Factors Influencing the Decision of Surgery Residency Graduates to Pursue General Surgery Practice Versus Fellowship

Klingensmith, Mary E.; Cogbill, Thomas H.; Luchette, Frederick A; Biester, Thomas W.; Samonte, Kelli; Jones, Andrew; Lewis, Frank R.; Malangoni, Mark A.

doi:10.1097/sla.0000000000001435

Cited by 105 publications

(42 citation statements)

References 10 publications

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“…3,31,32,36,49,56,61,74,91,96,97,[106][107][108][109][110][111][112][113][114][115][116][117][118][119][120] Clinical experience is known to have a significant impact on career decisions, but the mentorship during exciting clinical opportunities may lead to an especially transformative ex perience during surgical clerkship. We encourage that mentor relationships be established with medical students whenever possible and that same-gender mentors are more favourable if available.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of the factors affecting choice of surgery as a career

Peel

Schlachta

Alkhamesi

2018

cjs

189

129

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A systematic review of the factors affecting choice of surgery as a careerBackground: Interest in surgical careers among medical students has declined over the past decade. Multiple explanations have been offered for why top students are deterred or rejected from surgical programs, though no consensus has emerged. Methods:We conducted a review of the literature to better characterize what factors affect the pursuit of a surgical career. We searched PubMed and EMBASE and performed additional reference checks. Agency for Healthcare Research and Quality (AHRQ) and Newcastle-Ottawa Education scores were used to evaluate the included data.Results: Our search identified 122 full-text, primary articles. Analysis of this evidence identified 3 core concepts that impact surgical career decision-making: gender, features of surgical education, and student "fit" in the culture of surgery. Conclusion:Real and perceived gender discrimination has deterred female medical students from entering surgical careers. In addition, limited exposure to surgery during medical school and differences between student and surgeon personality traits and values may deter students from entering surgical careers. We suggest that deliberate and visible effort to include women and early-career medical students in surgical settings may enhance their interest in carreers in surgery.Contexte : On constate que l'intérêt pour une carrière en chirurgie a décliné chez les étudiants en médecine depuis une dizaine d'années. Plusieurs raisons ont été invoquées pour expliquer le désintérêt des étudiants talentueux à l'égard des programmes de chirurgie ou leur rejet de ces programmes, sans qu'on en arrive à un consensus.

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Section: Discussionmentioning

confidence: 99%

A systematic review of the factors affecting choice of surgery as a career

Peel

Schlachta

Alkhamesi

2018

cjs

189

129

View full text Add to dashboard Cite

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“…1 Most concerning is the lack of confidence to operate in dependently that has been reaffirmed as a common trait among general surgery graduates seeking postresidency subspecialty training. 2 In this setting, fellowship programs offer an additional opportunity to improve operative skills, encourage autonomy and build confidence at the subspecialty level before starting independent practice. Improved clinical outcomes for complex operations performed at high-volume centres and growing public demands for safety have further propelled the phenomenon of surgical subspecialization.…”

Section: Discussion In Surgery • Discussion En Chirurgiementioning

confidence: 99%

The adequacy of hepatopancreatobiliary training: How does operative exposure and perceived readiness in fellowship translate into subsequent practice?

Aubin

Bressan

Edwards

et al. 2017

CJS

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“…Prestige was identified in the aforementioned theoretical model as an important ‘lifestyle consideration’ influencing students . Prestige also appears to influence USA residents’ decisions to pursue subspecialty fellowship training . However, prestige has similarly been largely undefined in previous medical student studies.…”

Section: Introductionmentioning

confidence: 99%

“…14 Prestige also appears to influence USA residents' decisions to pursue subspecialty fellowship training. 26,27 However, prestige has similarly been largely undefined in previous medical student studies. This is important, because prestige has many different meanings.…”

mentioning

confidence: 99%

Specialty income and career decision making: a qualitative study of medical student perceptions

et al. 2019

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Context Medical educators in the USA are interested in the ways medical students make career choices because shortages in key specialties, particularly primary care specialties, limit access to care. Although anticipated specialty income is a strong predictor of student interest, no studies have qualitatively explored the reasons why income is important to students. By better understanding students’ perspectives on income and specialty choice, educators can help students make choices that fit their goals and better educate students about the specialties in which the need for expansion is greatest. Methods In 2012, Year‐2 students at one USA medical school were invited to write an essay about how debt and anticipated income levels influence their career choices. A total of 132 essays (response rate: 67%) were qualitatively analysed using a hermeneutic phenomenology approach to conventional content analysis, in which themes emerge inductively from the data. Researchers employed peer debriefing, modified member checking, thick description, code–recode strategies, audit trails and reflexivity to ensure quality and rigour. Although this analysis initially focused on student perceptions of specialty income, prestige also emerged as an important related theme. Results Three major findings emerged. Income is of varying importance to different students. Students value income because it provides freedom and flexibility, and power and security. Students recognise that high income confers social prestige. Students also define specialty prestige in other ways, including match competitiveness, perceived expertise, opportunities for advancement through fellowships, and power and autonomy. Conclusions Medical students’ perspectives of specialty income, specialty choice and prestige are more complex than previously reported. Medical educators should frame conversations about specialty choices in ways that incorporate varied perspectives on income and prestige. Health policymakers should recognise that income and prestige influence medical students’ decisions in complex ways. These insights may inform strategies to counteract shortages in key specialties, including primary care specialties.

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Factors Influencing the Decision of Surgery Residency Graduates to Pursue General Surgery Practice Versus Fellowship

Cited by 105 publications

References 10 publications

A systematic review of the factors affecting choice of surgery as a career

A systematic review of the factors affecting choice of surgery as a career

The adequacy of hepatopancreatobiliary training: How does operative exposure and perceived readiness in fellowship translate into subsequent practice?

Specialty income and career decision making: a qualitative study of medical student perceptions

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