Are surgical progeny more likely to pursue a surgical career?

BACKGROUND: For nearly two decades, interest in general surgery has been declining among U.S. medical school graduates. Many factors appear to be important in a medical student's choice of a surgical residency and career. We hypothesized that previous exposure to family members who are surgeons would significantly influence a student's decision to pursue a career in surgery. METHODS: Since 2001, nearly 600 third-year medical students completing the general surgery clerkship were issued a pre- and post-clerkship survey. Responses were collected, retrospectively analyzed, and correlated to the 2001-2007 National Residency Matching Program match results. RESULTS: The response rate of students completing both surveys was 87% (n = 510). Based on a numeric scale, surgical progeny (SP) indicated a significantly higher likelihood than nonsurgical progeny (NSP) of pursing a surgical career/residency in the pre-clerkship period (SP mean, 5.1 +/- 0.42; NSP mean, 3.7 +/- 0.11; P = 0.0005). Post-clerkship, SPs noted no more enjoyment from the surgical clerkship than NSPs (SP mean, 7.2 +/- 0.25; NSP mean, 6.9 +/- 0.96; P = 0.91); furthermore, there was no difference in the percentage of students pursuing a surgical residency (categorical or surgical subspecialty) in the National Residency Matching Program match (SP, 12.5%; NSP, 12.7%; P = 1.00). CONCLUSION: These data suggest that previous exposure to a surgeon within the family positively influences a medical student's pre-clerkship interest in pursuing a surgical career. However, this interest is not sustained; SPs and NSPs match into surgical residencies at equivalent rates. Clearly, further studies are needed to identify the factors responsible for this phenomenon.

Why do students choose careers in surgery?

BACKGROUND: Recent changes in medical education have emphasized primary care careers. This could have a negative impact on the number of applicants to surgical residencies. We hypothesized that experiences during the third year surgical clerkship are influential for students' subsequent residency choice. MATERIALS AND METHODS: Third year medical students who completed their surgical clerkship in the 2001-02 academic year were surveyed pre- and post-surgical clerkship. Responses were analyzed and correlated to the 2003 match results. RESULTS: The response rate of students surveyed was 98% (82 surveys/83 match results). Pre-clerkship, 6/82 students (7%) expressed an interest in surgery or surgical subspecialty careers. Post-clerkship, 34/84 students (40%) expressed an increased interest a surgical career; 13/84 (15%) expressed a decreased interest, and 37% of students expressed no change in career interest. Of those students expressing an increased interest in surgery, the clerkship experiences most noted to be influential were (1) number of cases participated/scrubbed (95%), (2) resident interaction (85%), (3) faculty interaction (80%), and (4) number of cases observed (65%). The number of hours spent on rotation (call, rounds) was the leading experience associated with a decreased interest in a surgical career. 12/83 students surveyed (14%) ultimately matched into a surgical program (NRMP 2003 match results). CONCLUSIONS: These data suggest that operative exposure and interaction with residents and faculty have a positive influence in students' choice of a surgical career. Although only 6% of students expressed an interest in surgery pre-clerkship, a 2-fold increase in this number was noted in choice of residency (14%). Work hours were the primary negative indicator for surgery residency. As medical curriculum is restructured and surgical exposure decreased, these data underscore the importance of quality exposure to both procedures and role models during the 3rd year surgical clerkship.

Medical student operative experience correlates with a match to a categorical surgical program.

BACKGROUND: Interest in general surgical residencies has decreased significantly. Because medical student clerkship experiences may affect specialty preferences, we attempted to determine if the degree of exposure to surgical procedures influenced career choices. METHODS: Operations observed by students who completed the third-year surgical clerkship between 1998 and 1999 were reviewed. These 146 medical students, who matched to residency training programs in March 2000, were then divided into three groups based upon residency fields. Surgical case exposures were then compared between the groups. RESULTS: The total number of operations observed was similar between the groups. However, students who matched into categorical general surgical programs participated in significantly more abdominal and general surgical procedures than those matching in surgical subspecialty or nonsurgical residencies (P < 0.01). CONCLUSIONS: There appears to be a correlation between surgical case exposure during the third-year clerkships and future residency fields. Thus, the degree of exposure to surgical procedures may influence medical student career choices.