Changes in Career Perceptions Following a Three-Month General Surgery Internship Among Newly Graduated Medical Doctors in Pakistan: A Pre–Post Study
This pre–post study of 124 newly graduated doctors in Pakistan found that while a three-month General Surgery internship significantly increased perceived exposure to surgery and mentorship, it did not broadly alter career perceptions, with those ultimately choosing the specialty distinguishing themselves through higher scores in perceived aptitude, personality fit, mentorship, and career diversity.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Every year, thousands of young doctors in Pakistan finish their medical school and begin a mandatory year of training known as a "house job." This period is designed to turn students into practicing physicians by rotating them through different hospital departments. One of these rotations is a three-month stint in general surgery, where they work alongside surgeons, assist in operations, and learn the rhythms of the operating room. For many, this is the first time they get a real taste of the surgical lifestyle, moving beyond textbooks to the reality of cutting, stitching, and managing patients under pressure. The question that has long puzzled educators and career counselors is whether this brief, intense exposure is enough to spark a lifelong passion for surgery, or if it simply confirms that the field is too demanding for some. Understanding this moment of decision is crucial because the future of surgical care depends on attracting enough new doctors to the specialty, a challenge that is particularly acute in developing nations where resources are already stretched thin.
A team of researchers at FMH College of Medicine & Dentistry in Lahore decided to investigate exactly how this three-month surgical rotation changes the minds of fresh medical graduates. They followed a group of 124 doctors who were just starting their house jobs, asking them to fill out a survey about their feelings toward surgery before they began the rotation and again immediately after they finished. The survey asked the doctors to rate their agreement with various statements, such as whether they felt they had the right skills for the job, if they saw themselves fitting the personality of a surgeon, and whether they had a mentor to guide them. By comparing the answers from the start of the rotation to the answers at the end, the researchers could see if the experience actually shifted their career perceptions.
The results showed that the internship did succeed in making the doctors feel more familiar with the environment. After the three months, the participants reported significantly higher levels of exposure to actual surgeries and felt they had better access to mentors in the field. However, this increased familiarity did not translate into a massive wave of new surgeons. At the end of the rotation, only 14 of the 124 participants, or about 11 percent, decided that general surgery would be their future career. For the vast majority, the rotation provided valuable experience but did not change their ultimate career path. The most popular choice for the group as a whole shifted from internal medicine before the rotation to obstetrics and gynecology after it, while general surgery remained the third most popular option, holding its ground but not surging ahead.
When the researchers looked closer at the small group of doctors who did choose surgery, a clear pattern emerged. These individuals felt a much stronger sense of personal aptitude, believing they had the natural skills for the work. They also felt a better match between their own personality and the values of the profession. Crucially, they were more likely to have a role model or a mentor who inspired them. The study also uncovered interesting differences based on gender. Male doctors tended to feel more confident in their aptitude and viewed surgery as a competitive field, while female doctors were more likely to perceive the career as gender-biased and expressed more concern about how the demanding schedule would affect their future family life. Those who had a family member already working as a surgeon felt less stress about the difficulty of the job and had stronger connections to mentors.
The researchers concluded that while a three-month rotation is effective at teaching doctors what the job looks like and connecting them with mentors, it is not a magic switch that converts interest into a career choice for most people. The doctors who did choose surgery were already inclined toward it, feeling a strong personal fit and having the right support systems in place. The study suggests that to attract more graduates to surgery, programs may need to do more than just offer exposure; they may need to actively foster mentorship and address the specific concerns that different groups of doctors have about the lifestyle. The authors note that their findings come from a single hospital in Pakistan, so the full picture might look different in other places, and they emphasize that longer studies are needed to see if these early decisions hold up over the course of a full career.
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