Factors Affecting Turkish Medical Students' Pursuit of a Career in Neurosurgery: A Single Center Survey Study.

BACKGROUND: Statistics show that over the past 2 decades, even in high-income countries, fewer and fewer students have listed neurosurgery as their top career option. Literature on medical students' pursuit of neurosurgical careers in middle- and low-income countries are scarce. The aim of this research, conducted in Turkey with a middle-income economy, was to contribute insights relevant to medical education and neurosurgery across the world. METHODS: A survey was conducted with a target sample of fourth-year (167 students), fifth-year (169 students), and sixth-year (140 students) medical students (476 in total) from the Medical School at Istanbul Medeniyet University in Turkey. The response rates of the fourth-, fifth-, and sixth-year students were 62% (104/167), 53% (90/169), and 50% (70/140), respectively (in total, 266, including 147 female and 119 male). RESULTS: In terms of the genuine intention, only 2.5% of men and 2.7% of women were committed to specializing in neurosurgery. This study further revealed that possible reasons for these students' low motivation to specialize in neurosurgery were their beliefs that in neurosurgery, the physical and psychological demands were high, and the night shifts were intense, meaning they would not have a social life or spare time for their hobbies; that morbidity/mortality were high; and that financial incentives were insufficient, especially in public institutions. CONCLUSION: Turkish medical students did not rank neurosurgery at the top of their career choices. Possible reasons for this are socioeconomic factors and the inadequate introduction of neurosurgery to medical students.

The radiological evaluation process of the potential live kidney donor assessment programme at al-Shifa Hospital: study and clinical audit.

BACKGROUND: In 2013, al-Shifa Hospital, the largest hospital in the Gaza Strip, introduced an assessment programme for potential kidney donors on the basis of medical and radiological evaluation. The aims of this study and an associated clinical audit were to examine the final outcome of the potential live kidney donors assessment programme, to review the findings and determine the level of accuracy of the radiological evaluations, to assess the completeness and standard of radiological record keeping, and to evaluate adherence to guidelines. METHODS: Donor assessment files were retrieved from the kidney transplant database in the renal department of al-Shifa Hospital. Patients who had surgery outside the Gaza Strip were excluded. Delivery of the assessment programme was assessed according to British Transplantation Society guidelines. Radiological investigations were reviewed. The head of the radiological department was interviewed to provide additional information about the approach to assessing donors and current challenges. FINDINGS: We retrieved files for 35 potential live kidney donors (mean age 36·82 years [range 23-54]). 32 (91%) donors had a nephrectomy, 33 (94%) donors were directed donors, and the type of donor donation was unknown for two (6%) donors. 24 (69%) donors were women, and 11 (31%) were men. 24 (69%) donors had CT angiography imaging reports as part of their pre-surgical evaluation. Digital access to those reports was limited and inefficient. Radiological assessments of renal parenchymal and renal anatomy and variants were made in 96% of cases. Of the 24 donors whose CT angiography imaging reports were retrieved, the excretory system was assessed in 16 (67%) donors, the presence of nephrolithiasis was assessed in 12 (50%) donors, and parenchymal disease was found in one (4%) donor. INTERPRETATION: The potential live kidney donors assessment programme requires improvement to achieve an organised, consistent, and comprehensive radiological approach to assist clinical decisions, research, and quality assurance. We recommend using the latest radiology management system for an efficient workflow that can provide economical storage and convenient and timely access to images, interpretation, and digital transmission (eg, the Picture Archiving and Communication system). FUNDING: None.