Berman Loren, Rosenthal Marjorie S, Curry Leslie A, Evans Leigh V, Gusberg Richard J
Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, New Haven, CT 06511, USA.
J Am Coll Surg. 2008 Dec;207(6):793-800, 800.e1-2. doi: 10.1016/j.jamcollsurg.2008.08.003. Epub 2008 Sep 27.
Declining interest in careers in surgery among medical students has contributed to growing concerns about the surgical workforce. Although the medical student clerkship is likely to play an important role in shaping students' impressions of careers in surgery, little is known about the nature of this process. This study was designed to identify those aspects of the clerkship that are associated with medical students expressing an interest in surgery at the end of the clerkship.
Medical students completed a survey at the end of the surgical clerkship assessing characteristics of the clerkship experience and students' level of interest in pursuing a career in surgery. The survey also included open-ended questions about students' reasons for having increased or decreased interest in surgery, which were systematically analyzed to complement quantitative findings.
Students who sutured (p = 0.001), drove the camera (p = 0.01), stated that they felt involved in the operating room (p = 0.009), and saw residents (p = 0.03) and attendings (p = 0.0003) as positive role models were more likely to be interested in surgery. After adjusting for covariates, students who sutured in the operating room were 4.8 times as likely to be interested in surgery (95% CI, 1.5 to 14.9) and students who drove the camera were 7.2 times as likely to be interested in surgery (95% CI, 1.1 to 46.8).
Students who participate actively in the operating room and those who are exposed to positive role models are more likely to be interested in pursuing a career in surgery. To optimize students' clerkship experiences and attract top candidates to the field of surgery, clerkship directors should encourage meaningful engagement of students in the operating room and facilitate mentoring experiences.
医学生对外科职业的兴趣下降引发了人们对外科医生队伍的日益担忧。尽管医学生临床实习可能在塑造学生对外科职业的印象方面发挥重要作用,但对于这一过程的本质却知之甚少。本研究旨在确定临床实习中与医学生在实习结束时表达对外科的兴趣相关的那些方面。
医学生在外科临床实习结束时完成一项调查,评估临床实习经历的特征以及学生追求外科职业的兴趣水平。该调查还包括关于学生对外科兴趣增加或减少原因的开放式问题,对这些问题进行系统分析以补充定量研究结果。
进行缝合操作的学生(p = 0.001)、操作摄像头的学生(p = 0.01)、表示感觉自己参与到手术室工作中的学生(p = 0.009),以及将住院医师(p = 0.03)和主治医生(p = 0.0003)视为正面榜样的学生,更有可能对外科感兴趣。在对协变量进行调整后,在手术室进行缝合操作的学生对外科感兴趣的可能性是其他学生的4.8倍(95%置信区间,1.5至14.9),而操作摄像头的学生对外科感兴趣的可能性是其他学生的7.2倍(95%置信区间,1.1至46.8)。
积极参与手术室工作以及接触正面榜样的学生更有可能对从事外科职业感兴趣。为了优化学生的临床实习体验并吸引顶尖人才投身外科领域,临床实习主任应鼓励学生在手术室进行有意义的参与,并促进指导体验。