Motivation of French medical students to pursue surgical careers: results of national survey of 1742 students

Objectives: Analyze the aspirations and personal motivations behind the choice of surgical specialties in a large sample of students in their 6th year of medical school.

Material and methods: In December 2008, 2588 students participated in a nation-wide mock exam, before taking the National Ranking Exam. When they looked for their grades on the web, the students were prompted to answer a questionnaire containing socio-demographic questions concerning their choice and motivation to pursue a career in a surgical specialty. The survey called also for listing the three main factors (out of a list of 11) motivating their choice.

Results: Students originated from 39 medical schools. Of the 2588 students, 1427 (55%) were women. The response rate to the questionnaire was 1742/2588=67%. Two hundred and twenty students (13%) did not express any specific professional orientation. Of the 1522 responses obtained, 522 students wanted to become surgeons. Gender was a determining factor as 44% of male students (n=252) versus 29% of female students wanted to become a surgeon; P<0.0001. The three most selected surgical subspecialties were gynecology (n=137), orthopedics (n=91) and ophthalmology (n=57). Once again gender played a role in the choice: 82% who chose gynecology were women while 73% of future urologists were men (P<0.0001). Special interest in specific diseases (n=356, 23%), the possibility of private practice (n=280, 18%) and life style (n=175, 11%) were the motivations most often cited to back their choice.

Conclusion: One third of medical students want to become surgeons. Feminization, life style and income are the principal factors influencing the choice of the type of surgical subspecialization.