Career orientation among medical students in Germany: perceived motivating factors and barriers to pursuing oral and maxillofacial surgery - a nationwide survey.

backgroundOral and maxillofacial surgery (OMFS) faces increasing challenges arising from evolving healthcare demands, rising case complexity, and ongoing workforce recruitment challenges, necessitating the long-term preservation of specialized expertise. Although training pathways are well established, career trajectories among medical students remain highly heterogeneous. This study addresses the structural recruitment challenge in OMFS in Germany. It focuses on the mismatch between presumably strong interest in OMFS among medical students, and key barriers, particularly dual-degree requirements. MATERIALS AND

methodsA cross-sectional, nationwide online survey was distributed by the Young Forum of the German Association of Oral and Maxillofacial Surgery (Junges Forum der DGMKG) across German medical schools to assess factors influencing career decisions for or against OMFS. The questionnaire covered demographic characteristics, career planning, knowledge and practical experience, and perceived stigma related to OMFS.

resultsThe study included 108 medical students (69% female; mean age 25 years), including 64% clinical students, 25% preclinical students, and 11% students in their final practical year. The primary outcome was self-reported interest in OMFS as a potential specialty choice. Interest was highest for OMFS (25%), followed by pediatrics (16%) and gynecology and obstetrics (12%). Completion of an OMFS internship and higher self-rated OMFS knowledge were independently associated with greater interest in OMFS, with internship completion associated with more than sixfold higher odds of naming OMFS as the preferred specialty (OR 6.65, p = 0.013). Female participants showed lower odds of preferring OMFS in the exploratory multivariable model and were also less willing to pursue a second dental degree (p < 0.001). While perception of training burden did not differ significantly by gender, it varied across training phases. Prior dental education showed a strong bivariate association with OMFS interest (Cramér's V = 0.50). Operative activity and reconstructive surgery emerged as the main motivators, whereas training duration and dual-degree requirement represented the dominant perceived barriers across all training phases.

conclusionWithin this exploratory sample of medical students, OMFS was frequently named as a specialty of interest. However, structural and environmental barriers may contribute to reduced willingness to pursue specialist training. Earlier OMFS exposure and greater specialty-specific knowledge were associated with increased interest, whereas the dual-degree requirement, prolonged training duration, and financial burden were perceived as barriers. These findings highlight the importance of earlier curricular exposure, structured practical experience, and targeted support strategies to improve long-term recruitment in OMFS.