Bucknor Alexandra, Pedreira Rachel, Bhat Deepa, Zamani Maryam, Nugent Nora, Furnas Heather J
From the Regional Plastic, Maxillofacial and Burn Unit, Hutt Hospital, New Zealand.
Division of Plastic and Reconstructive Surgery, Department of Surgery Stanford University, Palo Alto, Calif.
Plast Reconstr Surg Glob Open. 2024 Oct 28;12(10):e6224. doi: 10.1097/GOX.0000000000006224. eCollection 2024 Oct.
Currently, interest in surgical careers is declining globally, whereas aging populations are contributing to a rising demand for surgical procedures. Surgeons who conduct scientific investigations and share clinical advances internationally pay little attention to comparing differences in ways nations attract, educate, and train their surgeons. This study compares international pathways toward surgeon development with the aim of seeking best practices and improving the outlook of surgery as an attractive career.
A 70-question anonymous survey was distributed internationally to surgeons of all specialties. Data were analyzed in SPSS Statistics for Macintosh (IBM). A value of less than 0.05 indicates statistical significance.
The 463 respondents from the United States (59%), the United Kingdom (16%), Europe (10%), Canada (5%), and the rest of the world (10%) averaged age 46, and 64% were women. Non-US/Canadian respondents (93%) attended 5- and 6-year medical schools; US respondents were far more likely (91%) to attend nonmedical 4-or-more-year university before medical school. Weekly training-hour mandates spanned less than or equal to 48 (9%) to 80 or more (45%); 76% surpassed mandate hours, and just 9% reported accurate hours. Average educational debt ranged from $14,000 (Europe) to $179,000 (US). Few (19%) felt training allowed family building.
Based on best practices from different countries, the authors recommend a 6-year maximum university/medical education requirement, elimination of nonsurgical training years (mandatory in some countries), single-program surgical training, objective measure of work hours, optimizing weekly hours, improved support for family building, and end-of-training certification options.
目前，全球对外科职业的兴趣正在下降，而人口老龄化导致对外科手术的需求不断上升。开展科学研究并在国际上分享临床进展的外科医生很少关注比较各国吸引、教育和培训外科医生方式的差异。本研究比较了国际上培养外科医生的途径，旨在寻求最佳实践并改善外科作为一个有吸引力职业的前景。
向所有专业的外科医生在国际范围内发放了一份包含70个问题的匿名调查问卷。数据在适用于Macintosh的SPSS Statistics（IBM）中进行分析。小于0.05的值表示具有统计学意义。
来自美国（59%）、英国（16%）、欧洲（10%）、加拿大（5%）和世界其他地区（10%）的463名受访者平均年龄为46岁，64%为女性。非美国/加拿大受访者（93%）就读于5年制和6年制医学院；美国受访者在医学院之前更有可能（91%）就读于非医学类的4年制或更长学制的大学。每周培训时长要求从小于或等于48小时（9%）到80小时或更长时间（45%）不等；76%的人超过了规定时长，只有9%的人报告的时长准确。平均教育债务从14,000美元（欧洲）到179,000美元（美国）不等。很少有人（19%）觉得培训允许他们组建家庭。
基于不同国家的最佳实践，作者建议大学/医学教育的最长年限为6年，取消非外科培训年限（在一些国家是强制性的），进行单一项目的外科培训，客观衡量工作时长，优化每周工作时长，改善对组建家庭的支持，以及提供培训结束时的认证选项。
