the presurvey and 94 (45%) voluntarily attended the intervention and completed the post survey, of which 82 were matched responses. Only matched responses were used for the postsurvey analysis.
On the preintervention survey, factors that correlated with surgery as a career choice by univariate analysis are listed in Table 2 and by multivariable analysis in Table 3. Factors that were influenced by a brief
Discussion
Our study demonstrates that first-year medical students view surgery as a field that provides both career opportunity and intellectual challenge whereas lifestyle issues already prevail. However, through a brief intervention with 5 practicing surgeons, academic opportunities, patient relationships, prestige, and gender distribution became more important whereas concern about debt and length of training became less important.
The University of Texas-Houston is a state-owned university that prides
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Presented at the Annual Meeting of the Association for Academic Surgery, Boston, Massachusetts, November 2002.
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Current address: Department of Surgery, Stanford University, Stanford, CA.