A.L. Albuck1, A.K. Mortemore1, A.M. Kesick1, J.S. Turner1 1Tulane University School Of Medicine, New Orleans, LA, USA
Introduction: The decision-making process for medical students’ career paths is heavily influenced by their clinical clerkships. The third-year general surgery clerkship is a crucial point that can steer students toward a surgical career. This study explores the factors in clerkship experiences that guide students’ choices in pursuing a general surgery residency, focusing on the influences of placement, service, and experiences during the third year.
Methods: Participants were medical students from a single institution who completed their third-year surgical clerkship between May 2022 and May 2024. We used a de-identified survey to evaluate factors such as interest in a surgical career, career aspirations, timing of the clerkship, assigned surgical services, service structure, total hours, and influences on career decisions. We also assessed NBME subject exam performance and final grades in the surgery clerkship.
Results: In total, 91 out of 360 eligible students responded, yielding a response rate of 25%. Prior to commencing their surgical clerkship, 20% of participants reported no interest, 42% were not interested but open to the idea, 31% were interested, and 7% were committed to pursuing a career in surgery. The odds ratio (OR) for applying to a general surgery residency was not statistically significant for those who were not interested compared to those who were open or committed at the start of their clerkship, with an OR of 0.3 (95% CI: 0.11-0.83). Furthermore, the timing of the surgery clerkship, whether in the first or second half of the third year, did not significantly affect the odds of applying to a general surgery residency, with an OR of 2.04 (95% CI: 0.71-5.88). Performance on the NBME shelf exam above the 75th percentile and receiving a final clerkship grade of Honors also did not yield significant differences in the odds of applying to a general surgery residency, with ORs of 1.87 (95% CI: 0.7-4.98) and 1.44 (95% CI: 0.55-3.73), respectively. The average service hour contribution by third-year clerkship students was 30 hours per service. For students averaging more than this, the OR for applying to a general surgery residency was 1.17 (95% CI: 0.6-2.29). Regarding factors influencing students’ decisions to pursue surgery, 28% cited meaningful cases, 13% mentioned interactions with residents, 11% pointed to faculty interactions, and only 4% said their clerkship had no influence.
Conclusion: The study concluded that neither initial interest in surgery, timing of the surgical clerkship, academic performance, nor service hours significantly influenced students’ decisions to apply to a general surgery residency.