Surgeons of the small screen have a bad rap. When Dr. Robert Romano was killed by a falling helicopter on “ER” this year, few in the hospital or in the audience openly mourned the loss of the acerbic surgeon.
Then there’s the cocky yet affable surgeon Chris Turk on the show “Scrubs.” Turk -- most television surgeons are known strictly by their last names -- was late to his own wedding this season because of complications with a patient.
New research suggests that media portrayals of surgeons as caustic or career-driven people leading unbalanced lives might affect medical students’ decisions about whether to specialize in surgery.
“You can be a kind and gentle surgeon who is very effective in his specialty,” said Dr. Leo Gordon, associate director of surgical education at Cedars-Sinai Medical Center in Los Angeles. “That can be undone in 25 minutes in a major television show.”
The study, published in the June 15 issue of the Journal of Surgical Research, reported that second-year medical students are influenced in their choice not to pursue surgery, in part, by images of surgeons in the media. Researchers at the University of Texas-Houston Medical School and Stanford University Medical Center conducted focus groups with 29 medical students in Houston.
Medical students not interested in surgery thought programs such as “ER,” “Scrubs” and the reality show “Houston Medical” portrayed surgeons as “jerks,” the study said. A few students who were leaning toward surgery, however, found that the shows actually increased their enthusiasm for their career choice.
“I suppose that’s part of the job description,” said Benny Esparra, a junior at Arizona State University who plans to go to medical school and hopes to be a surgeon but who was not part of the study. “If you’re a surgeon, you kind of have to have a certain kind of arrogance.”
In addition to the media, the study found that other students and doctors reinforced negative stereotypes about surgeons.
“The comments are the same comments I heard 15 years ago, ‘Surgeons are jerks. You don’t want to do this,’ ” said Dr. Susan Brundage, an associate professor of surgery at Stanford and an author of the study.
The researchers at the University of Texas-Houston and Stanford found that students who opt for a career with a scalpel were more likely to associate personal happiness with career satisfaction. Students who choose other specialties tended to put family first.
For many years, intense competition for surgical positions meant no shortage of qualified applicants. Three years ago, things changed. The number of general surgical residency spots that were filled dropped from 98.5% to 93.5% in a year. Although the situation has improved -- 99.8% of surgical residencies were filled in 2004 -- medical educators remain concerned about the attractiveness of the field.
Restrictions on work hours may help. Last year, the Accreditation Council for Graduate Medical Education limited the work week of surgical trainees to 80 hours. That’s still a lot of hours, but it’s not as many as the 120 hours a week that some residents were working before the restrictions.
All the students in the recent study had few face-to-face interactions with surgeons in their first two years of medical school. Their main exposure to surgery was the media. That may be part of the problem, Brundage said.
In a 2003 intervention study, also reported in the Journal of Surgical Research, five surgeons at University of Texas-Houston Medical School met with first-year medical students to talk about their work and family lives. Those students came away with a more positive attitude toward surgery than others.
“No longer did they have that perception of the surgeon who was a jerk,” Brundage said.
Those students are about to enter their third year of medical school, so it remains to be seen whether any of them will go into surgery based on the intervention. Several universities are considering similar programs, Brundage said.