Attitudes of surgical trainees towards transplantation surgery as a career

At present there are a number of unfilled consultant posts in transplantation surgery in the United Kingdom, particularly within the field of kidney transplantation. Unless the current shortfall is addressed, it seems highly probable that the number of unfilled consultant posts will continue to increase. This survey aimed to highlight the reasons underlying trainees' reluctance to enter the field of transplantation surgery and to assess how the specialty might be changed to attract new trainees. Questionnaires were sent to 102 surgical trainees requesting details on age, sex, training grade, research interests and chosen specialty. They were asked to consider nine specified reasons commonly thought to influence a trainee's decision on whether or not he/she would enter their chosen specialty and to grade each of these according to their relative importance in the context of considering a career in transplantation. The survey then suggested five changes in training/structure, and the trainees were again asked to grade the relative importance of each with regard to whether it would attract them towards transplantation surgery. Replies were received from 61 trainees (60%). Trainees were deterred from transplantation surgery because of the on-call commitment, unpredictable workload, lack of exposure and a lack of information on the specialty. A reduced on-call commitment, increased income, increased exposure, improved training structure and increased information would all serve to attract new trainees to the specialty. To attract new trainees to transplantation surgery, there must be exposure to the specialty at an earlier stage in training, and a proactive stance must be adopted in providing information for the trainees. In addition, there needs to be ongoing commitment to improvements in training structure. The issues of increased income and an acceptable on-call commitment must be addressed.