Worldwide interest among medical students in surgical careers is declining.
According to recent research, concerns about lifestyle, competitiveness and inclusivity, as well as limited exposure to surgical practice, have contributed to dwindling numbers.
The authors of the paper are now calling for urgent recognition of these early perceptions, which are believed to be crucial for ensuring a diverse and adequately staffed surgical workforce.
The recent University of Glasgow study of third-year medical students without prior surgical experience found that limited exposure, work-life balance issues, training competitiveness and concerns about manual dexterity are significant barriers.
The statistics were:
• Lack of exposure or experience (20%)
• Poor work-life balance (16%)
• Competitiveness of training (15%)
• Concerns regarding manual dexterity (11%).
As a result, targeted education and mentorship to improve early exposure, perceptions of lifestyle and inclusivity could help boost recruitment.
Decisions to pursue surgery are largely influenced by personal interest, educational exposure and perceived lifestyle demands.
Over the past two decades, interest has waned globally, with work-life balance, lengthy training, and cultural barriers cited as reasons in both Western and Eastern contexts.
In the UK specifically, gender and socioeconomic disparities continue to affect application rates.
Concerns about long hours, limited flexibility and intense competition reduce students' enthusiasm.
Early positive surgical experiences are vital; without them, misconceptions may discourage students from considering surgery as a career.
Gender bias persists, with female students citing a lack of role models, discrimination, and family life challenges, and a lack of mentor diversity can be a barrier for Black students.
Addressing these barriers is essential to maintaining a diverse and inclusive surgical workforce, particularly as the underrepresentation of women and minorities persists despite some progress.
The study underscores the importance of examining initial attitudes among early-stage medical students. Unlike previous research focusing on senior students or subspecialties, this work provides insights into initial perceptions before formal clinical exposure, laying the groundwork for strategies to improve recruitment and diversity.
Medical students with no surgical experience often see surgery as competitive, technically demanding and incompatible with work-life balance.
Notably, the primary deterrent – lack of exposure – is modifiable. Addressing these barriers through early, inclusive interventions like structured exposure, mentorship, and clear messaging about lifestyle balance is critical.
The authors conclude: ‘Undergraduate students with no surgical exposure perceive surgery as competitive, technically demanding, and poorly compatible with work-life balance. However, the most common deterrent, lack of exposure, is modifiable. Addressing these barriers is critical to securing a diverse and sustainable surgical workforce. Early, inclusive interventions, such as structured exposure, mentorship, and clear messaging around lifestyle balance, can reshape perceptions, enhance recruitment, and ultimately benefit patient care through a workforce that reflects the diversity of the populations it serves.’
