Minor Samuel, Park Jason, Belliveau Paul, Walker Ross
Department of Surgery, Queen's University, Kingston General Hospital, 76 Stuart Street, Kingston, Ontario, K7L 2V7, Canada.
World J Surg. 2007 Mar;31(3):607-11; discussion 612. doi: 10.1007/s00268-006-0267-2.
Lifestyle has been identified by numerous studies as the number one deterrent to pursuing a career in general surgery. This study tests the hypothesis that a better lifestyle during general surgery clerkship correlates with a higher application rate to general surgery.
Canadian Residency Matching Service data from the past 10 years were used to identify institution-specific application rates to general surgery. Through a survey of all fourth-year medical students applying to general surgery in Canada and Canadian undergraduate surgery program directors, the lifestyle of each general surgery clerkship was described and given a score.
Multiple descriptions of the clerkship structure were obtained for every school in Canada to reduce recall bias, with an average of 4 sources per program. One school stood out as the most prolific producer of general surgery applicants, with an average of 7.9% of the total class applying to general surgery each year. This represented 80% more general surgery applicants relative to the national average (p < 0.05). Surprisingly, however, this institution also had the worst clerkship lifestyle score, having a higher call requirement, not sending their clerks home at noon post call, and placing a higher burden of responsibility on their clerks.
This study suggests that a lifestyle-friendly surgical clerkship may not be necessary to increase recruitment into general surgery.
众多研究已确定生活方式是阻碍人们从事普通外科职业的首要因素。本研究检验了这样一个假设，即在普通外科实习期间拥有更好的生活方式与更高的普通外科申请率相关。
使用过去10年加拿大住院医师匹配服务的数据来确定各机构的普通外科申请率。通过对所有申请加拿大普通外科的四年级医学生以及加拿大本科外科项目主任进行调查，描述了每个普通外科实习的生活方式并给出了分数。
为减少回忆偏倚，从加拿大的每所学校获得了对实习结构的多种描述，每个项目平均有4个信息来源。有一所学校脱颖而出，成为普通外科申请者最多的学校，每年平均有7.9%的班级学生申请普通外科。相对于全国平均水平，该校的普通外科申请者多出80%（p<0.05）。然而，令人惊讶的是，该机构的实习生活方式得分也是最差的，有更高的值班要求，值班后中午不让实习医生回家，并且给实习医生安排了更重的责任负担。
本研究表明，对生活方式友好的外科实习对于增加普通外科的招生人数可能并非必要。
