Perception of medical students and interns toward orthopedics as a future career in Saudi Arabia

INTRODUCTION

Deciding on a career post-medical school is a personal, multifaceted journey influenced by multiple factors, including individual interests, ambitions, values, and the desire to make a meaningful impact on patients’ lives. This critical moment signifies the culmination of extensive years of education and clinical training, establishing the path for a lifelong journey in the field of medicine.^[1] Many medical students remain uncertain about their future careers and are willing to explore different possibilities. This uncertainty often decreases with greater exposure to a particular career. This correlation is apparent in a study involving orthopedic residents.

The majority (71%) noted that their exposure to the orthopedic rotation significantly impacted their career decision in this field when they were medical students.^[2] This can be attributed to the student being introduced to the medical specialties and having the opportunity to observe the work. Consequently, this enables them to assess if it matches their personal preferences, interests, and character traits, thereby guiding their choice of future career path. Regarding the perception of orthopedics, medical students often view it as a dynamic, procedure-focused field. This perception can influence each individual differently. There is a significantly lower number of female residents in orthopedics compared to their male counterparts^[3] – four times less, in fact. This disparity can be attributed to the perception among some female medical students that the field is physically demanding, which may influence their career decisions.^[4,5] Another factor that may affect medical student perception is stereotypes. A common stereotype in the medical field suggests that orthopedic surgery requires brute force and ignorance, which is not necessarily true. In fact, a study comparing the IQ scores of orthopedic surgeons and anesthetists found that orthopedic surgeons had a higher mean intelligence score.^[6] False stereotypes and perceptions about orthopedics pose a risk of discouraging medical students from considering specialization in this field. If students hold inaccurate beliefs, they may be hesitant to explore orthopedics, limiting their exposure to a specialty that could align with their interests and skills, potentially causing them to overlook a rewarding career path. Orthopedics encompasses both surgical and non-surgical approaches to treating patients. Misconceptions about this specialty may lead students to undervalue the importance of conservative treatments, physical therapy, and lifestyle modifications in managing musculoskeletal conditions. If these misconceptions influence students’ specialty choices and they later realize the inaccuracies, it can result in career decision regret, impacting their psychological well-being and overall professional satisfaction.

Addressing and dismissing these stereotypes is crucial for ensuring that medical students and interns make informed and unbiased decisions about their career paths. Numerous studies have explored the factors influencing the selection of orthopedics as a prospective career path. Yet, none have thoroughly examined whether these factors are misinterpreted by medical students and interns. Therefore, due to the absence of comprehensive information within the global literature, this study aimed to investigate medical students’ perceptions of orthopedics as a future career, focusing on the influence of mentors, rotations, and misconceptions around orthopedics.

MATERIALS AND METHODS

This is a cross-sectional study conducted in Saudi Arabia during November 2023. The targeted population was all medical students and interns currently living in Saudi Arabia who agreed to participate in the survey. Of the surveys received, 393 respondents agreed to participate, and their responses were included in the analysis. The questionnaire content was reviewed by an orthopedic surgeon to ensure its pertinence, precision, and efficacy in capturing relevant data for the study. The questionnaire had 29 items, the first two sections starting with the demographic data (age, sex, marital status, region, and current year of study), followed by the interest in orthopedics as a future career, and the final section had multiple questions about the perception of orthopedics.

The questionnaire for this study was distributed through various social media platforms among medical students and interns. Specifically, it was shared on platforms such as WhatsApp, utilizing group chats and broadcast lists related to medical studies; X (Twitter), leveraging hashtags related to medical education. The study targeted medical students across Saudi Arabia [Figure 1]. The data was entered into Microsoft Excel 2016 (Microsoft Corporation, Redmond, Washington, United States). The statistical analysis was conducted using IBM Statistical Package for the Social Sciences Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, New York, United States). The Chi-square test was used to analyze the data. Statistical significance was defined as P < 0.05, with a confidence interval of 95%.

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Figure 1:

Distribution of study participants according to regions in Saudi Arabia.

