A. Berger1, J. Giacalone1, P. Barlow2, M. Kapadia3, J. Keith3 1University Of Iowa,College Of Medicine,Iowa City, IA, USA 2University Of Iowa,Department Of Internal Medicine,Iowa City, IA, USA 3University Of Iowa,Department of Surgery,Iowa City, IA, USA
Introduction: A medical student’s choice to pursue a career in surgery is influenced by many evolving factors and considerations, and likely by experiences during education. We hypothesize that quantifying these variables will reveal trends influencing choice of medical specialty. Our goal is to ascertain trends and factors that can be used to increase interest in surgery, and attract students to pursue a surgical career.
Methods: A questionnaire-based, longitudinal prospective study was conducted at a university program. Surveys were administered to medical students in the class of 2017 prior to the start of the first, second, and third years. The questions cover topics including specialty preferences, debt, mentorship, research, and factors deemed desirable or important in a future career. Residency choices were classified as surgical and nonsurgical. Z-tests for population proportions and odds ratios were calculated using SAS/STAT software.
Results: Data was collected from 143, 139, and 144 students at the beginning of their first, second, and third medical school year, respectively, and response rates were >90%. Students with any research experience prior to medical school were 64% less likely (p=0.016) to have surgical career interests in the first survey. By the third year, however, students expressing interest in surgery were 2.5 times more likely to be actively involved in research (p=0.029) and 8.4 times more likely to have a surgery-related research focus (p=0.0001), as compared to non-surgery classmates. At the beginning of their third year, students with an interest in surgical specialties were 2.2 times more likely to have a self-maintained surgeon-mentor relationship (p=0.031), as compared to students interested in non-surgical specialties. With near significance, students initially expressing interest in surgical specialties are 2.4 times more likely to change their interest to ‘undecided’ in future surveys (p=0.06). Students without both research experience and active surgeon-mentor relationships are 9 times more likely to switch to ‘undecided’ or non-surgical specialties (0.02619). Furthermore, students involved in research, but without a mentor, are 20 times more likely to change their interests to ‘undecided’ or non-surgical specialties (p=0.0012), compared to those with both research and active surgeon-mentor relationships.
Conclusion: Students involved in surgery-specific research are significantly more likely to continue expressing interest in a surgical career if they have a mentor. In the absence of a mentor, students involved in research are more likely to change interests than those not involved in research at all. Our preliminary conclusion is that while research attracts students to consider surgical specialties, meaningful surgeon-mentor relationships are essential to maintain a student’s interest.