• Elspeth J R Hill, Katherine A Bowman, Renée E Stalmeijer, Yvette Solomon, and Tim Dornan.
• School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; Manchester Medical School, Faculty of Medical and Human Sciences, The University of Manchester, Manchester, UK; Division of Plastic and Reconstructive Surgery, Washington University, St Louis, MO, USA. Electronic address: hille@wudosis.wustl.edu.
• Am. J. Surg. 2014 Nov 1;208(5):860-7.

BackgroundRecent years have seen a significant drop in applications to surgical residencies. Existing research has yet to explain how medical students make career decisions. This qualitative study explores students' perceptions of surgery and surgeons, and the influence of stereotypes on career decisions.MethodsExploratory questionnaires captured students' perceptions of surgeons and surgery. Questionnaire data informed individual interviews, exploring students' perceptions in depth. Rigorous qualitative interrogation of interviews identified emergent themes from which a cohesive analysis was synthesized.ResultsRespondents held uniform stereotypes of surgeons as self-confident and intimidating; surgery was competitive, masculine, and required sacrifice. To succeed in surgery, students felt they must fit these stereotypes, excluding those unwilling, or who felt unable, to conform. Deviating from the stereotypes required displaying such characteristics to a level exceptional even for surgery; consequently, surgery was neither an attractive nor realistic career option.ConclusionsStrong stereotypes of surgery deterred students from a surgical career. As a field, surgery must actively engage medical students to encourage participation and dispel negative stereotypes that are damaging recruitment into surgery.Copyright © 2014 Elsevier Inc. All rights reserved.

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