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Future of acute care surgery: A perspective from the next generation

Moore, Hunter B. BS; Moore, Peter K. BS; Grant, Abigail R. BS; Tello, Tiffany L. BS; Knudson, Margaret M. MD; Kornblith, Lucy Z. MD; Song, Tara E. BS; Sauaia, Angela MD, PhD; Zuckerbahn, Brian MD; Moore, Ernest E. MD

The Journal of Trauma and Acute Care Surgery: January 2012 - Volume 72 - Issue 1 - p 94–99
doi: 10.1097/TA.0b013e31823b990a
WTA 2011 Plenary Papers
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Background: Access to emergent surgical care has been identified as a crisis in the United States. To address this challenge, the American Association for Surgery of Trauma has developed a fellowship in acute care surgery (ACS) to reestablish broad-based surgical capabilities. But the viability of this new discipline will rest on the interests of the next generation of surgeons. The objective of this study was to determine key factors influencing the choice of surgical specialties among medical students with a focus on their interest in trauma/ACS (T/ACS).

Methods: An online questionnaire was distributed to students at four medical schools affiliated with Level I trauma centers, one of which also has an ACS fellowship. The survey was sent to medical students at all levels (first to fourth year). Students with an interest in surgery as a career were asked to complete the survey and rank factors and experiences influencing career selection on a scale of 1 (no influence) to 10 (critical). Students were also asked to select their top five surgical specialties.

Results: Three hundred thirty-seven students interested in surgery responded. Mean age was 26 years ± 0.2 years (range, 20–37 years), 58% were men, and 86% were single. Respondents were distributed evenly over medical schools and medical school years. The three most popular career choices were orthopedics (16%), T/ACS (12%), and pediatric surgery (8%). As students progressed through medical school, lifestyle factors such as predictable hours and family time became more important in influencing their career choice. Overall, 115 students (34%) selected emergent surgery (T/ACS) as one of their top three career choices. Factors that were ranked significantly higher by students interested in T/ACS were related to professional satisfaction. These students also placed less emphasis on lifestyle factors when choosing a surgical career.

Conclusions: Our results indicate that there is a reassuring interest to address the growing demand for emergency surgery among current medical students exposed to a broad range of T/ACS patients in Level I trauma centers. The T/ACS model is in accordance with the drives of these students looking for a diverse and challenging profession. Academic societies should make further efforts to encourage medical students to pursue T/ACS.

Denver, Colorado

From the University of Vermont College of Medicine (H.B.M., T.E.S.), Burlington, Vermont; University of Colorado Denver School of Medicine (P.K.M., T.L.T., E.E.M.), Denver, Colorado; University of Pittsburgh College of Medicine (A.R.G., B.Z.), Pittsburgh, Pennsylvania; Department of Surgery (M.M.K., L.Z.K.), University of California San Francisco, San Francisco, California; University of California San Francisco College of Medicine (M.M.K.), San Francisco, California; Department of Surgery (A.S., E.E.M.), University of Colorado Denver, Denver, Colorado; and Department of Surgery (B.Z.), University of Pittsburgh, Pittsburgh, Pennsylvania.

Submitted: February 21, 2011, Revised: July 29, 2011, Accepted: October 5, 2011.

Presented at the 41st annual meeting of the Western Trauma Association, February 28–March 3, 2011, Big Sky, Montana.

Address for reprints: Ernest E. Moore, MD, Department of Surgery, University of Colorado Denver, Denver Health, 777 Bannock St, Denver, Colorado 80204; email: ernest.moore@dhha.org.

© 2012 Lippincott Williams & Wilkins, Inc.