The research, published in BMC Medical Education, was led by Quang Thanh Nguyen and Hien Duy Pham along with colleagues at VinUniversity’s College of Health Sciences. The team drew on the specialty-preference module of a broader institutional survey on career identity and choice, administered between September and November 2024. Rather than asking a single yes-or-no question about surgery, the survey asked students in their second, third, and fourth years to rank three specialty preferences in order. That ranked structure allowed the investigators to distinguish between students whose top choice was surgical and those who merely listed a surgical field somewhere among their three options, a distinction that turns out to matter for how the results should be read.

The response rate was strikingly high. Of 144 eligible students, 131 participated, a 91.0 percent response rate that lends the findings considerable weight for this single institution. Within that group, 49 students, or 37.4 percent, placed a surgical specialty first on their list, while 74 students, or 56.5 percent, included a surgical specialty at any of the three ranks. In other words, roughly one in three students at this school named surgery as their dream destination, while more than half kept it on their shortlist. Those figures provide a useful baseline for a country where surgical capacity is a persistent concern, and they suggest that interest in surgery is far from absent among Vietnamese medical trainees.

Before running any models, the researchers asked students to rate the perceived influence of a wide range of factors, from lifestyle considerations and income expectations to stereotypes about different specialties. Because they were testing many item-level comparisons at once, the team applied the Benjamini-Hochberg procedure, a statistical correction designed to control the false discovery rate when multiple hypotheses are tested simultaneously. Across 33 such comparisons, none of the item-level differences between students who preferred surgery and those who did not survived the correction threshold of q less than 0.05. That null result is itself informative: it suggests that no single perceived influence, measured in isolation, cleanly separates aspiring surgeons from their peers, and it cautions against overinterpreting any one survey item.

The heart of the analysis lay in exploratory regression modeling. The investigators used Firth regression, a variant of logistic regression specifically designed for situations where outcomes may be imbalanced or sample sizes modest, as was the case here with 131 participants. Firth’s method applies a penalty that reduces the small-sample bias that can distort ordinary maximum-likelihood estimates, making it a defensible choice for an exploratory study of this scale. The primary outcome was a first-ranked surgical preference, and the model included gender, permanent residence, cohort year, and two numerical ratings: the perceived importance of administrative or leadership roles, and the perceived importance of research or teaching in a future career.

Two associations emerged from the primary model. First, male students had substantially higher odds of ranking a surgical specialty first than female students, with an odds ratio of 2.46 and a 95 percent confidence interval of 1.14 to 5.46. Because that interval excludes 1.0, the association is statistically meaningful, though the wide range reflects the uncertainty inherent in a modest sample. The finding echoes a pattern documented repeatedly in international literature on surgical career choice, where gender disparities in surgical specialties remain stubbornly persistent across many countries and training systems. Its appearance in a Vietnamese private medical school suggests the phenomenon is not confined to any single educational culture.

Second, students who rated administrative and leadership roles as more important to their future careers were more likely to prefer surgery. In the model specification that treated the rating as a continuous numerical score, each one-point increase in the rating was associated with an odds ratio of 1.62, with a 95 percent confidence interval of 1.17 to 2.33. This is an intriguing signal, because it hints that students drawn to surgery may also be drawn to positions of institutional authority, whether as department heads, hospital administrators, or leaders of surgical teams. However, the authors are careful to note that categorical analyses of the same variable did not establish a linear gradient, meaning the data do not prove that each incremental increase in the rating produces a proportional increase in surgical preference.

The study’s most important contribution may be its methodological honesty. The authors explicitly state that the estimates describe concurrent associations conditional on the selected model, not antecedent determinants. In plain terms, students rated their perceived influences after they had already stated their preferences, so the ratings capture how aspiring surgeons see their future rather than factors that demonstrably caused the preference. A student who dreams of surgery may, in retrospect, inflate the importance of leadership because surgeons lead teams; the survey cannot disentangle that direction of influence. Patterns for cohort year and for research and teaching ratings also shifted depending on which outcome definition and model specification was used, underscoring the fragility of exploratory findings in small samples.

That caution extends to the relationship between stated preference and actual career entry. The authors emphasize that a preference expressed in a survey should never be equated with subsequent entry into surgical training. Specialty choices evolve through clinical rotations, mentorship, exposure to role models, examination of lifestyle trade-offs, and the practical realities of residency positions. A student who lists surgery first in year two may abandon it after a demanding rotation, while another who never mentioned surgery may discover a passion for the operating room in year four. Longitudinal designs that follow students from preference to match are needed to establish whether the gender gap and the leadership association observed here predict real training decisions.

