Assessing interest in cardiothoracic surgery at an osteopathic medical school: Results of an institutional survey

Abstract

Objective: Cardiothoracic surgery is a surgical subspecialty that attracts few medical students. As integrated surgical residency programs continue to grow in number, there is increased interest in what factors influence specialty selection during undergraduate medical education. Previous institutional studies have studied allopathic medical schools affiliated with academic institutions. This study aimed to assess the interest and perception of cardiothoracic surgery at an osteopathic institution.

Methods: Active medical students at a US osteopathic institution were invited to complete an original online survey. Means and 95% confidence intervals were calculated and graphed for questions using Likert scale responses. Comparison of mean responses for preclinical versus clinical students was assessed by a Kruskal-Wallis nonparametric analysis of variance.

Results: There were 166 surveys (22%) completed, and interest in cardiothoracic surgery was indicated by 7.8% of respondents. Work/life balance, personality of cardiothoracic surgeons, and lack of family time were negative factors associated with cardiothoracic surgery. Clinical exposure, shadowing, mentorship, and significant personal/life events before medical school were strong factors in establishing students' interest in cardiothoracic surgery. Preclinical students noted exposure to cardiothoracic surgery would further increase their interest when compared with clinical students (μ = 3.39 vs μ = 2.69, P = .008).

Conclusions: All factors that established interest in cardiothoracic surgery occurred before students entered medical school. Although there are negative perceptions associated with cardiothoracic surgery, these may be ameliorated with more exposure to the field. Further research is needed to explore how early exposure in preclinical years of medical school affects students' perceptions and ultimate interest in cardiothoracic surgery.

Keywords: cardiothoracic surgery; interest groups; medical students; osteopathic medicine; surgical education.

Graphical abstract

Avenues to CT surgery exposure for premedical and preclinical students.

Figure 1

Specialties and surgical subspecialties of interest to students. The total number of survey responses for the listed specialties (A) and subspecialties (B) are depicted in the bar graphs. The number of preclinical (blue) and clinical (red) student responses are depicted for each specialty and subspecialty, with the total number of responses depicted by the stacked bars. Statistical difference between the proportion of preclinical and clinical student responses for each specialty and subspecialty were assessed via chi-square analyses, and significance (P < .05) depicted with an asterisk (∗). OB, Obstetrics; GYN, Gynecology.

Figure 2

Factors influencing decision to not pursue surgery. Participants were asked to rank their responses (1-5) for the factors influencing their decision to not pursue surgery. Mean ranks for all respondents (blue) are depicted, with the mean ranks for the preclinical population (red), and the clinical population (green) depicted below the total for each question. Error bars are indicative of the standard error of the mean. Differences between responses in the preclinical and clinical populations were compared with a Kruskal–Wallis test, and significance (P < .05) denoted by an asterisk (∗). COMLEX, Comprehensive Osteopathic Medical Licensure Examination; USMLE, United States Medical Licensing Examination.

Figure 3

Factors influencing decision to pursue surgery. Ranked responses for the factors influencing respondents' decision to pursue surgery are depicted in the graph above. Mean ranks for all respondents (blue), the preclinical population (red), and the clinical population (green) are depicted for each question. Error bars are indicative of the standard error of the mean. Differences between the mean ranks in the preclinical and clinical populations were compared with a Kruskal–Wallis Test, and significance (P < .05) denoted by an asterisk (∗). ACOM, Alabama College of Osteopathic Medicine; OMS, Osteopathic Medical Student.

Figure 4

Factors that started and continued interest in specialties and CT surgery. The total number of survey responses for the factors that started/continued student interest in their specialty for preclinical (blue) and clinical (red) students are depicted in graph (A). For survey participants who indicated an interest in CT surgery, the factors that started/continued their interest are denoted in graph (B). Differences between the proportion of preclinical and clinical student responses were assessed via chi-square analyses, and significance (P < .05) depicted with an asterisk (∗). OMS-I, First-year osteopathic medical student; OMS-II, second-year osteopathic medical student.

Figure 5

Perceptions regarding CT surgery and preclinical exposure. Likert scale responses were collected for questions pertaining to participant perceptions regarding CT surgery and preclinical exposure. Mean ranks for all respondents (blue), preclinical respondents (red), and clinical respondents (green) are depicted for each question. Error bars are indicative of standard error of the means, and the differences between the mean ranks in the preclinical and clinical populations were compared with a Kruskal–Wallis test. Significance (P < .05) is denoted by an asterisk (∗). OMS-I, First-year osteopathic medical student; OMS-II, second-year osteopathic medical student.

Figure 6

A summary of the key findings found in this study. OMS-I, First-year osteopathic medical student; OMS-II, second-year osteopathic medical student; CT, cardiothoracic.