Evolving Medical Student Experiences in the Surgery Clerkship: A New Generation

Abstract

Background: The surgery clerkship has a powerful impact on medical students' attitudes toward surgery. The primary aim of this study was to identify factors that influence current medical student experiences during the surgery clerkship and discern if they have shifted following the COVID pandemic and with a new generation of "Zillennial" students.

Materials and methods: We conducted a qualitative content analysis of medical student surgery clerkship evaluations from 2018 to 2022 at three clinical training sites of our medical school (n = 596). The codes and themes that emerged from the data were then compared between the pre-COVID cohort (pre-March 2020) and post-COVID (post June 2020) cohorts.

Results: Our analysis revealed four themes: clerkship factors, educator qualities, surgical culture, and student expectations. Clerkship factors included the overall clerkship organization, preparatory sessions, and having schedule flexibility. The clinical educators had a significant impact on medical student experience by setting expectations and providing actionable feedback. Surgical culture included the team dynamic and professionalism or diversity issues. Students were expected to have clear guidance for their roles, opportunities to shine, and sought meaningful learning. While the themes were consistent between both cohorts, the frequency of codes varied, with more students commenting on flexibility, neglect, and long work hours in the post-COVID cohort.

Conclusions: Numerous previously unreported factors impact surgical clerkship experiences, revealing a generational shift in medical student attitudes. These results suggest that educators and their institutions must be proactive in tracking student evaluations to adapt their clerkship curriculum for an optimal educational experience and evolving student expectations.

Keywords: COVID; Graduate medical education; Medical student; New generation; Surgery clerkship.