Educational exposures associated with preclinical medical student interest in pursuing surgical residency: Longitudinal mixed-methods study with narrative evaluation.

Introduction: Pre-clerkship medical students rely on various educational experiences to decide on the residency they would like to pursue. We conducted a longitudinal mixed-methods study to identify educational experiences in pre-clerkship that are associated with an interest in pursuing surgery. Methods: Pre-clerkship medical students were invited to complete an initial survey regarding their interest in surgery and educational exposures. After 10 months, a follow-up survey was sent to identify changes in their interest and the role of educational experiences they may have had in the interim. Univariate regression was used to determine associations, and thematic analysis was done. Results: Data from 218 pre-clerkship students showed that shadowing (OR = 2.7), participation in technical workshops (OR = 5.1), having a mentor (OR = 4.6) and conducting surgical research (OR = 4.6) were associated with an interest in pursuing surgery. From the students with follow-up data, thematic analysis showed that 94 %, 89 %, and 81 % of students found shadowing, research, and mentorship, respectively, as influential in the decision of pursuing a surgical specialty, respectively. Conclusions: Shadowing and mentorship were important factors for students in the decision-making process in pursuing surgery. Identifying high-yield educational experiences-for students to determine if one wants to pursue a surgical specialty is important for educators in curriculum design for resource allocation. Key message: We describe a longitudinal mixed-methods study to determine the role of early educational exposures which influence a medical student's decision to pursue a surgical specialty. Shadowing, technical skills workshops, surgical mentorship, involvement in surgical research, play an important role for student decisions.