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RESULTS

DISCUSSION

The study centered on understanding perceptions and stereotypes about orthopedics as a career among medical students and interns in Saudi Arabia. Some key results showed that the participants were predominantly Saudis (86.3%) and females (66.4%) across different academic years, with the 3^rd year being the most represented (30%). Notably, 44% of the students showed an interest in orthopedics. There was no significant difference between males and females in this regard, unlike a study that was done in Nigeria, where the ratio of male interest in the specialty was more than double that in females.^[5] Conversely, there was a similar interest percentage (47%) to our study in a Japanese study.^[7] Meanwhile, 57.5% did not see sex discrimination in orthopedic residency, leaving a concerning 42.5% who did. Interestingly, a similar percentage (40.7%) felt that the field was more suited for males.

A substantial majority (74.8%) perceived orthopedics as physically demanding despite other studies showing that the majority of their participants said that it was not.^[5] The sources shaping these perceptions were primarily hospital training (28.5%) and social media platforms (21.6%), underlining their influence in shaping future awareness campaigns. About half of the students (48.9%) believed the orthopedic specialty to have a good reputation, and 41.7% thought it offered a satisfactory work-life balance. Around two-thirds of the participants (65.9%) recognized the field’s substantial learning and academic opportunities. These percentages shed light on the various perceptions surrounding orthopedics, influencing students’ decisions when considering it as a specialty [Table 2].

Delving deeper, the results revealed an intricate relationship between personal aspirations, societal norms, and medical career choices [Table 3]. The interest level in orthopedics (44%) suggests an influence of various factors, including sex perceptions and biases. The data reflect a significant perception that orthopedics is more suitable for males, which might indicate existing sex stereotypes in medical specialties. Such perceptions might affect the career choices among female medical students, as shown in another study where 31 males preferred orthopedics, but only two females preferred the specialty.^[8]

The influence of the medical education stage on students’ interests indicates that experiences and exposure during training significantly impact career decisions. The perception of orthopedics as physically demanding in our study may discourage Saudi students from specializing in orthopedics. In another study, only 9.2% of their participants believed that orthopedic specialists have a bad work-life balance, showing a difference compared to 29.8% in our study, which shows a different stereotype in Saudi students.^[5] The influence of social media platforms in shaping perceptions, especially in a culture with potential sex communication barriers, could explain the sex disparity in orthopedics.^[9]

The positive view of career opportunities and income potential in orthopedics might be attractive incentives, and this is supported by the results of another study, which found that income was more important in the career choice of orthopedic-interested students compared with non-orthopedic-interested students.^[10] We should keep in mind that perceptions of challenges such as bad work-life balance and physical demand could deter interest.

This study offers a clearer understanding of factors influencing career choice, which is crucial for addressing workforce needs in healthcare. Medical institutions and health-care systems can strategize to mitigate potential shortages or imbalances by identifying what attracts or deters students from certain specialties. The study also highlights the importance of addressing sex-related stereotypes in orthopedics, which is crucial for promoting sex equality in medicine. In addition, these insights can help medical schools refine their curricula and clinical rotations to provide more comprehensive exposure to orthopedics.

CONCLUSION

This study shows an overall positive perception of orthopedics as a future career, with substantial stereotypes toward the high physical demand that the job requires. There is a considerable number who still, to this day, think that orthopedics is more suitable for males than females.

Overall, this study highlights the need for medical schools to enhance the reputation of orthopedics by providing students with the resources and mentorship to understand orthopedics as a discipline of interest. The pattern of significance suggests that as students progress through their medical education, their perceptions of orthopedics become more determined.

This signifies that exposure to the field and educational interventions can either enhance or worsen the perception. The influence of mentors plays a pivotal role in shaping students’ perceptions and guiding their career choices, underscoring the importance of mentorship in leading students toward a deeper understanding and appreciation of orthopedics as a rewarding career path. In addition, the experience gained from hospital rotations is highlighted as a significant factor in influencing medical students’ views, demonstrating the profound impact these practical experiences which have on their perception of orthopedics.

AUTHORS’ CONTRIBUTIONS

HAG and HMA designed the study protocol. AAA and MAA updated reference lists and wrote the manuscript draft. AMA and HA contributed to reviewing and proofreading the final manuscript. All authors have critically reviewed and approved the final draft and are responsible for the manuscript’s content and similarity index.