Medical College, Aga Khan University, Behind Aga Khan Hospital, Karachi, Pakistan.
J Surg Educ. 2010 Jul-Aug;67(4):237-48. doi: 10.1016/j.jsurg.2010.05.006.
Declining trends in surgery have been well-researched in the North American region, but little is known about the international dynamics affecting this phenomenon. A comprehensive approach to this emerging issue is lacking.
Our objective in this study is to explore global trends related to medical student interest in surgical careers. We will also identify factors influencing the choice of surgery as a career and outline practical interventions to nurture interest in these fields, as described in the literature.
We present a focused review of worldwide trends of surgical career selection among medical students of geographically distant and diverse sociocultural backgrounds. A systematic literature search was performed using PubMed. The studies were conducted over the last fifteen years with the study populations scattered over 6 continents.
North American studies have shown a declining trend for medical students to select surgery as a career, but a recent recovery has been observed. However, surgery is still the popular choice of career among Middle Eastern and Far-Eastern Asian men. Sociocultural variants and personal satisfaction are likely influential factors with financial rewards being the least significant. Surgery is also popular in Nigeria despite their increased awareness of risk of HIV/AIDS associated with surgery. A decline in surgery has been observed in Australia, New Zealand, and South Africa. Medical students and graduates of Greece, Switzerland, and the UK mostly prefer nonsurgical careers. Multiple extrinsic and intrinsic factors appear to play a role for such a phenomenon. Specific interventions are now being used to create a rebound effect for such a declining trend observed in most of the regions worldwide.
Global trends show a variation of interest in surgery as a career option throughout the 6 continents. Possible factors affecting this phenomenon are similar among geographically distant and diverse student cultures.
在北美地区，针对手术数量下降的趋势已有大量研究，但对于影响这一现象的国际动态却知之甚少。对于这一新兴问题，目前还缺乏全面的研究方法。
本研究旨在探讨全球范围内医学生对外科职业兴趣的变化趋势。我们还将确定影响选择外科职业的因素，并概述文献中描述的培养对这些领域兴趣的实际干预措施。
我们对来自地理上遥远和不同社会文化背景的医学生选择外科职业的全球趋势进行了重点综述。使用 PubMed 进行了系统的文献检索。这些研究在过去十五年中进行，研究人群分布在六大洲。
北美地区的研究表明，选择外科作为职业的医学生数量呈下降趋势，但最近有所回升。然而，外科仍然是中东和远东亚洲男性最受欢迎的职业选择。社会文化差异和个人满意度可能是影响因素，而经济回报的影响最小。尽管尼日利亚对与手术相关的 HIV/AIDS 风险的认识有所提高，但手术仍然很受欢迎。澳大利亚、新西兰和南非的手术数量也有所下降。希腊、瑞士和英国的医学生和毕业生大多选择非外科职业。多种外在和内在因素似乎对这种现象起到了作用。目前正在采取具体的干预措施，以扭转全球大部分地区观察到的这种下降趋势。
全球趋势显示，在六大洲，对外科职业的兴趣存在差异。影响这一现象的可能因素在地理上遥远和多样化的学生文化中是相似的。
