Table 4. Gender differences in undergraduate medical students' career intentions in surgery.

Author	Year	Participants	Number of articles/ participants male/female	Type of study	Study objective	Findings
Yu	2012	Medical students	17 articles	Review	To summarize the factors influencing female medical students when choosing a career in surgery	No gender differences in concerns about lifestyle and family priorities when considering a career in surgery. Gender discrimination and bias as a consistently and significant career deterrent reported by female medical students.
Fitzgerald	2012	Newly graduates	280 (78/130)	Survey	To investigate the perceptions of surgical careers among recent medical school graduates	42% males vs 25% females interested in a career in surgery. Reported negative attitudes toward women among the surgical teams. 59% of male and 68% of female respondents believed surgery was not a career welcoming women.
Bhat	2012	Interns/ Newly graduated	250 (130/120)	Survey	To investigate the factors influencing the preferences of medical graduates for specialization	Gender significantly influenced specialty choice with males choosing medicine and surgery and females choosing obstetrics and pediatrics. Factors which influenced specialty choice included job satisfaction, income, lifestyle friendliness and career prospects.
Zarebaczan	2011	3rd and 4th year students	505 (225/280)	Survey	To evaluate if the limitation of working hours increased medical students’ interest in pursuing a career in surgery	The 80-h work week has not improved medical students’ interests in surgery. 19% males vs 7.6% females were interested in surgery.
Maseghe Mwachaka	2010	Medical students	385	Survey	To assess specialty preferences and factors influencing specialty choices among male and female medical students	Significantly more males preferred surgery than females, who mainly selected pediatrics. Male students considered prestige in a specialty, female students considered ease of raising a family and gender distribution in the specialty.
Lefèvre	2010	6th year medical students	1742 (662/1080)	Survey	To analyze the aspirations and personal motivations behind the choice of surgical specialties	Gender as a determining factor to choose surgery: 44% of men vs 29% of women. Feminization, life style and income are the principal factors influencing the choice of the type of surgical specialization.
Deedar	2010	Medical students	39 articles	Review	To explore global trends related to medical student interest in surgical careers, and to identify factors influencing the choice of surgery as a career	Overall declining popularity of surgery, with the exception of Greece, Jordan, and Nigeria, and a relative rebound seen in US. Direct patient care, immediate intervention, and personal interest as common positive influential factors. Family considerations, increased stress and work hours, sacrifice of personal time, and lack of (or negative) role models as common negative factors.
Are	2009	4th year students	140 (67/73	Survey	To describe the attitudes of fourth-year medical students towards general surgery.	10% of students chose surgery (10 males and 5 females) Only 16% of the faculty department were female.
Table 4 (Cont.)
Author	Year	Participants	Number of articles/ participants male/female	Type of study	Study objective	Findings
Maggiori	2009	Medical graduates	929 (291/638)	Cohort study	To analyze the choices of specialties of interns	21% interested in surgery, more male (41%) than female (22%).
Soethout	2008	1st-5th year students	3102 (1055/2047)	Survey	To investigate the association between biographical characteristics and academic achievement with preferences for specialty	Overall, more males interested in surgery than females. Medical background of the parents and gender are positively associated with a preference for a career.
Copmton	2008	Medical students	942 (501/441)	Survey	To describe patterns of change in specialty interests during medical school	Pediatrics (20%) and surgery (18%) the most common specialty choices among students. More women interested in primary care. Prestige more important for men than women (48% vs 36%).
Khader	2008	2nd, 4th and 6th year students	440 (287/158)	Cross-sectional study	To investigate the career preferences of medical students at Jordan University	Surgery as the preferred specialty by male students, obstetrics and gynecology by female students.
Scott	2008	1st year medical students	2168	Survey	To identify the interest in surgery and the factors that influence a student's interest in pursuing a surgical career	Declining preference for surgical careers among students, with only 21% (441, 238 males/203 females) of students interested. Male students interested in surgery were more hospital-oriented and less social orientated than female students.
Tambyraja	2008	Final year medical students	193 (75/118)	Survey	To examine the attitudes of students to surgical training and their career intentions.	53% of male students consider a career in surgery, 35% of female do.
Bamboolal	2007	1st year medical students	136 (58/78)	Survey	To determine factors that influence career choice among 1st-year medical students.	Declining preferences for surgical careers among males and females students: 19% of the students chose surgery (not specify by gender).
Nohr	2007	Medical graduates applying for residency	1920	Cohort study	To describe differences in specialty choices and qualifications between male and female physicians at the start of their residency in Denmark 1998-2003	Gender differences in specialty choice and in the way men and women qualify for residency: women achieved higher points for clinical qualification and theoretical courses, while men achieved higher points for scientific and pedagogical qualification. Most of residents in orthopedic surgery were male, in psychiatry or obstetrics female.
