• Lejla Hadzikadic, Peter A Burke, Thomas J Esposito, and Suresh Agarwal.
• Department of General Surgery, Boston University Medical Center, 850 Harrison Ave, Boston, MA 02118, USA.
• Arch Surg. 2010 May 1; 145 (5): 445-50.

HypothesisPresenting the opinions of surgical residents about the appeal of trauma surgery as a specialty may influence current reform.DesignSurvey study.SettingAcademic research.ParticipantsGeneral surgery residents (postgraduate years 1-5 and recent graduates) registered with the American College of Surgeons.InterventionsA 22-item survey.Main Outcome MeasuresCareer plans and perceptions about trauma surgery as a specialty.ResultsOf 6006 mailed surveys, we had a 20.1% response rate. Midlevel residents comprised most of the respondents, and most were undecided about their career choice or planned to enter general surgical private practice. The typical residency programs represented were academic (81.7%), urban (90.6%), and level I trauma centers (78.7%), and included more than 6 months of trauma experience (77.6%). Most respondents (70.6%) thought that trauma surgery was unappealing. The most important deterrents to entering the field were lifestyle, poor reimbursement, and limited operating room exposure, while increased surgical critical care was not seen as a restriction. When questioned about the future of trauma surgery, they believed that trauma surgeons should perform elective (86.8%) and nontrauma emergency (91.5%) cases and would benefit from active association with an outpatient clinic (76.0%). Intellectual challenge and exciting nature of the field were listed as the most appealing aspects, and ideal practice characteristics included guaranteed salary and time away from work.ConclusionsAs demand for trauma surgeons increases, resident interest has dwindled. As a specialty, trauma surgery must undergo changes that reflect the needs of the incoming generation. We present a sampling of current surgical resident opinion and offer these data to assist the changing discipline and the evolving field of acute care surgery.

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