Brundage Susan I, Lucci Anthony, Miller Charles C, Azizzadeh Ali, Spain David A, Kozar Rosemary A
Department of Surgery, Stanford University Medical Center, Stanford, CA 94305, USA.
J Am Coll Surg. 2005 Jun;200(6):946-53. doi: 10.1016/j.jamcollsurg.2005.02.033.
Our goal was to identify factors that can be targeted during medical education to encourage a career in surgery.
We conducted a cross-sectional survey of first and fourth year classes in a Liaison Committee on Medical Education-accredited medical school. Students scored 19 items about perceptions of surgery using a Likert-type scale. Students also indicated their gender and ranked their top three career choices.
There were 121 of 210 (58%) first year and 110 of 212 (52%) fourth year students who completed the survey. First year students expressed a positive correlation between surgery and career opportunities, intellectual challenge, performing technical procedures, and obtaining a residency position, although length of training, work hours, and lifestyle during and after training were negatively correlated with choosing surgery. Fourth year student responses correlated positively with career and academic opportunities, intellectual challenge, technical skills, role models, prestige, and financial rewards. Factors that correlated negatively were length of training, residency lifestyle, hours, call schedule, and female gender of the student respondent. Forty-four percent of first year male students expressed an interest in surgery versus 27% of fourth year male students (p < 0.04). Eighteen percent of first year female students expressed an interest in surgery versus 5% of fourth year female students (p < 0.006).
Lifestyle issues remain at the forefront of student concerns. Intellectual challenge, career opportunities, and technical skills are consistently recognized as strengths of surgery. Additionally, fourth year students identify role models, prestige, and financial rewards as positive attributes. Emphasizing positive aspects may facilitate attracting quality students to future careers in surgery.
我们的目标是确定在医学教育过程中可以针对的因素，以鼓励学生从事外科职业。
我们对一所经医学教育联络委员会认证的医学院的一年级和四年级学生进行了横断面调查。学生们使用李克特量表对19项关于外科认知的项目进行评分。学生们还表明了自己的性别，并对他们的前三个职业选择进行了排名。
210名一年级学生中有121名（58%）、212名四年级学生中有110名（52%）完成了调查。一年级学生表示，外科与职业机会、智力挑战、进行技术操作以及获得住院医师职位之间存在正相关，尽管培训时长、工作时间以及培训期间和培训后的生活方式与选择外科呈负相关。四年级学生的回答与职业和学术机会、智力挑战、技术技能、榜样、声望和经济回报呈正相关。呈负相关的因素有培训时长、住院医师生活方式、工作时间、值班安排以及学生受访者的女性性别。44%的一年级男生表示对外科感兴趣，而四年级男生的这一比例为27%（p < 0.04）。18%的一年级女生表示对外科感兴趣，而四年级女生的这一比例为5%（p < 0.006）。
生活方式问题仍然是学生关注的首要问题。智力挑战、职业机会和技术技能一直被认为是外科的优势。此外，四年级学生将榜样、声望和经济回报视为积极因素。强调这些积极方面可能有助于吸引优秀学生投身未来的外科职业。
