Why are junior doctors deterred from choosing a surgical career?
Mary E. Rogers A D , Peter A. Creed B and Judy Searle CA Griffith Business School, Department of Employment Relations and Human Resources, Griffith University, Gold Coast Campus, Gold Coast, QLD 4222, Australia.
B School of Psychology, Griffith University, Gold Coast Campus, Gold Coast, QLD 4222, Australia. Email: p.creed@griffith.edu.au
C School of Medicine, Griffith University, Gold Coast Campus, Gold Coast, QLD 4222, Australia. Email: Judy.Searle@griffith.edu.au
D Corresponding author. Email: mary.rogers@griffith.edu.au
Submitted: 27 January 2011 Accepted: 21 September 2011 Published: 4 May 2012
Abstract
Objective. To identify the reasons why interns would not choose a surgical career.
Methods. This qualitative study used semi-structured telephone interviews to explore the future career choices of 41 junior doctors (14 men, 27 women). Doctors were asked to identify specialties they would not take up, and state why this was the case.
Results. Thirty (73.2%) of the 41 interns nominated surgery as a specialty they would not choose. Themes relating to reasons for not wanting to pursue a surgical career included the lifestyle associated with surgery (66.7%), the culture within the surgical work environment (53.3%), the lack of interest in performing surgical work (36.7%), and the training requirements associated with surgery (33.3%). Both sexes had similar reasons for not wanting to choose a surgical career; but additionally, women referred to the male domination of surgery, and the difficulty and inflexibility of the training program as deterrents.
Conclusions. Efforts are needed to promote interest in surgery as a career especially for women, to improve the surgical work environment so that medical students and junior doctors have exposure to positive role models and surgical placements, and to provide a more flexible approach to surgical training.
What is known about the topic? In Australia, there is an anticipated future shortage of surgeons, with acute shortages expected in some locations. Lifestyle issues are reported as the primary contributing factor.
What does this paper add? Little is known about Australian junior doctors’ perceptions of surgery as a possible specialty choice. The results of this qualitative study reveal that perceived lack of lifestyle, the culture within the surgical environment, the lack of interest in performing surgery, and concerns relating to the training program were the main disincentives to choosing a surgical career. These results add to the international literature in this area.
What are the implications for practitioners? To meet current and future workforce needs, educators need to be aware that positive role models and positive work environments are very important in attracting more medical students and graduates to choosing surgery as a career.
Additional keywords: career choice, deterrents, interns, surgery.
References
[1] Royal College of Surgeons of England. Developing a modern surgical workforce. London: RCSE; 2005. Available at http://www.rcseng.ac.uk [verified 1 September 2010].[2] Podnos Y, Cambell B, Wilson S. Patterns of graduating medical student career selections from 1993 to 1998 and their effect on surgery as a career choice. Arch Surg 1999; 134 876–81.
| Patterns of graduating medical student career selections from 1993 to 1998 and their effect on surgery as a career choice.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1MzntFCisA%3D%3D&md5=e4b3b6149e35130d4b4d8090deacc0c1CAS |
[3] Marschall JG, Karimuddin AA. Decline in popularity of general surgery as a career choice in North America: review of postgraduate residency training selection in Canada, 1996–2001. World J Surg 2003; 27 249–52.
| Decline in popularity of general surgery as a career choice in North America: review of postgraduate residency training selection in Canada, 1996–2001.Crossref | GoogleScholarGoogle Scholar |
[4] Brundage SI, Lucci A, Miller CC, Azizzadeh A, Spain DA, Kozar RA. Potential targets to encourage a surgical career. J Am Coll Surg 2005; 200 946–53.
| Potential targets to encourage a surgical career.Crossref | GoogleScholarGoogle Scholar |
[5] Royal Australasian College of Surgeons. The surgical workforce: 2005 census of the surgical workforce. East Melbourne, VIC: RACS; 2005. Available at http://www.surgeons.org/Content/NavigationMenu/CollegeResources/Publications/Activityreports/default.htm#wdp [verified 1 September 2010].
[6] Australian Medical Workforce Advisory Committee. The general surgery workforce in Australia. Sydney: AMWAC; 1997.
[7] Department of Health and Ageing. Medical training review panel twelfth annual report. Canberra, ACT: Attorney General’s Department; 2009.
