From the Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ont. (McKechnie); the Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Springer, Doumouras, Schroeder, Eskicioglu, Reid); the Division of General Surgery, Department of Surgery, St. Joseph Healthcare, Hamilton, Ont. (Doumouras, Eskicioglu); and the Division of General Surgery, Department of Surgery, Juravinski Hospital, Hamilton, Ont. (Reid).
Can J Surg. 2021 Mar 19;64(2):E183-E190. doi: 10.1503/cjs.018019.
The number of Canadian Residency Matching Service (CaRMS) applicants ranking surgical specialties as their first choice has declined over the past 20 years; concurrently, there has been a reduction in the number of hours spent teaching undergraduate medical education (UGME) anatomy, particularly with cadaveric dissection. The aim of this study was to determine the factors that most influence selection of a surgical specialty, with specific focus on the impact of UGME anatomy training.
A 36-item cross-sectional survey was designed by experts in medical education and distributed to all current surgical residents in Canada in October 2018. Responses were recorded on a 5-point Likert scale or by means of list ranking. We analyzed univariable outcomes with a t test for continuous outcomes and the χ2 test for dichotomous outcomes.
Of 1493 surgical residents, 228 responded to the survey (response rate 15.3%). Respondents reported experiences on core rotations and elective rotations, and access to a mentor as the most important factors in deciding to pursue a surgical residency. Anatomy training with or without cadaveric dissection was moderately influential in respondents' first-choice CaRMS discipline (mean Likert scale score 2.97 [standard deviation (SD) 1.34] and 2.87 [SD 1.26], respectively). General surgery residents' CaRMS applications were more likely to have been influenced by UGME anatomy training than the applications by residents in other surgical specialties (p < 0.001). The impact of UGME anatomy training did not vary between postgraduate years or between male and female residents.
Canadian surgical residents' decision to apply to a surgical specialty did not seem to be strongly influenced by their UGME anatomy training, with or without cadaveric dissection, but, rather, by factors such as clinical experience and surgical mentorship. Further evaluation of groups that were more positively affected by their UGME anatomy training is warranted.
在过去的 20 年中，加拿大住院医师匹配服务（CaRMS）申请将外科专业列为首选的人数有所下降；与此同时，本科医学教育（UGME）解剖学的教学时间，特别是使用尸体解剖的教学时间减少了。本研究旨在确定影响选择外科专业的最重要因素，重点关注 UGME 解剖学培训的影响。
由医学教育专家设计了一份 36 项的横断面调查，并于 2018 年 10 月分发给加拿大所有现任外科住院医师。调查结果采用 5 分制 Likert 量表或列表排名记录。我们使用 t 检验分析连续变量，使用 χ2 检验分析二分类变量，对单变量结果进行分析。
在 1493 名外科住院医师中，有 228 名（应答率为 15.3%）对调查做出了回应。受访者报告了核心轮转和选修轮转的经历，以及获得导师的机会是决定从事外科住院医师的最重要因素。是否有尸体解剖的解剖学培训对受访者的 CaRMS 首选学科具有中等影响力（平均 Likert 量表评分分别为 2.97（标准差 [SD] 1.34）和 2.87（SD 1.26））。与其他外科专业的住院医师相比，普通外科住院医师的 CaRMS 申请更有可能受到 UGME 解剖学培训的影响（p < 0.001）。UGME 解剖学培训的影响在研究生年限或男女住院医师之间没有差异。
加拿大外科住院医师申请外科专业的决定似乎并未受到 UGME 解剖学培训的强烈影响，无论是否有尸体解剖，而是受到临床经验和外科指导等因素的影响。需要进一步评估那些受到 UGME 解剖学培训更大影响的群体。
