Who wants to be a surgeon? Patterns of medical student career choice.

AIM: NZ needs a surgical workforce with the capacity to meet the increasing health demands of an aging population. This study determined longitudinal patterns of medical student interest in a surgical career and factors influencing that choice. METHOD: We studied medical students entering the Auckland medical programme from 2006-2008 who completed an entry and exit questionnaire on career intentions. Four notional groups were created, depending on the level of interest at entry and at exit. Demographic factors for each category were compared. Analysis of influencing factors was also undertaken. RESULTS: Of 488 students, 310 (64%) completed both an entry and exit questionnaire. Over 50% of students had a strong interest in a surgical career at entry, dropping to 26% at exit. The 'Never Evers' (No interest at entry /No interest at exit) made up 39%,'Divergers' (Strong/No) 35%, 'Die Hards' (Strong/Strong) 18%, and 'Convertibles' (No/Strong) 8%. Less interest in a surgical career was seen among female (P=0.001) and older students (P=0.017). Influencing factors differentiating the 'Die Hards' from the 'Divergers' were work hours and flexibility (less influence among 'Die Hards'), with procedural nature and consultants/mentors (higher). CONCLUSION: There is a significant reduction in interest in a surgical career over the course of the undergraduate programme, especially among female and older students. Yet the level appears sufficient for available training places. Consultant role models are an important career influence. Lack of flexibility in work and training programmes continue to provide challenges in creating a diverse surgical workforce.