The urgency motivating the program is demographic as much as educational. The United States faces a projected shortage of physicians, including surgeons, with the burden expected to fall hardest on rural and underserved communities. Previous studies cited by the authors have documented particular strain in rural and frontier counties, where general surgeon shortages translate directly into delayed operations, longer travel distances for patients, and worse outcomes for time-sensitive conditions such as trauma and appendicitis. Workforce projections extending to 2036 suggest that the problem will deepen without deliberate intervention, making the recruitment of future surgeons a matter of public health rather than simply professional preference.

Diversity is the second pillar of the program’s rationale. A substantial body of evidence links a physician workforce that reflects the population it serves to measurable improvements in patient care. Research summarized in the report indicates that underrepresented minority physicians are more likely to care for vulnerable populations, that racial and ethnic concordance between patients and physicians is associated with better communication and trust, and that representation of Black primary care physicians correlates with population-level life expectancy and mortality metrics. Yet students from historically underrepresented backgrounds continue to encounter structural barriers to medical careers, among the most fundamental of which is limited early exposure to healthcare professions. Many adolescents never meet a surgeon, let alone handle the instruments of the trade.

Pathway programs have emerged over the past several decades as a response to this exposure gap, but the FAST authors argue that many existing initiatives suffer from a common weakness: they lack scalable models and practical implementation guidance. A program that works at a single institution with a handful of motivated volunteers may collapse when attempts are made to replicate it elsewhere. The FAST report is explicitly designed to counter this by laying out the program’s planning processes, logistics, execution details, and hard-won lessons, offering what amounts to an open-source framework for organizations hoping to build similar initiatives.

The mechanics of a FAST event reveal why the model has proven durable. Each event is structured as a multi-station interactive experience rather than a lecture or career fair. Students rotate through stations that include surgical simulation, hands-on suturing and knot-tying instruction, anatomy demonstrations, and structured discussions of healthcare career pathways. The simulation components are particularly consequential: research on basic surgical skills education has shown that early experiential contact with surgical techniques can shift students’ attitudes toward surgical careers and accelerate skills acquisition. By letting teenagers physically perform the fundamental tasks of surgery, even in simplified form, the program converts an abstract career option into a concrete, memorable experience.

Scale has grown steadily. FAST events now engage approximately 80 to 150 students and 30 to 50 volunteers annually, drawing on surgeons across a wide range of clinical specialties. The authors describe FAST as one of the earliest and largest national efforts to bring high school students into direct contact with practicing surgeons in this way, unified by a shared commitment to education. The volunteer corps includes academic surgeons, trainees, and allied professionals, and the program has been supported by institutional partners and industry sponsors who contribute equipment, materials, and logistical assistance, from surgical simulation technology to basic event supplies.

Three operational factors stand out in the authors’ account as critical to successful implementation. The first is sustainable funding: outreach programs that depend on year-to-year improvisation tend to be fragile, and FAST’s stability has rested on institutional support from the Association for Surgical Education combined with contributions from partner organizations and sponsors. The second is structured volunteer coordination. With dozens of volunteers per event, many of them busy clinicians, the program requires clear role definitions, advance communication, and reliable on-site organization to function smoothly. The third is early engagement with local schools and surgeons, which ensures that students actually attend, that chaperones and institutional permissions are in place, and that local surgical communities feel ownership of the event.

The report is candid about the distinction between pipelines and pathways, a conceptual shift that has gained traction in education research. A pipeline metaphor implies a linear, passive flow of students through a fixed sequence, whereas a pathway framework emphasizes active, student-centered progression with multiple entry and exit points. This reframing matters because attrition in academic achievement and disciplinary disparities begin well before college, meaning that a single contact point in high school cannot carry the entire burden of workforce diversification. Pathway thinking encourages programs like FAST to position themselves as one node in a longer network of mentorship and support rather than as a standalone solution.

The evidence base for early outreach is encouraging but still developing. Studies of mini-medical school programs have found that they decrease perceived barriers to medical careers among underrepresented minority high school students, and evaluations of surgical high school outreach programs have reported positive effects on the career trajectories of underserved students. Systematic reviews of barriers facing Black premedical students and of diversity within surgical residency education confirm that the obstacles are cumulative and structural, spanning financial constraints, limited mentorship, and institutional culture. Programs that intervene early, provide visible role models, and offer hands-on contact address the earliest and arguably most formative of these barriers.

The FAST authors frame their ultimate goal in terms of health equity rather than workforce statistics alone. Diversifying the physician workforce, they argue, is essential to improving care delivery and advancing equity, and pathway programs play a critical role in supporting learners who are most vulnerable and historically marginalized. By publishing the tools, structures, and lessons learned from a decade of FAST events, the team has effectively lowered the barrier for surgical societies, hospitals, and medical schools elsewhere to launch their own initiatives. If the projected surgeon shortage materializes as forecast, the students now fumbling their first square knots at FAST stations may prove to be among the most consequential recruits the profession secures.

Subject of Research: A national surgical pathway program introducing high school students to surgical careers through hands-on outreach to address workforce shortages and diversity gaps

Article Title: Finding aspiring surgeons of tomorrow (FAST): a decade of lessons learned building a national surgical pathway program

Article References: Buonpane, C. L., Sanchez, S. E., Sheppard, O. O., Deckard, M. L., Kreinik, J. N., & Arora, T. K. (2026). Finding aspiring surgeons of tomorrow (FAST): a decade of lessons learned building a national surgical pathway program. Global Surgical Education – Journal of the Association for Surgical Education, 5(1), Article 147. https://doi.org/10.1007/s44186-026-00552-0

Image Credits: AI Generated

DOI: 10.1007/s44186-026-00552-0

Keywords: surgical education, pathway programs, workforce diversity, high school outreach, surgeon shortage, health equity, mentorship, medical education, surgical simulation, healthcare workforce, Association for Surgical Education, rural health