Surgical education
Medical student operative experience correlates with a match to a categorical surgical program

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Abstract

Background

Interest in general surgical residencies has decreased significantly. Because medical student clerkship experiences may affect specialty preferences, we attempted to determine if the degree of exposure to surgical procedures influenced career choices.

Methods

Operations observed by students who completed the third-year surgical clerkship between 1998 and 1999 were reviewed. These 146 medical students, who matched to residency training programs in March 2000, were then divided into three groups based upon residency fields. Surgical case exposures were then compared between the groups.

Results

The total number of operations observed was similar between the groups. However, students who matched into categorical general surgical programs participated in significantly more abdominal and general surgical procedures than those matching in surgical subspecialty or nonsurgical residencies (P < 0.01).

Conclusions

There appears to be a correlation between surgical case exposure during the third-year clerkships and future residency fields. Thus, the degree of exposure to surgical procedures may influence medical student career choices.

Section snippets

Methods

Medical students at the University of Wisconsin are required to keep a log of all operations observed during their 8-week third-year surgical clerkship. Students at our institution are assigned randomly to one of five surgical rotations, and have no ability to request one rotation over another in their third year. Most students spend 4 weeks on one of three University based general surgical services: the “Blue” service, which consists primarily of surgical oncology patients; the “Orange”

Demographic data

Of the 146 medical students included in the review, 40% were female. All students spent equal time on the third-year surgery clerkship: 4 weeks on general surgery and 4 weeks on the surgical subspecialty services. These students subsequently matched to residency training programs in March 2000. Of the 146 medical students, 9 matched to a categorical general surgery program, 13 to a surgical subspecialty field (ENT, orthopedics, urology), and the remaining 124 matched to other nonsurgical

Comments

This study was undertaken to determine if exposure to surgical cases in medical school influences future career choices. The results are interesting given the significant decline in match rates for surgical residencies over the past 5 years (NRMP data). We find that despite observing similar numbers of total operations, students do experience differences in operative exposure in their surgical clerkship.

Certain numbers of students, prior to their third-year clerkship, will have expressed an

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    Extrapolation from resident attrition and burnout studies suggests that the impact may be minimal.5 Conversely, numerous studies have demonstrated that a positive medical school surgery clerkship experience can encourage a student to pursue surgery.6-8 It is during this time that students are often exposed to their surgical mentors and recognize a personality fit with surgery, the two known positive influencers for students to apply to a surgical residency.2,9,10

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