Buddeberg-Fischer	2006	Medical graduates	522 (241/281)	Prospective cohort	To investigate the influence of gender, personality traits, career motivation and life goal aspirations on the choice of medical specialty	Gender had the greatest impact on specialty and career choice. Males were more likely to choose a surgical career, females preferred obstetrics, pediatrics and anesthesiology.
Huda	2006	Final year students	232	Survey	To identify the career and gender preferences of the final year medical students	21% students chose surgery, general surgery being the 2nd preferred for men and 3rd preferred choice for women.
Sanfey	2006	Medical students	1300 (680/620)	Web-based survey	To investigate if the increased enrollment of female medical students and different priorities of the current generation of students would have influence on the declining interest in surgical careers	35% of women (3% men) were discouraged by a lack of female role models. More male than female students interested in surgery agreed that their skill sets were compatible with surgical careers (30% men vs 24% women). The decision to have a family had bigger influence for women than men, but family and lifestyle priorities were also important to male students.
Sobral	2006	Medical graduates	578 (318/260)	Cohort study	To examine the differential impact of person-based and program-related features on graduates' dichotomous choice between surgical or non-surgical specialties.	Declining preferences for surgical careers among males and females students: only 23% students choosing surgery, 26% of them female. Male sex, updated preference, peer tutoring and selective training were the most significant predictors in the pathway to choose surgery.
Table 4 (Cont.)
Author	Year	Participants	Number of articles/ participants male/female	Type of study	Study objective	Findings
Harris	2005	Medical graduates	4259	Survey	To identify the relative importance of extrinsic determinants of doctors' choice of specialty.	Factors of particular importance to women, compared with men, were "appraisal of domestic circumstances", "hours of work" and "opportunity to work flexible hours".
Cochran	2005	4th year medical students	408 (214/189)	Cross-sectional internet survey	To analyze characteristics of general surgery residency and practice and their influence on student interest in surgical careers	Medical students who choose surgical careers are not deterred by a negative perception of lifestyle and workload considerations. Mentoring and personality fit are central in specialty selection. Surgery selected by 9%, with similar proportion male/female.
Ek	2005	Final year medical students	251 (126/125)	Survey	To determine the views of final year medical students in Melbourne regarding both undergraduate surgical teaching and the students' career aspirations.	Male students were more likely to be interested in surgery. 57% of female respondents felt discouraged from pursuing a surgical career and 99% of these women reported lifestyle/family factors as the main reason, with a further 72% identifying a lack of female role models.
Wendell	2003	Medical graduates	120 (48/54)	Survey	To evaluate factors affecting the choice of a surgical career among gender	Fewer women than men considered practice lifestyle in choosing their career. Both men and women considered lifestyle, elective in the field of choice and faculty important in career choice.
Azizzabeh	2003	4th year medical students	111 (48 M/ 31 F/ 32 unknown)	Survey	To determine factors that influence career choice among medical students	Prestige and career opportunities are more important to students seeking surgical residencies. Concerns about lifestyle and work hours are deterrents to surgery as a career. 19 (17%) students interested in surgery.
Figueireido	1997	Medical graduates	821	Data from Medical Faculty	To examine the influence of gender on the specialty choices of graduates from a Brazilian medical school during 2 periods	More male than female choosing surgery during both study periods (16 vs 2% resp 15 vs 6%).
Al-Faris	1997	5th (final) year medical students	253 (149/104)	Cross-sectional study	To identify the career choices and reasons for career choices of final-year Saudi medical students	16% students choose surgery. More men chose surgery, more women chose obstetrics-gynecology and ophthalmology.
Zulkifli	1997	5th (final) year medical students	241 (107/134)	Cross-sectional study	To investigate career choices among Malaysian medical students	Surgery ranked highest among male students, obstetrics and gynecology among female students.
Razali	1996	3rd year medical students	?	Survey	To investigate the reasons for entry to medicine and the career perspectives of phase III medical students of a Malaysian university	No significant differences in the intention of pursuing a career between genders, but women were less likely to seek entrance into private practice or pursue formal postgraduate education. The choice of surgery as a career was confined to men.
Baxter	1996	4th year medical students	245	Survey	To examine factors affecting career choice by medical students	Male more likely to choose a surgical career than females (27% versus 10%). Males were more likely to identity technical challenge, earning potential, and prestige whereas females were more likely to identify residency conditions, part-time work, and parental leave availability as important qualities in a specialty. Females were less likely to take surgical electives and more likely to identify a lack of role models.