Pursuing a career in surgery: What is holding medical students back?

Aim: In recent years there has been a decline in junior doctors opting for a surgical career. We aimed to ascertain the main factors influencing pre-clinical medical students' career choice. Methods: An online questionnaire was distributed to 122 pre-clinical medical students. Students were asked to rate separately the importance of commonly viewed limitations towards and possible attractants to a career in surgery. Results: There was a 97.5% (119) response rate. The most important factor limiting a surgical career was strong competition ratios. Female students placed greater importance towards family implications (p = 0.0003); students affiliated to a surgical society placed greater importance on career guidance (p = 0.001) and mentorship (p = 0.0004). More males were considering a career in surgery than females (47.2% vs 18.6%). Earlier exposure to a surgical environment and better career guidance were the highest ranked aspects to encourage this career choice. Conclusion: Strong competition ratios remain an important consideration for medical students perusing a surgical career. Female students view family commitments as a more important issue for a future career, which must be addressed. Increased availability of competition ratios, mentoring, less than-full time training opportunities, and role models at all levels should be priorities to attract more students to surgery.