Surgical career choices: the vital impact of mentoring.

OBJECTIVE: Few studies have analyzed the impact of mentoring on general surgical graduates' future career choices. We attempted to characterize the impact mentoring had on choices made by graduates from our residency program regarding surgical subspecialty training. METHODS: A 32 item web survey was sent to 99 graduates of a university general surgery program, who matriculated between 1985 and 2007. The intent of the questionnaire was to evaluate influences on future subspecialty choice. Focusing on the influence of mentoring, we compared graduates who indicated that an influential mentor was an important factor in their decision (MENTOR) to those respondents who ranked this factor as unimportant (OTHER). Results were analyzed using Fisher's exact test with significance determined at p < or = 0.05. RESULTS: A total of 83 respondents (84%) answered the questionnaire (61 men, 18 women, 4 not indicated). Of these respondents, 61 (75%) indicated that an influential mentor was important or very important in choosing their specialty field (MENTOR). The most common fields of the mentors were general surgery (22%), surgical oncology (15%), and plastic surgery (13%). Protégés indicated that their decision to pursue a subspecialty was most influenced by the following mentor characteristics: demonstrating expertise (77%), being a role model (72%), and practicing professional integrity (70%). In the MENTOR group, the vast majority of respondents [72% (43/60)] were in the same field as their mentor (P = <0.0001). Protégés also tended to practice in the same setting as their mentor: All (8/8) of those who identified a mentor in a non-academic practice were also currently in a non-academic practice (P = 0.002). Respondents in a non-academic practice were more likely than those in academic practice to have identified their mentor before or during medical school [59% (20/34) versus 8% (2/26)]. Alternatively, 62% (16/26) of academic practitioners identified their mentor during their PGY 2 or 3 y compared to only 21% (7/34) of those in a non-academic practice (P = 0.003). CONCLUSION: Mentored surgical residency graduates were likely to enter the same specialty and practice type as their mentor. Also, the timing of identifying a mentor was strongly correlated with future practice type. With increasing concerns about "the impending disappearance of the general surgeon" along with increasing growth in surgical sub-specialization, it is essential that all types of surgeons provide early and sustained mentorship to medical students and residents to help shape the future of surgery.

Motivation to pursue surgical subspecialty training: is there a gender difference?

BACKGROUND: Few studies have examined whether women and men identify the same factors as important in choosing their specialty. We sought to evaluate whether the factors influencing residents' choice of surgical specialty differed by gender. STUDY DESIGN: A 32-item Web survey, designed to elucidate which factors motivated residents to seek fellowship training, was sent to 99 graduates of a university general surgery program, all of whom matriculated between 1985 and 2006. RESULTS: A total of 74 (75%) respondents replied (16 women, 58 men). There was a higher proportion of men who pursued fellowship training than women (69% versus 38%, p=0.04), but there was no significant difference in those who were currently in academic practice (men, 46% versus women, 27%, p=0.2). Both genders were equally likely to respond that interest in and intellectual appeal of their field, clinical opportunities in that field, and having an influential mentor during residency were important in choosing their future specialty. But significantly more women listed lifestyle as an important factor in choosing their future careers (69% versus 43%, p=0.03). When respondents' data from the most recent decade were analyzed, there was no difference between genders in completion of fellowship training or in those in academic practice. But lifestyle continued to be more important to women. CONCLUSIONS: Both genders were influenced by many similar factors when deciding to pursue subspecialty training, but women were more likely than men to be influenced by their perception of the lifestyle associated with their career choice. These findings suggest that general surgical residency programs might improve efforts to recruit women by addressing the perception of the lifestyle associated with choosing a surgical career.