Exploring Medical Students' Perceptions of Peer-to-Peer Interactions Related to Applying to a Surgical Residency

Objective: The objectives were to (1) identify themes related to competitive peer-to-peer interactions elicited from the lived experiences of undergraduate medical students, and (2) understand how these experiences influenced medical students' choices related to surgical residency programs.

Design: A qualitative descriptive methodology, with purposive and maximal variation sampling (e.g., selection based on medical school location; gender), was adopted for this study.

Setting: Temerty Faculty of Medicine, University of Toronto.

Participants: Participants were 15 undergraduate medical students from 4 medical schools in Ontario, Canada, who agreed to an individual semi-structured interview by Zoom or telephone.

Results: Peer-to-peer interactions influence students' perception of self and identity formation related to surgical specialty decision-making and interest. These interactions were shown to hold greater value, specifically for information gathering. Identity formation, related to pursuing a surgical residency, was influenced by the attitudes and perceptions of competition with peers throughout medical school. Cultures of competition were seen to dictate peer-to-peer interactions and their associated value, with their perception and experience differing between medical schools.

Conclusions: Peer-to-peer interactions and a culture of competition have inherent roles in the residency decision-making process. We observed that student background and pre-formed relationships influenced how students perceived and responded to competition. Addressing the culture of competitiveness associated with peer-to-peer interactions along with considering student background and pre-existing relationships may provide insight into how medical educators can tailor learning experiences that limit the detrimental effects of hidden curriculum influences.