Recruiting trainees to surgery in the United States and Canadian system – What strategies are effective?

• Published in: The American journal of surgery Vol. 221; no. 2; pp. 410 - 423
• Main Authors: Yan, Qi, Jiang, Zheng, Clothier, Wesley T., Treffalls, John A., Fox-Good, Christopher G., Davies, Mark G.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2021; Elsevier Limited
• Subjects: Bias; Bone surgery; Canada; Career Choice; Gynecology; Heart surgery; Humans; Internship and Residency - organization & administration; Internship and Residency - statistics & numerical data; Intervention; Medical education; Medical residencies; Medical students; Meta-analysis; Neurosurgery; Obstetrics; Orthopedics; Performance evaluation; Personnel Selection - methods; Personnel Selection - statistics & numerical data; Quality assessment; Recruitment; Sample size; Simulation; Skills; Specialties, Surgical - education; Specialties, Surgical - statistics & numerical data; Students; Students, Medical - statistics & numerical data; Surgery; Surgical specialties; Training; United States; Vascular surgery; Canada; United States; United States > US; Medical students; Training; Career choice; Surgery; Recruitment; Surgical specialties; Meta-analysis
• ISSN: 0002-9610; 1879-1883; 1879-1883
• DOI: 10.1016/j.amjsurg.2020.12.006

There has been increasing concerns regarding the declining number of medical students entering surgical residencies. The aim of this study is to analyze strategies and outcomes to enhance recruitment to the surgical specialties. A systematic literature PRISMA-based search was performed. Study quality and bias were assessed. Meta-analysis was performed using DerSimonian Laird method. Of 3288 unique titles identified, 73 studies met inclusion criteria. Median study unique sample size was 84 participants (range 15–910). Subjective interest was reported in 59 studies, while objective match rate was reported by only 21 studies. The cumulative odds of students interested in the studied specialty was 1.98 (95% CI 1.47–2.67, I2 = 0%) and in any surgical specialty was 1.40 (95% 1.01–1.95, I2 = 37%) after an intervention compared to baseline. While studies show increased odds of “interested in” a surgical specialty, the results may be subject to high selective and confounding biases. •Significant heterogeneity in the design, outcome reporting, and quality of the current studies .•Most studies reported subjective interest data alone; only 21 (29%) studies reported objective match rate data.•The odds of students expressing interest in the studied surgical specialty after an intervention compared to baseline was 1.98.•Based on the current data available in the literature, the best timing and intervention type cannot be elucidated.