Introduction to surgery in preclinical years: curriculum development and impact

Exposure to surgery in preclinical years of medical school is traditionally very limited. It is estimated that 59% of students make their career decision before their core clinical year of medical school. Meanwhile, there is estimated to be a shortage of 14,300–23,400 surgical specialists by the year 2032. Factors contributing to medical students selecting non-surgical residencies include marginalization during the surgical clerkship as well as lack of preparedness and exposure to surgical careers. To provide timely and positive exposure to surgical fields, we designed a 12-week elective “Introduction to Surgery” course for preclinical medical students. This study describes the development and reports impact of this course.

A single institution prospective cohort study was performed. Forty preclinical medical students attended a total of ten didactic sessions, a surgical skills lab, and surgery resident panel in the Fall of 2021. Pre- and post-course Likert format surveys were distributed to participants. Participants also rated course content and lecturers after each course session. Paired t tests were used for analysis of pre- and post-course survey responses.

Students gave high ratings to course content (4.78/5) and lecturers (4.81/5). Students’ confidence in their basic surgical skills, perceived readiness for the surgical clerkship, reported likelihood of entering a surgical career, and reported satisfaction with exposure to surgery in the preclinical timeframe all significantly improved after course participation (p < 0.005). Similarly, students’ reported perceptions toward surgeons and surgery as a career significantly improved following course participation.

The development and implementation of a preclinical course in surgery significantly increased students’ interests in a surgical career, and students’ perceived readiness for the surgical clerkship. Preclinical introduction of surgery is a promising avenue through which to improve student perceptions of surgery while simultaneously preparing them for further exploration of surgical fields through exposure to surgical mentors and role models.