1132 The Best Way to Develop a Surgeon: An International Comparison of Medical Education and Surgical Training

Abstract Aim Currently, interest in surgical careers is declining globally. Surgeons share ideas internationally without sharing much about training. This study compares international pathways toward surgeon development with the aim of seeking improvements. Method A 70-question anonymous survey was distributed internationally to surgeons of all specialties. Data were analysed in SPSS Statistics for Macintosh (IBM). A value of p0. 05 indicates statistical significance. Results The 463 respondents from the U. S. (59%) ; U. K. (16%) ; Europe (10%) ; Canada (5%), and the Rest of the World (RotW) (10%) averaged age 46; 64% were female. Non-U. S. /Canadians (93%) attended 5- and 6-year medical schools; U. S. respondents were far more likely (91%) to attend non-medical 4+-year university before medical school. Weekly training-hour weekly mandates spanned 48 (9%) to 80+ (45%) ; 76% surpassed mandate hours; 9% reported accurate hours. Average educational debt ranged from 14, 000 (Europe) to 179, 000 (U. S. ). Few (19%) felt training allowed family building. Nearly all U. S. /Canadians felt competent after training, versus U. K. (81%), RotW (74%) and Europe (70%). Conclusions The outlook of surgery as an attractive career depends on the way we develop future surgeons. Based on best practices from different countries, the authors recommend a 6-year maximum university/medical education requirement; elimination of mandatory non-surgical training years; single-program surgical training; 60-hour work-weeks; competency-based training; AI tools for training and tasks; advanced-care providers for non-educational tasks; certifying at completing of training; and support of childbearing and childcare.