Medical students’ career expectations and interest in opting for a surgical career
BACKGROUND: Whilst surgery will face an imminent workforce shortage, an increasing majority of students decide against a surgical career. This study evaluated the current career expectations of medical students and tested a hands-on virtual reality (VR) intervention as a tool to increase their interest in surgery.
METHODS: Randomly selected medical students of the University of Basel received a short questionnaire to rank their interest in five different postgraduate working environments prior to a lecture. After the lecture they participated in a hands-on VR demonstration. Thereafter an online questionnaire regarding workplace expectations, surgery and VR was sent to the students.
RESULTS: The online questionnaire response rate was 87% (225/258). Before using the VR intervention, a nonsurgical career was preferred by the majority of students, followed by a surgical career, cross-disciplinary specialties, research and, finally, nonclinical work. Surgery (n = 99, 44%) and emergency medicine (n = 111, 49%) were rated as incompatible with a good work-life balance. Further drawbacks to surgery were apprehension of competitive mentality, unclear career perspectives and longer working hours. The VR intervention had limited impact on re-ranking the five working sectors and slightly increased the students’ interest in surgery.
CONCLUSION: Students’ work environment expectations, their declining interest in a surgical career and the increasing need for surgeons represent challenges for surgical societies to address, in order to improve the attractiveness of surgery amongst students. VR sessions may be integrated as part of the actions required to improve students’ interest in a surgical career and should be further evaluated within controlled study designs.
- Terhune KP, Zaydfudim V, Abumrad NN. International medical graduates in general surgery: increasing needs, decreasing numbers. J Am Coll Surg. 2010;210(6):990–6.
- Ruedin H, Weaver F, Roth M, Widmer M. Gesundheitspersonal in der Schweiz – Bestandesaufnahme und Perspektiven bis 2020;2010.
- Cooper RA, Getzen TE, McKee HJ, Laud P. Economic and demographic trends signal an impending physician shortage. Heal. Aff. 2002;21(1):140–54.
- Kmietowicz Z. Shortage of surgeons might threaten NHS targets. BMJ. 2005;330:379.
- Bland KI, Isaacs G. Contemporary Trends in Student Selection of Medical Specialties. Arch Surg. 2002;137:259–67.
- Sauer J, Dommisch K. Chirurg – Ein Wunschberuf? Der Chir. BDC. 2006;5:145–148.
- Ansorg J, Krones C, Schroeder W, Leschber G, Ochel U. Be courageous! No average job: Being a surgeon. Chirurg. 2009:52–3.
- Boyle E, Healy D, Hill ADK, O'Connell PR, Kerin M, McHug S, et al. Career choices of today’s medical students: where does surgery rank? Ir J Med Sci. 2013;182(3):337–43.
- Nüssler NC. Surgical graduate education in crisis. Chirurg. 2008;Suppl:86–88.
- Tolhurst HM, Stewart SM, Medical T. Balancing work, family and other lifestyle aspects: a qualitative study of Australian medical students’ attitudes. MJA. 2004;181(7):361–4.
- Azizzadeh A, Mccollum C, Charles C, Holliday K, Shilstone H, Lucci A. Medical Students Interested in Surgery. Curr Surg. 2003:210–3.
- Thiele K, Matziolis D, Perka C. Lack of new trainees in trauma surgery and orthopedics. An approach to a solution. Unfallchirurg. 2010;113(12):1053–6.
- Saalwachter AR, Freischlag JA, Sawyer RG, Sanfey HA. The training needs and priorities of male and female surgeons and their trainees. J Am Coll Surg. 2005;201(2):199–205.
- Gensch K. Occupational decisions of young physicians and possible future consequences for the provision of medical care. Results of an anonymous questionnaire. Gesundheitswesen. 2007;69(6):359–70.
- Baxter N, Cohen R, McLeod R. The impact of gender on the choice of surgery as a career. Am J Surg. 1996;172(4):373–6.
- Dyrbye LN, Freischlag J, Kaups KL, Oreskovich MR, Satele DV, Hanks JB, et al. Work-home conflicts have a substantial impact on career decisions that affect the adequacy of the surgical workforce. Arch Surg. 2012;147(10):933–9.
- Businger A, Villiger P, Sommer C, Furrer M. Arguments for and against a career in surgery: a qualitative analysis. Ann Surg. 2010;252(2):390–6.
- Matthes G, Rixen D, Tempka A, Schmidmaier G, Wölfl C, Ottersbach C, et al. Physicians in traumatology. Critically endangered? Results of an inquiry. Unfallchirurg. 2009;112(2):218–22.
- Leibrandt TJ, Pezzi CM, Fassler SA, Reilly EF, Morris JB. Has the 80-hour work week had an impact on voluntary attrition in general surgery residency programs? J Am Coll Surg. 2006;202(2):340–4.
- Spinner G. Gutachten zum “Ausstieg aus der kurativen ärztlichen Berufstätigkeit in Deutschland.”; 2004:1–71.
- O’Herrin JK, Lewis BJ, Rikkers LF, Chen H. Why do students choose careers in surgery? J Surg Res. 2004;119(2):124–9.
- Makama JG, Ameh EA. Does general surgery clerkship make a future career in surgery more appealing to medical students? Afr Heal. Sci. 2010;10(3):292–6.
- Al-Kadi AS, Donnon T, Oddone Paolucci E, Mitchell P, Debru E, Church N. The effect of simulation in improving students’ performance in laparoscopic surgery: a meta-analysis. Surg Endosc. 2012;26(11):3215–24.
- Grantcharov TP, Kristiansen VB, Bendix J, Bardram L, Rosenberg J, Funch-Jensen P. Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg. 2004;91(2):146–50.
- Lucas S, Tuncel A, Bensalah K, Zeltser I, Jenkins A, Pearle M, et al. Virtual reality training improves simulated laparoscopic surgery performance in laparoscopy naïve medical students. J Endourol. 2008;22(5):1047–51.
- Miskovic D, Wyles SM, Ni M, Darzi AW, Hanna GB. Systematic review on mentoring and simulation in laparoscopic colorectal surgery. Ann Surg. 2010;252(6):943–51.
- Patrício M, Harden RM. The Bologna Process - A global vision for the future of medical education. Med Teach. 2010;32(4):305–15.
- Michaud PA. Reforms of the pre-graduate curriculum for medical students: the Bologna process and beyond. Swiss Med Wkly. 2012;142:w13738.
- Newson R. Confidence intervals for rank statistics: Percentile slopes, differences, and ratios. Stata J. 2006;6(4):497–520.
- Dorsey ER, Jarjoura D, Rutecki GW. Influence of controllable lifestyle on recent trends in specialty choice by US medical students. JAMA. 2003;290(9):1173–8.
- Drolet BC, Sangisetty S, Mulvaney PM, Ryder BA, Cioffi WG. A mentorship-based preclinical elective increases exposure, confidence, and interest in surgery. Am J Surg. 2013.
- Mayer KL, Perez R V, Ho HS. Factors affecting choice of surgical residency training program. J Surg Res. 2001;98(2):71–5.
- Ayodeji ID, Schijven M, Jakimowicz J, Greve JW. Face validation of the Simbionix LAP Mentor virtual reality training module and its applicability in the surgical curriculum. Surg Endosc. 2007;21(9):1641–9.