Propagating the "SEAD": Exploring the Value of an Overnight Call Shift in the Surgical Exploration and Discovery (SEAD) Program

Abstract

Objective: Attrition of general surgery residents highlights a need to support well-informed specialty selection. This study evaluated preclerkship medical students' perception of overnight call shifts in surgical career exploration.

Design: A mixed-methods design was used, involving entry and postcall shift surveys and focus groups. Survey data characterized the population and call shift, guided focus group segmentation by baseline interest in surgery, and provided context for interpretation of qualitative data. Focus groups were transcribed and analyzed with a phenomenological approach using thematic analysis.

Setting: Call shifts took place at the University of Toronto's Sunnybrook Health Sciences Centre and St. Michael's Hospital, 2 Level 1 trauma centers in Toronto, Canada.

Participants: Twenty-five first-year medical students participating in the Surgical Exploration and Discovery program.

Results: Sixty-four percent (n = 16) of the participants were male. Students in the high interest group (n = 9) had more prior operating room exposure than students in the moderate (n = 12) and low (n = 4) interest groups (p = 0.039). Most students valued participating in a call shift; 80% (n = 20) rated the experience "positive" or "very positive." Thematic analysis yielded 2 categories of themes: (1) Valuable aspects of the experience, including being part of a team, mentorship, understanding the clerk's role, dispelling misconceptions, trial of working overnight, and influencing interest in a surgical career; and (2) Determinants of an enjoyable experience, including resident engagement and number of traumas.

Conclusions: An overnight call shift experience was valuable to preclerkship medical students regardless of baseline interest in surgery. While it only influenced a few students' specialty preferences, exposure facilitated a better understanding of a unique component of surgical careers and provided valuable mentorship. These findings support implementing calls shifts in other curricular or extracurricular programs to make the experience more widely available and enable earlier, informed career decision-making.

Keywords: Patient Care; Practice-Based Learning and Improvement; Systems-Based Practice; career planning; medical student; mentorship; surgery; undergraduate medical education.