# The Current State of Surgical Interest Amongst Rural Junior Doctors and Medical Students

## TL;DR

This study finds that interest in surgical careers declines as medical students and junior doctors gain experience, especially in rural areas, and highlights the importance of early engagement.

## Contribution

The study identifies baseline surgical interest as a key predictor of future interest and emphasizes early intervention in rural medical training.

## Key findings

- Interest in surgery declines as training progresses from student to junior doctor.
- Baseline surgical interest is the strongest predictor of increased interest after a surgical rotation.
- Rural upbringing is linked to a higher likelihood of returning to rural practice.

## Abstract

Background

Over recent years, there has been a declining interest in the pursuit of a surgical career by medical students and junior doctors. There is a present need to actively foster interest in surgical careers, which is especially true in the rural setting. The aim of this study was to determine the current level of interest in a surgical career amongst medical students and junior doctors and identify factors that may influence desires to pursue a surgical career.

Methods

In this cross-sectional study, a survey was distributed to medical students and junior doctors in their final week of placement on a surgical term at a major surgical referral centre in regional Australia. Questions regarding participants’ interest in a surgical career, self-reported engagement with operating theatres, subjective opinions on barriers and enablers of surgical careers were asked. Survey responses were assessed on a five-point Likert scale.

Results

A total of 69 participants completed the survey, including 30 students (43.5%) and 39 junior doctors (56.5%). As training level increased from medical student to junior doctor, interest in surgery declined (OR = 0.51, 95% CI: 0.35 - 0.71, p < 0.001). A perception of bad work-life balance was reported as a negatively contributing factor by 91% of participants. Engagement in the operating theatres, baseline surgical interest, and being a medical student were associated with a statistically significant positive change in surgical interest. Multivariable analysis showed that baseline surgical interest was the only predictor of positive change in surgical interest. Students and doctors who grew up in a rural setting were significantly more likely to express desires to return to a rural setting for long-term practice (Wilcoxon rank-sum test: W=389, p = 0.01)

Conclusion

Baseline surgical interest is a strong predictor of a positive change in surgical interest following a surgical rotation. Surgical interest appears to decline as students and junior doctors progress through their training, highlighting the necessity to instil interest at an early stage in their medical careers.