Factors Influencing the Intention to Pursue Surgery among Female Pre‐Medical Students: A Cross‐Sectional Study in Pakistan

Abstract

Background While gender disparities in surgery are documented worldwide, it is unclear to what extent women consider surgery as a career before embarking on their medical school journey. This study aimed to report the percentage of pre-medical women in Pakistan who intend to eventually specialize in surgery and assess the factors motivating and deterring this decision. Methods An online survey was conducted among female pre-medical (high school) students across Pakistan. Multivariable logistic regression was performed to determine motivating and deterring factors associated with the intention to pursue surgery. Results Out of 1219 female high-school students, 764 (62.7) intended to join medical school. Among these 764, only 9.8% reported an exclusive intent to pursue surgery, while just 20.3% reported considering other specialties in addition to surgery. Significant motivators to pursue surgery exclusively were the intellectual satisfaction of pursuing surgery (adjusted odds ratio: 2.302), having opportunities to travel internationally for work (2.300) and use cuttingedge technology (2.203), interest in the specialty of surgery (2.031), the social prestige of becoming a surgeon (1.910), and considering one's personality well-suited to surgery (1.888). Major deterrents included the lack of interest in surgery (adjusted odds ratio: 3.812), surgical education and training being too difficult (2.440) and lengthy (1.404), and the risk of aggressive behavior from patients (2.239). Conclusion Even before entering medical school, most female pre-medical students have already decided against considering a future surgical career. Deterrents likely stem from women being pressured to conform to deep-seated societal expectations to dedicate their time and energy to domestic responsibilities.

Investigating factors that influence residency program selection among medical students

“…The results were in accordance with previous studies showing that ~ 30% of medical graduates now pursue residency programs in medicine [ 27 , 28 ]. It has been observed over the years that more and more medical graduates were choosing surgical specialties, such that today 15% of medical graduates were pursuing surgical training [ 29 , 30 ], In line with our study’s findings. Family medicine, OB/GYN, radiology, orthopedics, and psychiatry were among the other major specialties pursued by graduates.…”

Causes and consequences of the shortage of physicians in Sindh, Pakistan: a local perspective

“…The physician workforce is the foundation of any nation's healthcare system and economic expansion, but a significant lack of skilled healthcare professionals is one of the fundamental factors preventing further advancement in the health sector. There are many causes for the shortage of physicians in Pakistan, but the major ones include emigration to other countries 12,13 , the absence of a sizable number of female doctors 14,15, female doctors' preferences for particular specialties 18 , gender preferences 19 , dislike of night shifts 19 , and the growing trend of non-clinical jobs among physicians 24 . By identifying the factors that contribute to the shortage, investigating how it affects patient care and safety, and making strategic recommendations to address the healthcare needs, the study's key findings establish a strong correlation between physician workforce shortages and patient care.…”

“…The main deterrents were a lack of interest in surgery, the difficulty and length of surgical education, training and practice, role models and the potential for violent patient behaviour. 18 However, the departure of female physicians has expanded the divide between female doctors and female patients in medical practices. 12 Another factor for female doctors leaving the profession is gender bias, as most female doctors do not want to handle male patients and refuse to perform night shifts.…”

Sex‐based Disparities Among Surgical Faculty Positions Across Medical Colleges in Pakistan

“…Women are also more likely to suffer from mental health issues, such as depression, during their surgical training [ 16 ]. In addition, given frequent occurrences of physical aggression from patients or attendants [ 17 ], particularly during the COVID-19 (coronavirus disease 2019) pandemic [ 18 , 19 ], many aspiring women surgeons in Pakistan are deterred from pursuing a surgical career due to the threat of aggressive behavior [ 20 ]. Even as surgical faculty, women in Pakistan still face hindrances to progression up the academic hierarchy, with sex-based biases in the workplace affecting most aspects of their careers, including promotion opportunities and access to leadership positions [ 11 ].…”