Wednesday, September 19, 2018

“Number of medical students pursuing surgery specialty drops by half”

That was the headline in a September 10 Becker’s ACS Review article. The first sentence of the piece was more specific, “Only 4 percent of medical students surveyed in 2018 said their chosen medical specialty is general surgery, compared with 8 percent in 2016, according to Medscape's Medical Student Life & Education Report 2018.”

This caused some consternation among general surgeons on Twitter. I tweeted, “Interesting. Lifestyle is finally catching up to us. I think it will get worse.”

The first thing I did when the handwringing subsided was to pull up the National Resident Matching Program data for 2018. Table 8 shows some remarkably consistent statistics for the number of applicants matching to categorical general surgery over the last five years.
Click on the figure to enlarge it.
Despite an increase of over 100 categorical positions since 2014, the number of positions filled through the match has never been less than 99.4% and the number of US grads filling those positions has ranged from 76.2 to 80.0%.

This doesn't look like less interest to me.

The Medscape data from the Becker’s article is displayed below. 

Click on the figure to enlarge it.
As you can see, general surgery was ranked number 9 with 4% of students choosing it as their specialty. I was a little confused by number 11 listed as orthopedic surgery, 3% and number 23 orthopedics, 1%. In checking with the Medscape report, the same confusing numbers were present.

This prompted me to look at the 2016 Medscape Medical Student Life & Education Report. The rankings are shown below.

Click on the figure to enlarge it.
In 2016, general surgery was bundled with “specialized” surgery [as if general surgery is not a specialty. Don’t get me started on that].

I conclude both the Medscape data and the Becker's article are unreliable. The wording of the questions has changed since the last survey, and interest in surgery of all types in 2016 was compared to general surgery alone in 2018. Orthopedic surgery and orthopedics are considered two separate specialties by Medscape.

I don’t believe anything in this survey. You shouldn’t either.


artiger said...

I read Becker's fairly frequently, and used to rely on it heavily to keep up with the business aspect of healthcare. I've noticed a lot of shoddy reporting and sometimes flat out errors in it lately, and at times the headlines border on sensationalism, i.e., clickbait. Its articles about medical students and residents are particularly inaccurate. I used to read Medscape a lot too, but nowadays there are so many things you can read that you have to narrow down your list if you want to get anything done.

That said, it appears that despite a tendency to prioritize lifestyle, surgery still remains a popular choice. Work hour limitations may have made it a more viable choice for a lot of students.

Skeptical Scalpel said...

Neither the reporting nor the survey itself were good. I worry that the work hours limitations are making surgery look like it's easier than it was. But it's not.

Dr. Hanna Rhee said...

It's due to lack of dedication & challenges.

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