[8] Creed PA, Searle J, Rogers ME. Medical specialty prestige and lifestyle preferences for medical students. Soc Sci Med 2010; 71 1084–8.
| Medical specialty prestige and lifestyle preferences for medical students.Crossref | GoogleScholarGoogle Scholar |
[9] Tambyraja AL, McCrea CA, Parks RW, Garden OJ. Attitudes of medical students toward careers in general surgery. World J Surg 2008; 32 960–3.
| Attitudes of medical students toward careers in general surgery.Crossref | GoogleScholarGoogle Scholar |
[10] Evans J, Goldacre MJ, Lambert TW. Views of UK medical graduates about flexible and part-time working in medicine: a qualitative study. Med Educ 2000; 34 355–62.
| Views of UK medical graduates about flexible and part-time working in medicine: a qualitative study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c3itlKluw%3D%3D&md5=37cae02b0dcf970c0defbd4afd12abd8CAS |
[11] Dorsey ER, Jarjoura D, Rutecki GW. The influence of controllable lifestyle and sex on the specialty choices of graduating U.S. medical students, 1996–2003. Acad Med 2005; 80 791–6.
| The influence of controllable lifestyle and sex on the specialty choices of graduating U.S. medical students, 1996–2003.Crossref | GoogleScholarGoogle Scholar |
[12] Tolhurst HM, Stewart SM. Balancing work, family and other lifestyle aspects: a qualitative study of Australian medical students’ attitudes. Med J Aust 2004; 181 361–4.
[13] Wendel TM, Godellas CV, Prinz RA. Are there gender differences in choosing a surgical career? Surgery 2003; 134 591–6.
| Are there gender differences in choosing a surgical career?Crossref | GoogleScholarGoogle Scholar |
[14] Saalwachter AR, Freischlag JA, Sawyer RG, Sanfrey HA. Part-time training in general surgery. Arch Surg 2006; 141 977–82.
| Part-time training in general surgery.Crossref | GoogleScholarGoogle Scholar |
[15] Baxter N, Cohen R, McLeod R. The impact of gender on the choice of surgery as a career. Am J Surg 1996; 172 373–6.
| The impact of gender on the choice of surgery as a career.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2s%2Fisleqtg%3D%3D&md5=955910887b9aedbb5b3369ed8e309364CAS |
[16] Gabram SGA, Allen LW, Deckers PJ. Surgical residents in the 1990s: issues and concerns for men and women. Arch Surg 1995; 130 24–8.
| Surgical residents in the 1990s: issues and concerns for men and women.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2M7gtVyltg%3D%3D&md5=3978165297ee2bde572478b06b806c29CAS |
[17] Park J, Minor S, Taylor RA, Vikis E, Poenaru D. Why are women deterred from general surgery training? Am J Surg 2005; 190 141–6.
| Why are women deterred from general surgery training?Crossref | GoogleScholarGoogle Scholar |
[18] Walters BC. Why don’t more women choose surgery as a career? Acad Med 1993; 68 350–1.
| Why don’t more women choose surgery as a career?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3s3kvFGnsA%3D%3D&md5=253cbc000a344cd9fbb6d3d4d13dc610CAS |
[19] Reed VA, Buddeberg-Fischer B. Career obstacles for women in medicine: an overview. Med Educ 2001; 35 139–47.
| Career obstacles for women in medicine: an overview.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M3gsVWksw%3D%3D&md5=7c76db0bd35e0e87cc43390855ff9146CAS |
[20] Gargiulo DA, Hyma NH, Hebert JC. Women in surgery: do we really understand the deterrents? Arch Surg 2006; 141 405–8.
| Women in surgery: do we really understand the deterrents?Crossref | GoogleScholarGoogle Scholar |
[21] Williams C, Cantillon P. A surgical career? The views of junior women doctors. Med Educ 2000; 34 602–7.
| A surgical career? The views of junior women doctors.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3cvjtVCqsQ%3D%3D&md5=bf1bd19123719f34a03dbc9145ac8108CAS |
[22] Ek EW, Ek ET, Mackay SD. Undergraduate experience of surgical teaching and its influence on career choice. ANZ J Surg 2005; 75 713–8.
| Undergraduate experience of surgical teaching and its influence on career choice.Crossref | GoogleScholarGoogle Scholar |
[23] Gjerberg E. Gender similarities in doctors’ preferences - and gender differences in final specialisation. Soc Sci Med 2002; 54 591–605.
| Gender similarities in doctors’ preferences - and gender differences in final specialisation.Crossref | GoogleScholarGoogle Scholar |
[24] Royal Australasian College of Surgeons. Women in surgery. East Melbourne, VIC: RACS; 2010. Available at http://www.surgeons.org/Content/NavigationMenu/FellowshipandStandards/FellowshipServices/WomeninSurgery/default.htm [verified 1 September 2010].
[25] Australian Government. Medical training review panel twelfth annual report. Canberra: Department of Health and Ageing; 2009. Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/E0919C9B7F532639CA2575B4000DA4E4/$File/mtrp12cov.pdf [verified 1 September 2010].
[26] Australian Medical Association. AMA work-life flexibility survey. Kingston, ACT: Australian Medical Association; 2008.
