ReviewTrends of Surgical Career Selection Among Medical Students and Graduates: A Global Perspective
Introduction
Declining trends in surgery have been well-researched in the North American region, but little is known about the international dynamics and factors affecting this phenomenon. A comprehensive approach to this emerging issue is lacking. The goal of this paper is to review the global trends of medical students' and graduates' interest in surgical careers, and identify factors influencing these choices with practical interventions from the current literature. We have included available worldwide evidence that addresses this issue based on the selection criteria as shown in Fig. 1.
An advanced search was performed in PubMed with the phrases “career in surgery AND medical students OR postgraduates AND factors in surgery.” Limits were applied on type of article as Journal Article, and on dates as 1 January 1996 through 31 April 2010 (studies conducted within the last 15 years).
The search returned 114 articles. These were narrowed down by going through each study and its location (subsequently categorized according to the 6 continents: Asia, Africa, Australasia, Europe, and North and South America).
Section snippets
Trends from Asia
In the Middle East, a study done among the medical students of a university in the Kingdom of Jordan (Table 1, 1.1.1) identified general surgery and obstetrics and gynecology as the most preferred specialty among male and female students, respectively. The 2 most influential factors affecting their career selection were intellectual content of the specialty and individual competencies. Jordanian male students preferred surgery based on the lifestyle determinants, such as flexibility of
Extrinsic Factors Affecting Surgical Career Selection (TABLE 2)
Intrinsic Factors Affecting Surgical Career Selection (TABLE 3)
Discussion
Although Asia contributes significantly to the global population, there are relatively few studies based in Asia addressing our area of interest. Existing data suggest that surgical careers are popular among Asian male medical students while obstetrics and gynecology is the popular choice among females.1, 2, 3, 5 This trend may be accounted by the fact that Asian countries in specific geographic regions share similar cultures.
In the South Asian economies and Middle East, most male medical
Conclusions
Global trends show a variation of interest in surgical careers throughout the 6 continents. Studies suggest declining popularity of surgery for the most part with the exception of Greece, Jordan, and Nigeria with a relative rebound seen in the United States.
Possible factors affecting this phenomenon are similar among geographically distant and diverse student cultures. Direct patient care, immediate intervention, and personal interest are the most common positive influential factors. Family
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2020, American Journal of SurgeryCitation Excerpt :These trends are arguably worrisome as they forebode a decrease in the pool and quality of applicants for surgical training programs, and may potentially lead to future shortfalls in certain specialties.6 Interestingly, preferences for medical specializations appear to vary across races, with medical students of Caucasian descent less likely to indicate interest in surgical careers as compared to their Asian counterparts.1–5 These ethnic disparities are certainly peculiar, and detailed investigations may afford unique insights that can help to shape current ideas regarding the drivers of declining surgical interests worldwide, and also inform medical education policies in Asian countries.