What Preclinical Medical Students Value When Choosing a Surgical Career: A Cluster Analysis.

INTRODUCTION

Understanding what students value when choosing a surgical career and whether early exposure changes them is crucial for effective recruitment. This study used a prospective preclinical surgical skills course to evaluate specialty choice factors and determine whether improved skills influence them or interest in the sponsoring specialty.

METHODS

Forty-seven preclinical medical students enrolled in an 8-wk vascular surgery-sponsored elective skills course. Students completed standardized precourse and postcourse surveys assessing interest in surgery and the sponsoring specialty, confidence in surgical abilities, perceptions of surgery, and eleven specialty choice factors. K-means cluster analysis identified groups of factors by importance. Surgical performance was assessed using knot tying and suturing metrics. Normally distributed variables were compared using paired t-tests; non-normal and Likert scale variables using Wilcoxon signed-rank tests.

RESULTS

Students significantly improved across all skills metrics. Median attending-rated competency scores improved from 1 to 4/5 for knot tying and suturing (both P < 0.001). Interest in the sponsoring specialty did not change and remained lower than interest in surgery overall (P < 0.01). K-means clustering identified a high-importance cluster comprising personality fit, early specialty exposure, attending lifestyle, mentorship, attending workload, and income potential, and a low-importance cluster comprising residency-related factors including training length, research years, competitiveness, resident lifestyle, and resident workload. The only factor that changed postcourse was early exposure (P = 0.010).

CONCLUSIONS

Preclinical students prioritize attending-level factors and early exposure over residency-related factors when choosing a specialty. Despite significant skill improvement, interest in the sponsoring specialty did not increase. Recruitment efforts should prioritize mentorship, early exposure, and attending lifestyle-not skills training alone.