I. H. Marks3, M. Keem2, A. Diaz1, S. L. Seyedian4, G. S. Philipo9, I. Di Salvo7, H. Munir8, T. Pomerani6, N. Peter5, C. Lavy5 1Virginia Commonwealth University,School Of Medicine,Richmond, VA, USA 2University Of Melbourne,Melbourne, , Australia 3Barts And The London School Of Medicine And Dentistry,London, , United Kingdom 4Tehran University Of Medical Sciences,Student Scientific Research Center,,Tehran, , Iran 5University Of Oxford,Oxford, , United Kingdom 6University Of Florence,Florence, , Italy 7University Of Pavia,Lombardy, , Italy 8Allama Iqbal Medical College,Lahore, , Pakistan 9Mwananyamala Regional Referral Hospital,Mwananyamala, , Tanzania
Introduction: Approximately 5 billion people have no access to basic surgical care. The global burden of noncommunicable diseases and injury requiring surgical care has overtaken that of infectious disease, with conditions such as cancer, heart disease and diabetes, increasing dramatically in less-developed countries. Evidence suggest that barriers to accessing surgical care in low- and middle-income countries include difficulty accessing surgical services due to distance, poor roads, and lack of suitable transport; lack of local resources and expertise; and direct and indirect costs related to surgical care. What is less clear is what elements are responsible for influencing medical students in choosing a career in surgery. The goal of this study is to elucidate the reasons why medical students may or may not choose a career in surgery, identify common themes across different regions, genders and income strata.
Methods: In collaboration with the University of Oxford, we developed an electronic, multi-question survey to help elucidate the reasons why medical students may choose or discount surgical careers. Hosted on a web-based survey platform via the University of Oxford, the survey was distributed via multiple mailing lists as well as social media. The study was open to all medical students and was entirely anonymous and confidential.
Results: 499 medical students from 63 countries in six different regions including Africa, Asia, The Americas, Australasia, Eastern Mediterranean and Europe completed the survey (n=499), 43% (216) of which were male. 68%(339) of responders are considering a surgical career comprising 83% (192) female and 68% (147) male responders. Responses were analyzed both collectively and by region. Those from the East Mediterranean region were the most likely to be considering a career in surgery (81%) while those from Europe and Australasia was the least likely (67%). With the exception of Australasia, all regions disagreed with the statement that medical students had good access to undergraduate surgical education. The cost of postgraduate surgical training was expressed as a significant concern only in the African region. Over half the responders from Asia, Africa and the East Mediterranean agreed that surgeons in their countries dedicated the majority of their time to private sector patients. These regions were also the most likely to say that surgeons had poor access to resources. All regions except for Europe perceived surgeons to be overworked.
Conclusion: While the study is not yet adequately powered, trends in elements influencing medical students to choose a surgical career are appearing within our preliminary data. Whilst applications from female surgeons remain low in different regions globally, enthusiasm amongst female medical students appears to be high. Barriers to female students having successful surgical careers may therefore be more influential after completion of medical school.