Attitudes des étudiants en médecine canadiens à l’égard de la formation en chirurgie et obstacles perçus à la carrière dans la discipline : une enquête multicentrique

Background: Medical student interest in surgical specialties continues to decline. This study aims to characterize attitudes of Canadian medical students towards surgical training and perceived barriers to surgical careers. Methods: An anonymous survey was custom designed and distributed to medical students at the University of Alberta and University of Calgary. Survey questions characterized student interest in surgical specialties, barriers to pursuing surgery, and influence of surgical education opportunities on career interest. Results: Survey engagement was 26.7% in 2015 and 24.2% in 2021. General surgery had the highest rate of interest in both survey years (2015: 38.3%, 2021: 39.2%). The most frequently reported barrier was worry about the stress that surgical careers can put on personal relationships (2015: 70.9%, 2021: 73.8%, p = 0.50). Female respondents were significantly more likely to cite gender discrimination as a deterrent to surgical careers (F: 52.0%, M: 5.8%, p < 0.001). Conclusions: Despite substantial interest, perception of work-life imbalance was the primary reported barrier to surgical careers. Further, female medical students’ awareness of gender discrimination in surgery highlights the need for continued efforts to promote gender inclusivity within surgical disciplines to support early career women interested in surgery.Contexte : L’intérêt des étudiants en médecine canadiens pour les spécialités chirurgicales est en diminution constante. Cette étude vise à caractériser leurs attitudes à l’égard de la formation en chirurgie et les obstacles qu’ils perçoivent à la poursuite d’une carrière dans cette discipline. Méthodes : Un sondage anonyme conçu sur mesure a été distribué aux étudiants en médecine de l’Université de l’Alberta et de l’Université de Calgary. Les questions de l’enquête portaient sur leur intérêt pour les spécialités chirurgicales, sur ce qui les empêche de les choisir comme voie de carrière et sur l’influence des possibilités de formation en chirurgie sur leur intérêt à suivre une carrière dans ces spécialités. Résultats : Le taux de participation à l’enquête était de 26,7 % en 2015 et de 24,2 % en 2021. La spécialité qui a recueilli le taux d’intérêt le plus élevé était la chirurgie générale, et ce pour les deux années d’enquête (2015 : 38,3 %, 2021 : 39,2 %). L’obstacle le plus fréquemment cité était la difficile conciliation entre la vie personnelle et les exigences des carrières chirurgicales (2015 : 70,9 %, 2021 : 73,8 %, p = 0,50). Les femmes interrogées étaient significativement plus susceptibles de citer la discrimination fondée sur le sexe comme frein au choix d’une carrière chirurgicale (F : 52,0 %, M : 5,8 %, p < 0,001). Conclusions : Malgré un intérêt considérable, la perception d’un déséquilibre entre la vie professionnelle et la vie personnelle est le principal obstacle déclaré au choix d’une carrière dans le domaine de la chirurgie. De plus, la discrimination sexuelle perçue par les étudiantes dans la discipline souligne le besoin d’efforts soutenus pour promouvoir l’inclusivité des sexes dans les spécialités chirurgicales afin de soutenir les femmes en début de carrière qui s’intéressent à la chirurgie

Attitudes of Canadian medical students towards surgical training and perceived barriers to surgical careers: a multicentre survey

Background: Medical student interest in surgical specialties continues to decline. This study aims to characterize attitudes of Canadian medical students towards surgical training and perceived barriers to surgical careers. Methods: An anonymous survey was custom designed and distributed to medical students at the University of Alberta and University of Calgary. Survey questions characterized student interest in surgical specialties, barriers to pursuing surgery, and influence of surgical education opportunities on career interest. Results: Survey engagement was 26.7% in 2015 and 24.2% in 2021. General surgery had the highest rate of interest in both survey years (2015: 38.3%, 2021: 39.2%). The most frequently reported barrier was worry about the stress that surgical careers can put on personal relationships (2015: 70.9%, 2021: 73.8%, p = 0.50). Female respondents were significantly more likely to cite gender discrimination as a deterrent to surgical careers (F: 52.0%, M: 5.8%, p < 0.001). Conclusions: Despite substantial interest, perception of work-life imbalance was the primary reported barrier to surgical careers. Further, female medical students’ awareness of gender discrimination in surgery highlights the need for continued efforts to promote gender inclusivity within surgical disciplines to support early career women interested in surgery

Amyloid β (1–40) Toxicity Depends on the Molecular Contact between Phenylalanine 19 and Leucine 34

The formation of the hydrophobic contact between phenylalanine 19 (F19) and leucine 34 (L34) of amyloid β (1–40) (Aβ(1–40)) is known to be an important step in the fibrillation of Aβ(1–40) peptides. Mutations of this putatively early molecular contact were shown to strongly influence the toxicity of Aβ(1–40) (Das et al. (2015) ACS Chem. Neurosci. 6, 1290−1295). Any mutation of residue F19 completely abolished the toxicity of Aβ(1–40), suggesting that a proper F19–L34 contact is crucial also for the formation of transient oligomers. In this work, we investigate a series of isomeric substitutions of L34, namely, d-leucine, isoleucine, and valine, to study further details of this molecular contact. These replacements represent very minor alterations in the Aβ(1–40) structure posing the question how these alterations challenge the fibrillation kinetics, structure, dynamics, and toxicity of the Aβ(1–40) aggregates. Our work involves kinetic studies using thioflavin T, transmission electron microscopy, X-ray diffraction for the analysis of the fibril morphology, and nuclear magnetic resonance experiments for local structure and molecular dynamics investigations. Combined with cell toxicity assays of the mutated Aβ(1–40) peptides, the physicochemical and biological importance of the early folding contact between F19 and L34 in Aβ(1–40) is underlined. This implies that the F19–L34 contact influences a broad range of different processes including the initiation of fibrillation, oligomer stability, fibril elongation, local fibril structure, and dynamics and cellular toxicity. These processes do not only cover a broad range of diverse mechanisms, but also proved to be highly sensitive to minor modulations of this crucial contact. Furthermore, our work shows that the contact is not simply mediated by general hydrophobic interactions, but also depends on stereospecific mechanisms