title: The Impact of Early Medical School Surgical Exposure on Interest in Neurosurgery.
abstract: BACKGROUND
  Medical student interest in neurosurgery is decreasing and resident attrition is trending upwards in favor of more lifestyle-friendly specialties that receive greater exposure during medical school. The University of Toronto began offering an annual two week comprehensive, focused surgical experience (Surgical Exploration and Discovery (SEAD) program) to 20 first year medical students increasing exposure to surgical careers. This study determines how SEAD affects students' views of a career in neurosurgery.
  
  
  METHODS
  Surveys were administered to 38 SEAD participants over two program cycles. Information was obtained regarding demographics, impacts of SEAD, and factors affecting career decision making. Subgroup analyses assessed for factors predicting pre- and post-intervention interest in neurosurgery.
  
  
  RESULTS
  Ninety-seven percent (n=37) of students completed the survey. Before SEAD, 25% were interested in neurosurgery but this decreased to 10% post-SEAD (p=0.001). However, post-SEAD interest increased from 10% to 38% if lifestyle factors were theoretically controlled across surgical specialties (p<0.005). A majority (81%) felt SEAD improved their understanding of neurosurgery, 62.2% felt that exposure to other surgical specialties reduced their interest in neurosurgery, and 21% felt SEAD increased their interest in neurosurgery. Nineteen percent intended to explore neurosurgery further with observerships and one student planned to organize neurosurgical research.
  
  
  CONCLUSIONS
  This surgical exposure intervention increased understanding about neurosurgery and reduced overall interest in neurosurgery as a career. However, those remaining interested were motivated to plan further neurosurgical clinical experiences. The SEAD program may, therefore, aid in early selection of students motivated to satisfy the demands of a neurosurgical career.
authors.affiliation: 1Neurosurgery Residency Program,Postgraduate Medical Education, Director,Neurosurgery Residency Program,University of Toronto,500 University Avenue,Toronto,Ontario, M5G 1V7,Canada.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Zuccato
authors.affiliation: 2Neurosurgery Residency Program,Department of Surgery, Director,Neurosurgery Residency Program,University of Toronto,500 University Avenue,Toronto,Ontario, M5G 1V7,Canada.
authors.forename: Abhaya V
authors.initials: AV
authors.lastname: Kulkarni
mesh_terms: D000704:Analysis of Variance; D002321:Career Choice; D002983:Clinical Competence; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008297:Male; D013043:Specialties, Surgical / Q000193:education*; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Medical; Career Choice; Medical; Education; Neurosurgery; Students