Inspiring Medical Students to Pursue Surgical Careers: Outcomes From Our Cardiothoracic Surgery Research Program

doi:10.1016/j.athoracsur.2009.03.007

The Annals of Thoracic Surgery

Volume 87, Issue 6, June 2009, Pages 1816-1819

Presented at the Poster Session of the Forty-fifth Annual Meeting of The Society of Thoracic Surgeons, San Francisco, CA, Jan 26–28, 2009.

https://doi.org/10.1016/j.athoracsur.2009.03.007 Get rights and content

Background

The past several years have witnessed a dramatic decline in the number of general surgery residents pursuing cardiothoracic surgery residency training. We believe that attracting individuals to pursue surgical careers should begin during the formative years of medical education. We implemented a program to introduce first-year medical students to cardiothoracic surgery and laboratory research.

Methods

In 2003, we began a program providing an introduction to cardiothoracic laboratory research and surgery for medical students. Students are competitively selected for our three-part 8-week summer program. First, students are paired with a cardiothoracic surgery attending for shadowing in clinic and the operating room. Second, students actively participate in large-animal operations in the laboratory. Finally, students complete a clinical research project under the direction of a laboratory resident and faculty mentor. These projects are the students' own. They are responsible for presenting their findings to the division of cardiac surgery at the end of the program.

Results

Since 2003, 18 students have completed the program. Each one has completed a project, collectively resulting in 39 peer-reviewed manuscripts. One student has published 28 peer-reviewed manuscripts. Of 10 students eligible for residency, 8 have applied in general surgery or surgical subspecialty (3 general, 2 plastic, 2 cardiothoracic, and 1 neurosurgery).

Conclusions

Implementing a program to introduce medical students to clinical and laboratory surgery has been successful, as measured by academic productivity. Eighty percent of eligible students entered a surgical field. Programs like these serve to stimulate interest in our specialty.

Section snippets

Program Specifics

In the summer of 2003, the CT surgery laboratory at the Johns Hopkins Hospital began a formal 8-week program for medical students at the Johns Hopkins School of Medicine, aimed at providing an intensive, focused experience in CT clinical and basic science research. Students are taught early operative skills and exposed to mentors within the division at the resident, fellow, and attending levels. Before this program, occasional medical students participated in an unstructured manner in active

Results

Since 2003, 18 medical students have completed our summer CT surgery research program. These students have coauthored a total of 39 peer-reviewed journal articles, presented 41 abstracts at national meetings, and coauthored 2 book chapters (Table 1), while still in medical school. Of note, we have included all publications in the field of CT surgery coauthored by these students, even if the initial work was not done during the 8 weeks of their program. Eleven (61%) have coauthored a journal

Comment

In this study, we have presented early results from our dedicated summer program for medical students. We initially created the program to provide students early exposure to CT surgery. The results have shown that both students and our division have benefited from this program. Specifically, the 18 students who have entered the program have been academically productive, and many have chosen careers in the surgical subspecialties.

