Attitudes of Canadian medical students towards surgical training and perceived barriers to surgical careers: a multicentre survey
DOI:
https://doi.org/10.36834/cmej.74694Abstract
Background: Medical student interest in surgical specialties continues to decline. This study aims to characterize attitudes of Canadian medical students towards surgical training and perceived barriers to surgical careers.
Methods: An anonymous survey was custom designed and distributed to medical students at the University of Alberta and University of Calgary. Survey questions characterized student interest in surgical specialties, barriers to pursuing surgery, and influence of surgical education opportunities on career interest.
Results: Survey engagement was 26.7% in 2015 and 24.2% in 2021. General surgery had the highest rate of interest in both survey years (2015: 38.3%, 2021: 39.2%). The most frequently reported barrier was worry about the stress that surgical careers can put on personal relationships (2015: 70.9%, 2021: 73.8%, p = 0.50). Female respondents were significantly more likely to cite gender discrimination as a deterrent to surgical careers (F: 52.0%, M: 5.8%, p < 0.001).
Conclusions: Despite substantial interest, perception of work-life imbalance was the primary reported barrier to surgical careers. Further, female medical students’ awareness of gender discrimination in surgery highlights the need for continued efforts to promote gender inclusivity within surgical disciplines to support early career women interested in surgery.
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References
CRMS. Canadian Residency Matching Service Report. Ottawa (ON); 2021.
Dolan-Evans E, Rogers GD. Barriers for students pursuing a surgical career and where the Surgical Interest Association can intervene. ANZ J Surg. 2014;84(6):406-11. https://doi.org/10.1111/ans.12521 DOI: https://doi.org/10.1111/ans.12521
Keshinro A, Frangos S, Berman RS, et al. Underrepresented Minorities in Surgical Residencies: were are they? A call to action to increase the pipeline. Ann Surg. 2020;272(3):512-20. https://doi.org/10.1097/SLA.0000000000004209 DOI: https://doi.org/10.1097/SLA.0000000000004209
Pointer DT, Jr., Freeman MD, Korndorffer JR, Jr., Meade PC, Jaffe BM, Slakey DP. Choosing surgery: identifying factors leading to increased general surgery matriculation rate. Am Surg. 2017;83(3):290-5. DOI: https://doi.org/10.1177/000313481708300325
Peel JK, Schlachta CM, Alkhamesi NA. A systematic review of the factors affecting choice of surgery as a career. Can J Surg. 2018;61(1):58-67. https://doi.org/10.1503/cjs.008217 DOI: https://doi.org/10.1503/cjs.008217
Banning LBD, Meyer VM, Keupers J, Lange JFM, Pol RA, Benjamens S. Surveys in surgical education: a systematic review and reporting guideline. Eur Surg Res. 2021;62(2):61-7. https://doi.org/10.1159/000516125 DOI: https://doi.org/10.1159/000516125
Pitt SC, Schwartz TA, Chu D. AAPOR Reporting Guidelines for Survey Studies. JAMA Surg. 2021;156(8):785-6. https://doi.org/10.1001/jamasurg.2021.0543 DOI: https://doi.org/10.1001/jamasurg.2021.0543
Association of Faculties of Medicine of Canada. Canadian Medical Education Statistics 2019: the AFMC undergraduate medical education enrolment (MD program) study. 2019 2019.
Minor S, Poenaru D, Park J. A study of career choice patterns among Canadian medical students. Am J Surg. 2003;186(2):182-8. https://doi.org/10.1016/s0002-9610(03)00181-8 DOI: https://doi.org/10.1016/S0002-9610(03)00181-8
Boyle E, Healy D, Hill AD, et al. Career choices of today's medical students: where does surgery rank? Ir J Med Sci. 2013;182(3):337-43. https://doi.org/10.1007/s11845-012-0882-x DOI: https://doi.org/10.1007/s11845-012-0882-x
Corless KG, Samy A, Kamil A, et al. The future of general surgery in Ireland: factors influencing career decisions of medical students. Ir J Med Sci. 2021;190(2):741-7. https://doi.org/10.1007/s11845-020-02347-8 DOI: https://doi.org/10.1007/s11845-020-02347-8
Association CM. CMA Physician Workforce Survey. 2019.
