Medical student and faculty perceptions of undergraduate surgical training: A comparison between South Africa and Sweden
INTRODUCTION: There is a paucity of literature comparing the views and perceptions of medical students and surgical faculty regarding the surgical curriculum. Additionally, little evidence is available illustrating the prevalence of surgical mentors and role models, as well astheirspecific characteristics. Comparing the learning climates and current state of mentorship during undergraduate surgical training between developing and developed countries may offer insight into curricular improvement, and may shed light on methods to improve and stimulate surgical interest amongst medical students globally. METHODOLOGY: An electronic, online questionnaire was anonymously distributed to medical students and surgical faculty at the University of Cape Town, South Africa, and Karolinska Institutet, Sweden. The questionnaire explored the perceptions of medical students and surgical faculty regarding the current undergraduate surgical curriculum, existing clinical and theoretical instructional methods, as well as mentorship and role models within the surgical discipline. RESULTS: A total of 120 students (response rate of 24.4%) and 41 faculty (response rate of 74.5%) responded. Compared to South African faculty, Swedish faculty were predominantly male and were significantly older (p=0.009). Medical students desired more hours of instruction compared to faculty (p=0.017). South African students expected to study more hours compared to Swedish students (p=0.029). There was general agreement that ‘small-group tutorials’ was the area students learn the most from, whereas students reported ‘lectures’ least helpful. Registrars were reported as the first person students should consult regarding patient care. A large proportion (42.5%) of medical students believed that faculty viewed students as an inconvenience, and 35.0% of students believed that faculty would rather not have students on the clinical team. Faculty believed the current surgical curriculum was less adequate compared to medical students (p=0.010). A total of 41 (34.2%) students stated they had a mentor during their surgical training, which was significantly different to the perception of faculty that students ought to have a mentor during their undergraduate surgical training (p< 0.001). A significant difference was found between students from South Africa and Sweden in the number reported to have had a mentor (p< 0.001). The majority of respondents believed that registrars were the best role model. With regards to the most important qualities of a mentor, students rated encouragement, adequate supervision, setting of fair expectations, and teaching skills significantly higher compared to faculty (p=0.037, p=0.007, p=0.002, and p=0.010 respectively). CONCLUSIONS: Significant differences exist between surgical faculty and medical student perceptions of undergraduate surgical training and mentorship, as assessed in cohorts from a developing and a developed country. In order to increase surgical interest amongst undergraduate medical students, it is imperative for surgical educators to be aware of these differences, and to find specific strategies to bridge this gap.
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