ArticleActa orthopaedica et traumatologica turcica2025
Challenges and influencing factors in hand surgery subspecialty training: a nationwide survey of orthopedic, plastic, and hand surgery residents in Türkiye.
Article in Acta orthopaedica et traumatologica turcica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This study aimed to identify the factors influencing the decisions of orthopedic and plastic surgery residents in Türkiye regarding their pursuit of a subspecialty in hand surgery, as well as to evaluate the challenges faced during hand surgery training. Methods: A national survey was conducted among residents in orthopedic and trauma surgery (n=92), plastic surgery (n=84), and hand surgery (n=12). The survey, developed from literature reviews and previous studies, was distributed online, and responses were collected via Google Forms. Orthopedic and plastic surgery residents responded using a 4-point Likert scale, while hand surgery residents answered multiple-choice questions. The collected data were analyzed to determine factors influencing career choices, training adequacy, and the challenges faced by residents. Results: The analysis revealed a negative correlation between the high volume of emergency hand surgery cases and residents' inclination toward the subspecialty (r=-0.217, P < .05). Theoretical training was significantly linked to enhanced hand surgery knowledge and skills (r=0.213, P < .05), whereas the lack of adequate training infrastructure negatively affected residents' experience (r=0.390, P < .05). Financial concerns and heavy workloads were identified as major challenges, with 33.3% of hand surgery subspecialty residents considering quitting their program. The study also highlighted a lack of continuity in training, insufficient exposure to elective hand surgery cases, and limited access to international educational opportunities. Conclusion: The findings indicate a need to enhance both the theoretical and practical aspects of hand surgery training in Türkiye. By addressing financial and workload-related concerns, improving clinical exposure, and expanding access to microsurgical tools and training resources, it may be possible to increase interest in the subspecialty and ensure a sustainable workforce of hand surgeons in the future. Level of Evidence: N/A.
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