Journal of surgical education | 2019
The PreOp Program: Intensive Preclinical Surgical Exposure is Associated With Increased Medical Student Surgical Interest and Competency.
Abstract
OBJECTIVE\nAs medical students interest in surgical fields wanes, we investigated the impact of a preclinical surgical exposure program on students attitudes toward pursuing surgical careers.\n\n\nDESIGN\nThis is a prospective longitudinal study of PreOp, a preclinical rotation-based surgical exposure program for first-year medical students, from 2013 to 2017. Surveys assessed PreOp rotation quality, students surgical interest, and students self-reported preparedness for the surgical clerkship. Surgery clerkship grades were obtained as a measure of surgical competency and compared to class-wide peers. Match data was collected and compared to class-wide peers as well as historical norms.\n\n\nSETTING\nNewYork-Presbyterian Hospital/Weill Cornell Medicine, New York, NY; tertiary care center.\n\n\nPARTICIPANTS\nFifty-four PreOp students from 2013 to 2017.\n\n\nRESULTS\nFifty-four PreOp participants were recruited. After completing the PreOp program, 66.7% of PreOp students reported being very likely to apply into a surgical field compared to 29.4% when they started medical school. Ultimately, 71.4% of PreOp students versus 21.7% of non-PreOp class-wide peers matched into surgical fields (p < 0.001). From the preceding 5 match years before PreOp implementation, 21.4% of all students matched into surgical fields compared to 25.6% of all students after PreOp was started (p\u202f=\u202f0.26). In terms of preparedness, 75% of PreOp students reported feeling more prepared for the third-year surgery clerkship than their non-PreOp peers after the second year of medical school. PreOp students were significantly more likely than non-PreOp class-wide peers to receive honors in the surgery clerkship when controlling for cumulative clerkship GPA (p\u202f=\u202f0.012, adjusted odds ratio\u202f=\u202f5.5 [95% confidence interval 1.5-22.1]).\n\n\nCONCLUSIONS\nHands-on preclinical surgical exposure was associated with student-reported increased surgical interest that was maintained longitudinally and reflected in significantly increased surgical matches relative to non-PreOp class-wide peers. This study uniquely demonstrates that participation in PreOp was also associated with increased self-reported surgical preparedness and significantly higher surgery clerkship grades relative to overall academic performance.