The future of general surgery in Ireland: factors influencing career decisions of medical students

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ORIGINAL ARTICLE

The future of general surgery in Ireland: factors influencing career decisions of medical students Kevin Gerard Corless 1 & Amir Samy 1 & Ahmed Kamil 1 & Eanna J. Ryan 1 & Lidia Shafik 2 & Kirolos Bassily 3 & A. Basil Ali 4 & Kaitlynn O’Brien 5 & Aisling Maria Hogan 1 Received: 18 June 2020 / Accepted: 13 August 2020 # Royal Academy of Medicine in Ireland 2020

Abstract Introduction The decline in popularity of general surgery as a career has been well described. A number of factors have been put forward to explain this, for example, trainee burnout and perceived difficulty with work/life balance. The aim of this study was to elucidate the reasons for this among medical students in Ireland. Method A questionnaire was distributed to clinical year medical students in Ireland using an online survey via SurveyMonkey™. Domains assessed included demographics, career plan and associated rationale. Anonymised responses were collated and evaluated. Results There were 307 responses (response 23%). Females accounted for 66% (202). Mean age was 24 years (SD = 2.89). One hundred twelve responses (36%) were contemplating becoming surgeons. One hundred nine-five responses were not considering surgery: however 87 had previously considered. Of the 87, 41 (47%) attributed the decision to work/life balance, 30 (35%) to impact on personal relationships and 10 (11%) blamed unclear career projection. Students interested in surgery were asked to quantify their knowledge of the application process—17 (15%) good, 39 (35%) fair and 56 (50%) poor. Conclusion A small proportion of respondents plan to pursue a career in general surgery. This is concerning in view of attrition rates through junior years. Although lifestyle factors are significant, clarity regarding training pathways was also reported. Undergraduate education regarding career trajectory, quality of life and practicalities of a career in general surgery may increase applications. Keywords General surgery . Medical students . Surgical education . Surgical training

Introduction Surgical healthcare provision in the modern era requires dynamic, highly motivated trainees to adequately staff the service and to ensure that there are sufficient qualified candidates to assume consultant positions in the future. With the

* Kevin Gerard Corless [email protected] 1

Department of Surgery, University Hospital Galway, Galway, Ireland

2

Medical School, National University of Ireland Galway, Galway, Ireland

3

Medical School, University of Limerick, Limerick, Ireland

4

Medical School, Royal College of Surgeons Ireland, Dublin, Ireland

5

Medical School, Trinity College Dublin, Dublin, Ireland

increasing Irish population, there is an increase in the number of surgeons required, particularly general surgeons [1]. There has been a widely reported difficulty in the Irish healthcare system to recruit adequate consultant numbers to meet patient demands, with 2777 of 3323 consultant posts in Ireland being filled, with 164 of 184 general surgical consultant posts filled [2