Impact of medical school experiences on the career choice of neurosurgery: a cross- sectional study from Pakistan.

BACKGROUND: Pakistan grapples with the issue of an inadequate neurosurgery workforce but the reasons for such a disparity remain uncertain. Previous studies have highlighted how various factors including medical school experiences have an impact on career choice, but no study has delved into the impact of medical school exposure among Pakistani medical students, especially for the field of neurosurgery. This study aims to evaluate the impact of neurosurgery exposure, mentorship, and interest groups on medical students' decision to pursue neurosurgery. METHODS: A national cross-sectional survey was conducted in Pakistan, collecting data from medical students, interns, and medical officers over a one-month period. Ethical approval was obtained from the Ethical Review Committee at Aga Khan University, Pakistan. The data was analyzed using SPSS version 26. RESULTS: Out of 2618 participants, 38.0% were male and 62.0% were female, with an average age of 21.82 years (± 2.65). Among them, only 358 (13.6%) were interested in pursuing neurosurgery as a career, while the remaining 2,260 (86.3%) were not. More females (58.9%) than males (41.1%) expressed interest in pursuing neurosurgery as their intended career. Most medical students interested in pursuing neurosurgery were in the early years of their medical school (1st Year: 19.6%, 2nd Year: 26.0%, 3rd Year: 20.9%). In our study, students from public sector institutions (52.2%) showed more interest in neurosurgery as a career choice compared to those from private sector institutions (44.1%). The main deterrents for choosing neurosurgery were intense training (42.2%), work-life balance (39.9%), limited residency slots (56.7%), medical knowledge (34.1%), and surgical skills (36.6%). CONCLUSION: This study highlights the need for increased student engagement to inculcate the decision to pursue neurosurgery among medical students in Pakistan. A significant gap is highlighted, with the majority of interested students in early years. Public sector students show higher interest than their private sector counterparts. However, barriers like intense training, limited residency slots, and work-life balance concerns influence career choice. Targeted interventions like mentorship programs are crucial for fostering future neurosurgeons and advancing patient care and research. By addressing the identified disparities in experiences and promoting a supportive educational environment, it is possible to cultivate a future generation of skilled and dedicated neurosurgeons who can contribute to advancements in patient care and research in the field.

Gender Differences in Medical Students' Perception of Neurosurgery: A Cross-Sectional Study from Pakistan.

BACKGROUND: Despite 15,000 annual medical graduates, few choose neurosurgery, especially women. The scarcity of female neurosurgeons is a global concern, particularly in resource-limited settings such as Pakistan. This study focuses on gender-based differences in medical student perceptions of neurosurgery in Pakistan. METHODS: A nationwide cross-sectional study was conducted from March 6 to April 20, 2023, using a Web-based survey. Data collectors were recruited through an ambassadorship program, distributed evenly across all provinces. A questionnaire was used after a pilot study. Data analysis was performed using SPSS version 26 and STATA 15. RESULTS: A total of 2353 medical students participated in the study, of which 63.4% were female and 36.5% were male. Around 40.3% of women strongly agreed to the existence of potential gender bias in neurosurgery, in contrast to their corresponding male students, at 17.3%. Some of the highlighted deterring factors in pursuing neurosurgery as a career according to women include longer training duration (44.6%), poor work-life balance (41%), limited residency slots (50.6%), and limited exposure to neurosurgery (45.1%). Other factors included the high-intensity nature of training (33.6%), perceived gender bias (31.4%), competitive work environment (29.1%), complex surgical skills (38.6%), required level of medical knowledge (29.6%), and financial burden (33.9%). CONCLUSIONS: Our study shows that female students are more likely to believe in the existence of potential gender bias in the field compared with their counterpart male participants, which highlights the graveness of the situation in view of the evident paucity of female neurosurgeons in the country.