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Changes in Medical Student Perceptions of Surgery Are Sustainable Through Focused Preclinical Surgical Exposure
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Many medical students hold negative perceptions about the surgical field that deter them from pursuing surgical training. We hypothesize that these perceptions can be sustainably changed with preclinical surgical education.
Students were administered a 10-question survey before the educational experience, immediately after completing the experience, and 1-3 years later. Survey questions focused on perceptions about surgery. Changes in responses over time were measured and analyzed.
The study was performed in the setting of a voluntary preclinical surgical education experience.
Surveys were administered to 217 first-year medical students who all participated in the preclinical surgical education experience from 2017 to 2019. Follow-up surveys were administered to all cohorts simultaneously and anonymously via email.
Nine of the ten questions demonstrated statistically significant changes in perceptions from pre-experience to immediately post-experience (p < 0.048). Though attenuation was seen over time, changes in perception regarding the workload and time investment of surgical training, the role of women in surgery, and the relationships between surgeons and their patients were sustained over time (p < 0.044).
The results indicated that our model of surgical education could effect long-term changes in negative perceptions about the surgical field. Many of these negative perceptions are highly concerning to medical students. As such, success in changing perceptions about length and difficulty of training, gender inclusivity, and patient-centered care in surgery is important in increasing student interest in the surgical field. This becomes relevant in the current climate of a nationwide shortage of surgeons and the need to better attract students to this profession.
Bridging gaps in transition to practice
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Where Do We Begin? Building Blocks to Establish a Cardiothoracic Surgery Interest Group
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Citation Excerpt :
Furthermore, a significant number of students reported their desire to schedule a future elective or subinternship in CT surgery. In contrast to previous efforts to increase excitement about a career in CT surgery [1, 4–9], our program provided a longitudinal platform to continually expose medical students to our field. No matter the intervention, however, early exposure has been universally emphasized in recruitment endeavors [1, 6, 7, 12].
With the impending shortage of cardiothoracic (CT) surgeons, much focus has been on increasing trainee interest, particularly at the medical student level. We aimed to determine the effect of participation in our Cardiothoracic Surgery Interest Group (CTSIG) on medical student attitudes regarding surgery, and especially CT surgery.
An anonymous survey was administered at two time points to the current member list of our 2015 to 2016 CTSIG and repeated for the 2016 to 2017 academic year. A set CTSIG event schedule was developed with current CT faculty and included events every 1 to 2 months. Total CTSIG membership was 101 students. Descriptive analysis was performed on quantitative data.
Of 73 preclinical students completing both pre/postsurveys, 62% (45) were male. Postsurveys demonstrated increased interest in surgery and CT surgery as a career, which was significantly greater than those reporting no change (p < 0.01 for both). Common factors mentioned as deterrents for a CT surgery career included lifestyle, length of training, and associated personality/culture. Events hosted by the CTSIG most frequently reported as increasing interest included lunches/dinners with CT surgery faculty (89%), a “Leadership in Surgery” event (58%), and an “Intro to CT Surgery and Q/A Session” hosted by a CT surgeon (51%).
Establishing a CTSIG that includes preset events with exposure to CT surgery by shadowing and interaction with faculty in a relaxed setting has the ability to increase preclinical interest in CT surgery. More emphasis on advocacy is needed to clear up misconceptions about CT surgery to maintain recruitment of outstanding students in our CT surgery heritage.
Determining the educational value of a technical and nontechnical skills medical student curriculum
2018, Journal of Surgical Research
Residency application rates to general surgery remain low. The purpose of this study is to describe the educational value of a curriculum designed to increase preclinical medical student interest in surgical careers to better understand the process by which medical students decide to pursue a career in surgery.
We used qualitative methodology to describe the educational value of a technical and nontechnical skills curriculum offered to preclinical medical students at our institution. We conducted semistructured interviews of students and instructors who completed the curriculum in 2016. The interviews were recorded, transcribed, and inductively coded. The data were analyzed for emergent themes.
A total of eight students and five instructors were interviewed. After analysis of 13 transcripts, four themes emerged: (1) The course provides a safe environment for learning, (2) acquisition and synthesis of basic technical skills increases preclinical student comfort in the operating room, (3) developing relationships with surgeons creates opportunities for extracurricular learning and scholarship, and (4) operative experiences can inspire students to explore a future career in surgery.
These factors can help inform the design of future interventions to increase student interest, with the ultimate goal of increasing the number of students who apply to surgical residency programs.

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Original articleAdult cardiacInspiring Medical Students to Pursue Surgical Careers: Outcomes From Our Cardiothoracic Surgery Research Program

Background

Methods

Results

Conclusions

Section snippets

Program Specifics

Results

Comment

Cardiothoracic surgery resident education: update on resident recruitment and job placement

Ann Thorac Surg

Are there enough jobs in cardiothoracic surgery?The Thoracic Surgery Residents Association job placement survey for finishing residents

Ann Thorac Surg

National Residency Matching ProgramMatch results statistics: thoracic surgery fellowship

How many lives did you save today?

Ann Thoracic Surg

Issues in the recruitment and success of women in academic surgery

Surgery

Original article
Adult cardiac
Inspiring Medical Students to Pursue Surgical Careers: Outcomes From Our Cardiothoracic Surgery Research Program