How Can We Attract More Medical Students to General Surgery Residencies ? A Study of Medical Student Evaluations of a General Surgery Clerkship for 10 Years : 2005-2015

Background: Medical student interest in general surgery has been declining for over three decades leading to projections of future surgeon shortages and decreased quality of surgical applicants. Research has identified numerous factors in students’ medical school experience that influence students to choose general surgery such as operative experience, interaction with faculty, and opportunities for mentoring. The third year surgery clerkship provides a unique and invaluable opportunity to create an experience that influences students to pursue surgery. However, student and faculty perceptions of the third year surgery clerkship experience are often very different. Design, Setting and Participants: Medical student evaluations of the general surgery clerkship at the Tuscaloosa Campus of the University of Alabama School of Medicine from 2005 to 2015 were reviewed. The evaluations were required of all students at the completion of their two month surgery clerkship. Scaled numerical responses were used to measure student satisfaction with the clerkship in 15 aspects of the clerkship and the clerkship overall. Narrative evaluations from student participants regarding what were done well, areas for improvement and further recommendations were also obtained. Results: Three hundred-four medical students completed the surgery clerkship during the study period and 299 students’ submitted evaluations. All areas were rated excellently with the exception of organization of lectures (6.5), value of lectures (6.6), observation of history and physicals (6.2), and constructive criticism (6.9). The highest rated areas were the number of patients seen by students (7.9) and the receptiveness of the course director to concerns (7.8), quality of faculty teaching (7.7), and faculty responsiveness to student concerns (7.7). Content analysis of narrative responses demonstrated strong satisfaction with operative experience and the quality of teaching, but students were dissatisfied that many lectures were canceled or improperly scheduled. Recommendations for improvement of the clerkship included more case studies, more surgical experience, elective time, more postoperative management, and more technical skills training. Discussion: Student responses demonstrated strong satisfaction with operative experience and the responsiveness of faculty to student concerns. Areas evaluated less strongly were the quality and organization of lectures and feedback regarding observation of student performance on the clerkship. These results are consistent with the results of other research evaluating student expectations and desires for the third year surgery clerkship as well as research into factors that drive student interest in surgery. Efforts to incorporate student feedback into the organization of the third year surgery clerkship may result in increased student interest in Categorical Surgery residency positions. Garrett Taylor, Joseph C Wallace, Andrew G Harrell, John Burkhardt, Daniel M Avery Jr*, Charles E Geno, Catherine Skinner and Gregg Bell Department of Obstetrics and Gynecology, College of Community Health Sciences, The University of Alabama, USA