Recruiting trainees to surgery in the United States and Canadian system - What strategies are effective?

Background: There has been increasing concerns regarding the declining number of medical students entering surgical residencies. The aim of this study is to analyze strategies and outcomes to enhance recruitment to the surgical specialties.

Methods: A systematic literature PRISMA-based search was performed. Study quality and bias were assessed. Meta-analysis was performed using DerSimonian Laird method.

Results: Of 3288 unique titles identified, 73 studies met inclusion criteria. Median study unique sample size was 84 participants (range 15-910). Subjective interest was reported in 59 studies, while objective match rate was reported by only 21 studies. The cumulative odds of students interested in the studied specialty was 1.98 (95% CI 1.47-2.67, I = 0%) and in any surgical specialty was 1.40 (95% 1.01-1.95, I = 37%) after an intervention compared to baseline.

Conclusion: While studies show increased odds of "interested in" a surgical specialty, the results may be subject to high selective and confounding biases.