Schmidt Lauren E, Cooper Clairice A, Guo Weidun Alan
Department of Surgery, SUNY-Buffalo, Buffalo, New York.
Department of Surgery, SUNY-Buffalo, Buffalo, New York.
J Surg Res. 2016 Jun 1;203(1):64-74. doi: 10.1016/j.jss.2016.03.054. Epub 2016 Mar 31.
Interest and applications to surgery have steadily decreased over recent years in the United States. The goal of this review is to collect the current literature regarding US medical students' experience in surgery and factors influencing their intention to pursue surgery as a career. We hypothesize that multiple factors influence US medical students' career choice in surgery.
Six electronic databases (PubMed, SCOPUS, Web of Science, Education Resources Information Center, Embase, and PsycINFO) were searched. The inclusion criteria were studies published after the new century related to factors influencing surgical career choice among US medical students. Factors influencing US medical student surgical career decision-making were recorded. A quality index score was given to each article selected to minimize risk of bias.
We identified 38 relevant articles of more than 1000 nonduplicated titles. The factors influencing medical student decision for a surgical career were categorized into five domains: mentorship and role model (n = 12), experience (clerkship n = 9, stereotype n = 4), timing of exposure (n = 9), personal (lifestyle n = 8, gender n = 6, finance n = 3), and others (n = 2).
This comprehensive systemic review identifies mentorship, experience in surgery, stereotypes, timing of exposure, and personal factors to be major determinants in medical students' decisions to pursue surgery. These represent areas that can be improved to attract applicants to general surgery residencies. Surgical faculty and residents can have a positive influence on medical students' decisions to pursue surgery as a career. Early introduction to the field of surgery, as well as recruitment strategies during the preclinical and clinical years of medical school can increase students' interest in a surgical career.
近年来，美国对外科手术专业的兴趣和申请人数持续下降。本综述的目的是收集有关美国医学生外科手术经历以及影响他们将外科手术作为职业选择意向的因素的当前文献。我们假设多种因素影响美国医学生对外科手术职业的选择。
检索了六个电子数据库（PubMed、SCOPUS、科学网、教育资源信息中心、Embase和PsycINFO）。纳入标准为新世纪后发表的与影响美国医学生外科手术职业选择因素相关的研究。记录影响美国医学生外科手术职业决策的因素。为所选的每篇文章给出质量指数评分，以尽量减少偏倚风险。
我们从1000多个非重复标题中识别出38篇相关文章。影响医学生选择外科手术职业的因素分为五个领域：导师指导和榜样（n = 12）、经历（临床实习n = 9、刻板印象n = 4）、接触时机（n = 9）、个人因素（生活方式n = 8、性别n = 6、经济状况n = 3）以及其他因素（n = 2）。
这项全面的系统综述确定了导师指导、外科手术经历、刻板印象、接触时机和个人因素是医学生选择外科手术职业的主要决定因素。这些是可以改进的领域，以吸引申请人进入普通外科住院医师培训项目。外科教员和住院医师可以对医学生选择外科手术作为职业的决策产生积极影响。在医学院校的临床前和临床阶段尽早引入外科领域以及采用招募策略，可以提高学生对外科手术职业的兴趣。
