Factors Responsible for Final-Year Medical Students Selecting Orthopedic Specialty in Enugu State

Medical training is one of the core components of the health system of any country. The specialty preferences of medical undergraduates and young medical graduates reflect the pattern of distribution of specialists in the future work-force in the health care system. The preference of Orthopaedic surgery specialty by medical students has been poor.

This study aims to explore the factors responsible for final year medical students choosing orthopedic surgery specialty in Enugu state, Southeast Nigeria.

A cross-sectional survey of Final year medical Students from two Universities in Enugu state in Southeastern Nigeria was conducted. The Universities were; University of Nigeria, Nsukka (UNN) and Enugu State University of Science and Technology (ESUT). A structured questionnaire designed using the free software google forms was utilized for the study and electronically distributed randomly to 132 final year medical students in Enugu state, Southeast Nigeria using platforms including Whatsapp® and Telegram®. The data collected was analysed by Statistical Package for the Social Sciences (SPSS).

At the end of the study, 132 final year medical students completed and submitted the questionnaires. Majority of the students (73%) were not interested in Orthopaedic surgery. Among those who were interested, most indicated that the interest arose spontaneously (31%, n = 11), about 11% attributed the interest to either seeing a movie that showcased the specialty or to good performance in related courses (Anatomy, Radiology, Surgery), while only 8% attributed the interest to effect of lectures in the course or to having a family member who was an orthopedic surgeon. In another 9%, an interest in orthopaedic surgery developed during their posting in the specialty.Among those who were not interested, about 66% attributed this to the specialty being physically demanding while a minority attributed it to other factors like the long duration of residency program in orthopaedic surgery, the interference by traditional bone-setters and male dominated field. A greater proportion of the female respondents (68%) were discouraged by the physical demands of the specialty compared to males (62%).No factors was found to be significantly associated statistically with the interest/lack of interest in orthopaedic surgery specialty among the reasons (Perceived Job prestige x² ₌ 0.762 P = 0.859, Perceived income x²=2.962 P = 0.227, Perceived work life balance x²=4.087 P = 0.252, Perceived opportunities for research x²=6.895 P = 0.075, Perceived relevance of orthopaedic specialists x²=1.777 P = 0.620). Significance value was P < 0.05.

There is a low preference towards orthopedic surgery among final year medical students. This study attempted to highlight the factors responsible for final year medical students selecting orthopedic surgery in Enugu state, Southeast Nigeria and it revealed that clinical rotations, mentorship, work-life balance, job prestige, income and opportunities for research were all important factors.

We recommend that more time be allotted to Orthopedics postings to increase interest in the specialty. More Orthopedic surgeons should provide proper guidance and mentorship to medical students in order to influence students choice of specialty.