Balch CM, Shanafelt TS. Dynamic tension between success in a surgical career and personal wellness: how can we succeed in a stressful environment and a "culture of bravado"? Ann Surg Oncol. 2011;18(5):1213-6. https://doi.org/10.1245/s10434-011-1629-z DOI: https://doi.org/10.1245/s10434-011-1629-z
Lim WH, Wong C, Jain SR, et al. The unspoken reality of gender bias in surgery: a qualitative systematic review. PLoS One. 2021;16(2):e0246420. https://doi.org/10.1371/journal.pone.0246420 DOI: https://doi.org/10.1371/journal.pone.0246420
Mocanu V, Kuper TM, Marini W, et al. Intersectionality of gender and visible minority status among general surgery residents in Canada. JAMA Surg. 2020;155(10):e202828. https://doi.org/10.1001/jamasurg.2020.2828 DOI: https://doi.org/10.1001/jamasurg.2020.2828
Bettis J, Thrush CR, Slotcavage RL, Stephenson K, Petersen E, Kimbrough MK. What makes them different? An exploration of mentoring for female faculty, residents, and medical students pursuing a career in surgery. Am J Surg. 2019;218(4):767-71. https://doi.org/10.1016/j.amjsurg.2019.07.029 DOI: https://doi.org/10.1016/j.amjsurg.2019.07.029
Trinh LN, O'Rorke E, Mulcahey MK. Factors influencing female medical students' decision to pursue surgical specialties: a systematic review. J Surg Educ. 2021;78(3):836-49. https://doi.org/10.1016/j.jsurg.2020.08.050 DOI: https://doi.org/10.1016/j.jsurg.2020.08.050
Stephens EH, Heisler CA, Temkin SM, Miller P. The current status of women in surgery: how to affect the future. JAMA Surg. 2020;155(9):876-85. https://doi.org/10.1001/jamasurg.2020.0312 DOI: https://doi.org/10.1001/jamasurg.2020.0312
Stentz NC, Griffith KA, Perkins E, Jones RD, Jagsi R. Fertility and childbearing among american female physicians. J Womens Health (Larchmt). 2016;25(10):1059-65. https://doi.org/10.1089/jwh.2015.5638 DOI: https://doi.org/10.1089/jwh.2015.5638
Phillips EA, Nimeh T, Braga J, Lerner LB. Does a surgical career affect a woman's childbearing and fertility? A report on pregnancy and fertility trends among female surgeons. J Am Coll Surg. 2014;219(5):944-50. https://doi.org/10.1016/j.jamcollsurg.2014.07.936 DOI: https://doi.org/10.1016/j.jamcollsurg.2014.07.936
Rangel EL, Castillo-Angeles M, Easter SR, et al. Incidence of infertility and pregnancy complications in US female surgeons. JAMA Surg. 2021;156(10):905-15. https://doi.org/10.1001/jamasurg.2021.3301 DOI: https://doi.org/10.1001/jamasurg.2021.3301
Simpson AN, Cusimano MC, Baxter NN. The inconvenience of motherhood during a medical career. CMAJ. 2021;193(37):E1465-E6. https://doi.org/10.1503/cmaj.211255 DOI: https://doi.org/10.1503/cmaj.211255
Duong D. Medical training remains a barrier to starting a family. CMAJ. 2021;193(21):E782-E3. https://doi.org/10.1503/cmaj.1095942 DOI: https://doi.org/10.1503/cmaj.1095942
Augustine H, Rizvi SA, Dunn E, et al. Pregnancy and parental leave among plastic surgery residents in Canada: a nationwide survey of attitudes and experiences. Can J Surg. 2020;63(5):E454-E9. DOI: https://doi.org/10.1503/cjs.004919
Altieri MS, Salles A, Bevilacqua LA, et al. Perceptions of surgery residents about parental leave during training. JAMA Surg. 2019;154(10):952-8. https://doi.org/10.1001/jamasurg.2019.2985 DOI: https://doi.org/10.1001/jamasurg.2019.2985
Merchant SJ, Hameed SM, Melck AL. Pregnancy among residents enrolled in general surgery: a nationwide survey of attitudes and experiences. Am J Surg. 2013;206(4):605-10. https://doi.org/10.1016/j.amjsurg.2012.04.005 DOI: https://doi.org/10.1016/j.amjsurg.2012.04.005
Merchant S, Hameed M, Melck A. Pregnancy among residents enrolled in general surgery (PREGS): a survey of residents in a single Canadian training program. Can J Surg. 2011;54(6):375-80. https://doi.org/10.1503/cjs.015710 DOI: https://doi.org/10.1503/cjs.015710
Deng M, Nham E, Malvea A, Ramsay T, Seabrook C, Watterson J. Exploring the impact of the Surgical Exploration and Discovery (SEAD) program on medical students' perceptions of gender biases in surgery: a mixed-method evaluation. J Surg Educ. 2021;78(4):1236-49. https://doi.org/10.1016/j.jsurg.2020.11.016 DOI: https://doi.org/10.1016/j.jsurg.2020.11.016
Market M, Battaglia F, Langlois E, Shin J, Seabrook C, Brandys T. Using self-reported measures of confidence and anxiety to Determine the efficacy of the surgical exploration and Discovery (SEAD) Program in reducing anxiety and increasing confidence in performing procedural skills. J Surg Educ. 2020;77(5):1154-60. https://doi.org/10.1016/j.jsurg.2020.03.010 DOI: https://doi.org/10.1016/j.jsurg.2020.03.010
Head LK, Greene B, Gawad N, Hamstra SJ, Brandys T. Harvesting the 'SEAD': long-term follow-up of the surgical exploration and discovery program. J Surg Educ. 2020;77(1):96-103. https://doi.org/10.1016/j.jsurg.2019.07.012 DOI: https://doi.org/10.1016/j.jsurg.2019.07.012
Ziegler T, Adibfar A, Abbasian A, Jiang SX, Rutka JT, Gawad N. Propagating the "SEAD": exploring the value of an overnight call shift in the Surgical Exploration and Discovery (SEAD) Program. J Surg Educ. 2020;77(1):104-14. https://doi.org/10.1016/j.jsurg.2019.08.011 DOI: https://doi.org/10.1016/j.jsurg.2019.08.011
Gawad N, Head LK, McGuire C, et al. Branches from the "SEAD": sustained and feasible expansion of the surgical exploration and discovery program. J Surg Res. 2019;235:315-21. https://doi.org/10.1016/j.jss.2018.10.014 DOI: https://doi.org/10.1016/j.jss.2018.10.014
Greene B, Head L, Gawad N, Hamstra SJ, McLean L. Surgical exploration and discovery program: inaugural involvement of otolaryngology - head and neck surgery. J Otolaryngol Head Neck Surg. 2015;44:3. https://doi.org/10.1186/s40463-015-0059-5 DOI: https://doi.org/10.1186/s40463-015-0059-5
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