J. L. Lazarus2, A. Gibson1, S. Campbell1 1Texas Tech Univeristy Health Science Center,Lubbock, TX, USA 2University Of Michigan,Ann Arbor, MI, USA
Introduction:
Demand for surgeons is increasing and expected to continue. Though the number of general surgery residency positions has increased accordingly, the number of applicants has not proportionally increased. Few have investigated the perceptions and behavioral dynamics of medical students and their mentors in regards to student career choice. Increasing awareness regarding inappropriate behavior of physicians and trainees has led to professionalism included as a core competency in surgical training. Since perceptions involve cultural and generational differences and are integral in interpersonal relationships, we hypothesize that perceptions of inappropriate behavior vary among medical students and attending surgeons subsequently directing students’ career paths.
Methods:
Medical students were given an evaluation twice during their surgery clerkship: at midpoint and rotation end. From a list, students were asked to select which behaviors they thought were appropriate or inappropriate. Some behaviors included raising one’s voice, making sexual comments, and using foul language. Students were also asked if they had witnessed or experienced any of these behaviors at the end of the clerkship. Half of the participant’s evaluations were paired from mid to endpoint and specialty choice assessed. Seven attending surgeons participated in a separate survey and selected from a similar list of behaviors and rated them on appropriateness.
Results:
We first investigated whether the students and attending surgeons agreed on what they perceived as inappropriate behavior. No behavior was completely agreed upon by either group. The following behavior had at least a 20% disparity among groups: use of foul language, ignoring someone, raising one's voice and making sexual comments. We then investigated any change in student’s perception of inappropriate behavior during the clerkship. Interestingly, most students’ perceptions regarding at least one behavior changed from midpoint compared to the end of the rotation. Of 41 students, 16 witnessed or experienced behavior they thought was inappropriate. Three of these 16 students were considering surgery as a specialty at midpoint. One of these three changed to a non-surgical specialty at the end of the rotation secondary these experiences.
Conclusion:
Perception of inappropriate behavior varies among individuals, not only between students themselves, but between students and attending surgeons. Since most students changed their perceptions during the rotation, we can conclude perceptions may be influenced by the interactions during the clerkship itself. Furthermore, witnessing or experiencing perceived inappropriate behavior leads to an undesirable learning environment. Specific core professionalism training for both attending surgeons and medical students is necessary to ensure an inspiring learning environment fostering positive attitudes towards surgical careers.