Does Global Surgery Interest Influence the Choice of Surgical Residency Program?

OBJECTIVE: Medical students actively seek global health opportunities. Surgical residents also show great enthusiasm for international missions, rotations and global surgery. Unfortunately, only 18% to 34% of all surgery residency programs offer such international opportunities. We surveyed fourth year medical students applying for surgery residency to determine if international surgery opportunities offered by a program would influence their match rank list. DESIGN: A 20 question survey was given to interviewees at our surgery residency program. Survey was optional and anonymous. We queried prior volunteerism, interest in global surgery and importance of international opportunities offered during residency. SETTING: Hackensack University Medical Center, Hackensack New Jersey PARTICIPANTS: All candidates interviewing for general surgery residency at Hackensack University Medical Center from October 2019 to January 2020. RESULTS: A total of 97 fourth year medical students interviewed, with a 66% response rate to the survey. Mean age was 27 years. 92% of students had volunteered during college and/or medical school. 41% of students had volunteered internationally. Majority of students were interested in a surgery residency program offering international opportunity. 78% of students planned to volunteer internationally after residency, and two-thirds planned to include global surgery in future career. Half of the students reported they would rank a residency program higher if it offered an international opportunity. Students who were immigrants were significantly more likely to rank a program higher in the match if an international opportunity was offered, compared to students born in the US (p < 0.05). CONCLUSIONS: There is great interest in global surgery and international volunteer opportunities amongst fourth year medical students who apply for surgery residency. The majority of applicants have prior volunteer experience either locally or abroad. Majority of students plan to volunteer internationally after residency and are interested in academic global surgery careers. Students will rank surgery residency programs that offer international opportunities higher in the match.

Surgery resident participation in short-term humanitarian international surgical missions can supplement exposure where program case volumes are low.

BACKGROUND: General surgery training programs face declining case volume and diversity. We wanted to determine if resident participation in international surgical missions would increase exposure to cases underrepresented in our program case mix. METHODS: Accreditation Council for Graduate Medical Education program data from 2008 to 2011 (University of Medicine and Dentistry-New Jersey Medical School, Newark, NJ) were analyzed to identify categories where volume was below national average. This was compared with case logs from 3 missions conducted by International Surgical Health Initiatives between 2011 and 2012. RESULTS: All chief residents completed more than minimum required index cases. Categories head and neck, alimentary tract, abdomen, and endocrine showed percentile below national average. Seven residents participated in 3 missions to Philippines and Sierra Leone. Sixty-five percent of the operations performed were in the 4 low-volume categories. CONCLUSIONS: International surgery missions expose residents to a high volume and variety of cases. Participation can be one way to increase case volume and diversity during training. Cases completed on missions with board certified surgeons should be considered for Accreditation Council for Graduate Medical Education credit.

Increasing educational indebtedness influences medical students to pursue specialization: a military recruitment potential?

BACKGROUND: Cost of medical education and student indebtedness has increased dramatically. This study surveyed medical students on educational debt, educational costs, and whether indebtedness influenced career choice. Responses should impact (1) Department of Defense (DoD) recruitment of physicians and (2) future of primary care. METHOD: The authors surveyed 188 incoming medical students (University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Class of 2012) concerning educational indebtedness, perceptions about educational costs, and plans regarding loan repayment. Data were analyzed and expressed as mean +/- standard error. RESULTS: Students with loans anticipated their medical educational costs to be $155,993. 62% felt costs were "exorbitant," and 28% "appropriate." 64% planned to specialize, whereas only 9% chose primary care. 28% of students planning specialization said income potential influenced their decision. 70% of students said cost was a factor in choosing New Jersey Medical School over a more expensive school. Students anticipated taking about 10 years to repay loans. CONCLUSIONS: As medical educational costs and student indebtedness rise, students are choosing less costly education and career paths with higher potential future earnings. These trends will negatively impact health care availability, accessibility, and cost. DoD programs to provide financial assistance in exchange for military service are not well publicized. These findings should increase DoD recruitment opportunities.

Don't know, don't care: revisited.

OBJECTIVES: This study re-evaluates the awareness and attitudes of medical students concerning military programs, which can provide financial support for medical student education. An original study, 10 years ago, demonstrated a minimal awareness of these programs. With medical school tuitions rising dramatically in the intervening years, as well as the resultant student indebtedness increasing significantly, it is appropriate to readdress this knowledge of attitude toward financial options through military programs for medical students. Reassessment was undertaken using the same evaluation instrument. In the decade in which these four assessments were made, attitudes toward amelioration of medical student tuitional indebtedness, through programs sponsored by the Department of Defense, have worsened. This phenomenon jeopardizes military medicine and, in so doing, negatively impacts readiness of our Armed Forces.