title: Trends of surgical career selection among medical students and graduates: a global perspective.
abstract: BACKGROUND
  Declining trends in surgery have been well-researched in the North American region, but little is known about the international dynamics affecting this phenomenon. A comprehensive approach to this emerging issue is lacking.
  
  
  OBJECTIVE
  Our objective in this study is to explore global trends related to medical student interest in surgical careers. We will also identify factors influencing the choice of surgery as a career and outline practical interventions to nurture interest in these fields, as described in the literature.
  
  
  METHODS
  We present a focused review of worldwide trends of surgical career selection among medical students of geographically distant and diverse sociocultural backgrounds. A systematic literature search was performed using PubMed. The studies were conducted over the last fifteen years with the study populations scattered over 6 continents.
  
  
  RESULTS
  North American studies have shown a declining trend for medical students to select surgery as a career, but a recent recovery has been observed. However, surgery is still the popular choice of career among Middle Eastern and Far-Eastern Asian men. Sociocultural variants and personal satisfaction are likely influential factors with financial rewards being the least significant. Surgery is also popular in Nigeria despite their increased awareness of risk of HIV/AIDS associated with surgery. A decline in surgery has been observed in Australia, New Zealand, and South Africa. Medical students and graduates of Greece, Switzerland, and the UK mostly prefer nonsurgical careers. Multiple extrinsic and intrinsic factors appear to play a role for such a phenomenon. Specific interventions are now being used to create a rebound effect for such a declining trend observed in most of the regions worldwide.
  
  
  CONCLUSIONS
  Global trends show a variation of interest in surgery as a career option throughout the 6 continents. Possible factors affecting this phenomenon are similar among geographically distant and diverse student cultures.
authors.affiliation: Medical College, Aga Khan University, Behind Aga Khan Hospital, Karachi, Pakistan. ranish.deedarali.m07@student.aku.edu
authors.forename: Ranish
authors.initials: R
authors.lastname: Deedar-Ali-Khawaja
authors.forename: Sadaf Mumtaz
authors.initials: SM
authors.lastname: Khan
mesh_terms: D002321:Career Choice; D013502:General Surgery / Q000639:trends*; D006801:Humans; D038622:Internationality; D007396:Internship and Residency; D008019:Life Style; D008611:Mentors; D013337:Students, Medical