Perceptions of neurosurgery: a survey of medical students and foundation doctors

The ratio of applications per place for the British neurosurgical training programme (ST1 level) is currently significantly less than in many other specialities including competitive surgical and radiological programmes. A survey of medical students and junior doctors prior to speciality selection was conducted to assess their perceptions of neurosurgery as a speciality and identify factors that affect career choice and recruitment. A three domain, 17-item questionnaire with a Likert 5-point scale was produced. Two hundred individual paper questionnaires were randomly distributed across a central London teaching trust. Response rate in both groups was 100% with no exclusions. Data were collected by one group and analysed independently with descriptive methods and independent t-tests to determine statistically significant intra-group variability. Results showed marked differences in opinions at the two stages of medical progression and identified several consistencies. Examples include a tendency to rule out neurosurgical careers on the basis of experience with other surgical specialities and fear of inadequate dexterity or intelligence. The results showed variable persistence of traditional stereotypes including a common view that it is a highly competitive male dominated profession although this view significantly diminished with experience. Neurosurgery is an expanding profession at the cutting edge of technology. This study offers an important and interesting insight into why it is not more popular and what can be done to attract the best candidates.