What Kind of Surgeon Will You Be? An Analysis of Specialty Interest Changes Over the Course of General Surgery Residency

Background: Integrated surgical residency programs and early specialization tracts have increased, with proposed benefits including shorter training time and increased exposure. Drawbacks include a loss of breadth and the need for earlier trainee career decisions. We sought to assess the rate of changing specialty interests over the course of general surgery residency, and what, if any, factors influenced that decision. Methods: An 11-question, web-based survey was sent to alumni (2009–2019) of a single academic general surgery residency training program. It queried demographics and experiences during medical school and residency, whether specialty interest changed, and if so, what factors influenced that decision. Results: The survey was emailed to 53 alumni and completed by 59% (n = 31). The majority were male (n = 24, 77%) and Caucasian (n = 26, 84%). All 31 respondents went on to fellowship training. Three individuals (10%) did not declare a specialty interest when applying to residency. Of the 28 who declared an interest, the majority (n = 17, 61%) changed their interest over the course of residency and ultimately applied to fellowship in a different field. Amongst these, only six (25%) had previous exposure in medical school to the field they ultimately went in to. All who changed specialties (n = 17) reported an impactful clinical rotation influencing their decision. Conclusions: Nearly two-thirds of general surgery residents at a single academic institution changed their specialty interest over the course of residency. Our findings suggest that while integrated programs may provide benefits, many medical students are not being exposed to these potential fields.