Fourth-Year Medical Students' Perceptions of Vascular Surgery: Can We Improve the Pipeline?

Background: Since their inception, Integrated Vascular Surgery Residency (IVSR) programs have expanded widely and attracted highly competitive medical students by offering a more focused approach to learning both open surgical and endovascular techniques. However, despite substantial modifications to the training paradigm, a shortage of vascular surgeons is still projected through 2050. We aimed to gather and analyze fourth-year medical students' knowledge and perceptions of vascular surgery (VS) to further inform strategies for recruiting future vascular surgeons.Methods: We sent anonymous electronic questionnaires to fourth-year medical students at 7 allopathic and 3 osteopathic medical schools, with questions detailing demographics, specialty preferences, and exposure to and perceptions of VS. Descriptive statistics were obtained, and responses were compared between students applying to surgical specialties (SS) and nonsurgical specialties (NSS).Results: Two hundred eleven of 1,764 (12%) participants responded (56% female). 56% re-ported VS exposure, most commonly during the third year. 64 (30%) planned to apply to SS. 57% of respondents reported knowledge of the management of vascular disease, and 56% understood procedures performed by vascular surgeons. Ranking the importance of factors in choosing specialties, SS selected "experiences gained during medical school rotations"(P < 0.05), "types and/or variety of treatment modalities used in this field"(P < 0.001), and "interest in the pathology or disease processes treated"(P < 0.05) as highest priorities. NSS preferred ''lifestyle (work-life balance) as an attending"(P < 0.001). Only 7% of all respondents believed vascular surgeons have a good work-life balance, with a larger percentage of SS (P < 0.001) agreeing. Stratified by gender, female students rated ''limited ability of childbirth during residency and/or postponement of family plans"(P < 0.05), ''gender-related concerns, such as discrimination at work or unfair career possibilities"(P < 0.001), and ''fear of unfair competition"(P < 0.05) as potential negative aspects of VS careers. 55% of respondents believed the IVSR makes VS more appealing.Conclusions: Medical students perceive poor quality of life and work-life balance as deterring factors to a career in VS. Opportunities exist to educate students on the pathologies treated, procedures performed, and attainable quality of life available in our field. We should also continue to develop recruitment strategies to stimulate student interest and increase early exposure in VS.