RESUMEN
INTRODUCTION: Choosing surgery as a career is declining among U.S. medical students. The 8-wk third year surgery clerkship at our institution can be an intense learning experience, and we hypothesized that during this clerkship medical student quality-of-life would drop significantly from baseline, and that this drop would be greater among certain subgroups, such as women students not interested in pursuing a surgical career, and those who place a high value on a controllable lifestyle. METHODS: At clerkship orientation (baseline), students were asked to complete a survey that measured quality-of-life on an 84-point scale, and depression on a 40-point scale. The quality-of-life scale was composed of select questions from the Medical Outcomes Study, and the Harvard Department of Psychiatry/NDSD brief screening instrument was used to measure depression. Students were also asked the typical number of hours they slept per night. Demographics, attitude toward a controllable lifestyle, and top three specialties of interest were also gathered at baseline. On week 6 of the clerkship, students were surveyed on the same quality-of -life and depression scales, and asked average hours of sleep per night for the previous week. RESULTS: From June 2005 through December 2006, 143 of 177 (81%) students agreed to participate, and after exclusions for missing data, 137 students were included in the analysis. Sixty-nine students were women (51%), and the average age was 25.8 (sd 2.6). Mean quality-of-life at baseline was 57.0 (sd 11.3) and at week 6 was 50.4 (sd 10.1) representing a statistically significant average decline of 6.6 points (P < 0.0001). Mean depression at baseline was 14.4 (sd 3.8) and at week 6 was 15.1 (sd 3.6), representing a small but significant average decline of 0.7 points (P = 0.0155). Mean sleep at baseline was 6.3 h/night (sd 0.9) and at week 6 was 5.7 h/night (sd 1.2), representing a statistically significant average decline of 0.6 h/night (P < 0.0001). Declines were similar on all outcomes between men versus women, those who ranked surgery in their top three career choices versus those who did not, and those who ranked controllable lifestyle as "very important" versus all other categories. CONCLUSION: Quality-of-life and sleep declines and depression increases significantly in third-year medical students from orientation to week 6 of their surgery clerkship at our institution. We look forward to studying quality-of-life on other clerkships for comparison, assessing whether the magnitude of this decline in quality-of-life predicts students avoiding a future career in surgery, and testing interventions to prevent this decline in quality-of-life during the clerkship.
Asunto(s)
Prácticas Clínicas , Cirugía General/educación , Calidad de Vida , Estudiantes de Medicina/psicología , Adulto , Actitud del Personal de Salud , Selección de Profesión , Recolección de Datos , Depresión/psicología , Femenino , Humanos , Estilo de Vida , Masculino , SueñoRESUMEN
INTRODUCTION: A deficit of surgeons currently exists in the health care workforce. We have designed a study that identifies predictors of students choosing a career in surgery. First, we conducted two feasibility studies, and on the basis of these data, designed a third study for addressing our specific aims. The design and one-year results for the new study are provided here. METHODS: For the feasibility studies, students participating in the third-year surgery clerkship at our institution were asked to complete surveys using two different study designs. For the new study, which began in June 2005, students complete surveys covering domains of interest at the beginning of the clerkship and at weekly intervals throughout the clerkship, and will be providing match results. RESULTS: The feasibility studies offered insight into ways to improve our study design. In the first year of this multi-year study, 93 students participated (response rate = 77%). Forty-five students were women (48%), and the average age was 26.09 (sd 2.85). Proportion of students rating general surgery or a surgery subspecialty in their top three choices for a career increased over the course of the clerkship by 24.7% (n = 32, 34.4% at baseline; n = 55, 59.1% at end of clerkship). Seventy-one students (76.3%) reported having a meaningful experience on the clerkship, and 30 (32.3%) received honors grades. CONCLUSION: Our study design benefitted from the knowledge we gained from our feasibility studies. We look forward to achieving the necessary sample size in the next several years to report the final results of this study.