What influences medical students' choice of surgical careers.

BACKGROUND: Recent emphasis in medical education has been to encourage students to pursue primary care careers. This could have a negative impact on applications to surgical residencies. METHODS: To determine what factors are most influential for a student to pursue a surgical career in spite of this environment, third- and fourth-year medical students were surveyed with a 40-item questionnaire. RESULTS: The response rate was 37% (76/205). Those students considering a career in surgery were more likely than their counterparts to be motivated by role models (P <.006), career opportunities (P <.006), and academic opportunities (P <.013) in surgery. They were less likely than their counterparts to be discouraged from surgery on the basis of lifestyle (P <.001), time commitment (P <.001), call schedules (P <.001), or residency length (P <.028). No differences regarding financial rewards, research opportunities, or intellectual challenges were seen between the groups. Neither race nor sex had a significant role in the selection of surgery as a career. CONCLUSIONS: The data suggests that students are more likely to be influenced to pursue surgical careers by offering early exposure to positive role models and career and academic opportunities in surgery. Knowledge of these influences on student career choices should help surgical educators attract and maintain student interest in surgical careers.

Pancreatic pseudocyst masquerading as an incarcerated inguinal hernia.

We present a case in which a pancreatic pseudocyst dissected into the right inguinal region, thus masquerading as an incarcerated right inguinal hernia. Computed tomography (CT) confirmed the diagnosis of a pseudocyst, and the patient was treated successfully with percutaneous drainage.

Synchronous laparoscopic vasectomy and hernia repair.

Over the last few years, general surgery has seen the use of more and more laparoscopic techniques in the management of common surgical problems. This expanded use is attributable not only to the excellent results seen with laparoscopic procedures but also to patient demand. A 48-year-old man requested a laparoscopic hernia repair with synchronous vasectomy. The technique of synchronous laparoscopic hernia repair and vasectomy is discussed, and a literature review is provided. Certain disadvantages along with the difficulty in reanastomosis after a laparoscopic vasectomy will prevent the replacement of traditional vasectomy with the laparoscopic technique.

Self-inflicted burn injuries.

Self-inflicted burns are uncommon yet disturbing. A 9-year retrospective review of all admissions to the Mercy Hospital of Pittsburgh Burn Center from 1987 to 1995 found 11 out of 1135 patients to have self-inflicted burns. Ten of these patients had a psychiatric diagnosis prior to injury: major depression in 6 cases, schizophrenia in 3 cases, and a personality disorder in 1 case. The other patient was diagnosed with major depression during her hospitalization. Escape from stress/sadness was the motive for 6 patients. Two were actually attempting suicide and 2 were motivated by hallucinations/delusions. On the basis of this review, we recommend that patients with an abnormal psychological profile--including suicidal ideation--be adequately monitored and regularly followed by appropriate mental health professionals. It is hoped that an awareness of the phenomena of self-destruction by burning will prevent these injuries in the future.

Stump appendicitis: a case report.

Residual appendicitis is a rare event that occurs when there is incomplete resection of the organ. A recent report suggested that this may be a complication of laparoscopic surgery. Following a case of stump appendicitis in a young patient, we thoroughly reviewed the literature and found that most reported cases have occurred in open appendectomy. Awareness of the existence of this uncommon condition will help in the early diagnosis and prompt treatment of this pathology.