Abstract Background: The percentage of female medical students is steadily increasing, yet women remain underrepresented in most surgical specialties. This study aimed to identify the factors that influence the decision to pursue a surgical versus a non-surgical career, with particular attention to gender-specific influences and potential untapped opportunities in medical education. Methods: A monocentric mixed methods approach was employed. A total of 200 medical students at the University of Ulm completed an online questionnaire. Subsequently, semi-structured guideline-based interviews were conducted with 20 of the participants (10 female, 10 male). The interviews were transcribed and analysed using qualitative content analysis as described by Kuckartz & Rädiker. Results: Among the participants, 22.2% of male and 23.4% of female students indicated a preference for a surgical specialty. The most relevant factors explaining the variance were identified as prioritization of private life over career (B = -0.596, p = 0.009), the number of surgical internships completed (B = 0.714, p = 0.007), current semester (B = -0.683, p = 0.009), and self-confidence in surgical skills (B = 0.576, p < 0.001). Gender itself showed no statistically significant influence (B = 0.146, p = 0.745). However, female students reported significantly more negative experiences in the operating room (OPR) (χ² = 13.795, p = 0.001). The interviews also revealed a strong desire among students for more practical training during medical school and highlighted the substantial influence of teaching staff in fostering interest in particular specialties. Discussion: Throughout medical education, instructors have a significant—partially gender-specific—influence on specialty choice through their role-modelling and teaching approaches. The quality of practical training, perceived competence in surgical skills, and experiences in the OPR all play crucial roles in shaping career decisions.
Koop et al. (Tue,) studied this question.