Even with those limits, the study offers practical value for educators and policymakers confronting surgical workforce shortages. The high response rate and the ranked-preference design provide a template that other institutions in Vietnam and comparable settings can adapt, and the finding that more than half of students keep a surgical field on their shortlist suggests a reservoir of latent interest that targeted interventions might convert into applications. If the association between leadership orientation and surgical preference holds up in prospective work, mentorship programs could highlight the genuine leadership pathways that surgical careers offer, while simultaneously addressing the gender disparities that continue to steer women away from the operating theater. For now, the study stands as a carefully calibrated snapshot: a single Vietnamese medical school, 131 students, and a statistical framework honest enough to say what the data cannot yet prove.

Subject of Research: Factors associated with medical students' preference for surgical specialties at a Vietnamese medical school

Article Title: Factors associated with medical students’ preference for surgical specialties at a Vietnamese medical school: a cross-sectional study

Article References: Nguyen, Q. T., Nguyen, N. L. K., Pham, T. H. M., Nguyen, H. V., Ly, D. B., & Pham, H. D. (2026). Factors associated with medical students’ preference for surgical specialties at a Vietnamese medical school: a cross-sectional study. BMC Medical Education. https://doi.org/10.1186/s12909-026-10627-7

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10627-7

Keywords: medical education, surgical specialties, specialty preference, career choice, medical students, Vietnam, gender disparity, cross-sectional study, Firth regression, surgical workforce, leadership roles, BMC Medical Education

The study surveyed medical students from all six years of training at Kırşehir Ahi Evran University Faculty of Medicine, using a twenty-item questionnaire designed to probe perceptions of gender roles in the selection of a specialty. A total of 275 students participated, of whom 184 were female and 91 were male, meaning women made up roughly two-thirds of the sample. The researchers analyzed their data with SPSS version 29.0 and compared categorical responses using the Pearson chi-square test, a standard statistical approach for determining whether differences between groups are likely to be genuine or merely the product of random variation. The study protocol received approval from the Kırşehir Ahi Evran University Research Ethics Committee, and all participants provided electronic informed consent before completing the questionnaire, in line with the Declaration of Helsinki.

One of the most striking findings concerns the gap between interest and intention. Among male students, 48.4 percent reported considering a surgical specialty, compared with 35.9 percent of female students. On the surface, that twelve-and-a-half-point difference looks meaningful, yet when the researchers subjected it to statistical testing, it failed to reach significance, with a p-value of 0.139. In practical terms, this means the observed difference could plausibly have arisen by chance in a sample of this size. The authors interpret this carefully: while the raw numbers hint that men lean slightly more toward surgery, the evidence does not support the conclusion that female students are fundamentally less interested in surgical careers. The real story, they argue, lies elsewhere, in the perceptions and barriers that surround the decision rather than in the decision itself.

Where the study did find robust differences was in the realm of perception. A substantial proportion of participants believed that gender does influence specialty preference, and they pointed to particular fields as examples. Obstetrics and gynecology and urology emerged as the specialties most commonly seen as gender-influenced, a finding that mirrors long-standing cultural assumptions in medicine. Obstetrics and gynecology is often perceived as a field where female patients prefer female physicians and where women are assumed to be naturally suited, while urology carries the opposite stereotype, frequently viewed as awkward or inhospitable territory for women because of the intimate nature of its examinations and its historically male-dominated workforce. These perceptions matter because students internalize them early, and they can quietly narrow the range of careers that seem realistic or welcoming before anyone has formally applied for a training position.

The questionnaire also revealed that female students reported higher perceived barriers related to leadership, discrimination, and working conditions. This triad of obstacles is well recognized in the broader literature on women in surgery. Leadership in surgical departments remains disproportionately male in many countries, which can deprive female students of role models who demonstrate that women can rise to the top of operative specialties. Discrimination, whether overt or subtle, ranges from dismissive attitudes in the operating room to doubts about a woman’s stamina or commitment. Working conditions add a further layer of complexity, since surgical careers traditionally demand long, inflexible hours and unpredictable call schedules that collide with societal expectations placed on women regarding family and caregiving. The fact that female students in this sample perceived these barriers more acutely than their male peers suggests that the playing field is not experienced as level, even when stated interest in surgery does not differ significantly.

The methodological design of the study deserves attention for what it can and cannot show. As a cross-sectional survey, it captures a snapshot of attitudes at a single institution at a single point in time, rather than tracking how perceptions evolve across a career. The single-site design means the findings may reflect the specific cultural and institutional context of a Turkish medical school, and generalizing to other countries or even other universities within Turkey requires caution. The sample of 275 students, while respectable for a single faculty, is modest, and the imbalance between female and male participants, though reflective of modern medical school demographics, complicates direct comparisons. The non-significant p-value for the interest question illustrates the importance of statistical power: with more respondents, a genuine difference of that magnitude might have crossed the threshold of significance, or the apparent trend might have dissolved entirely. The authors are appropriately measured, describing gender-related perceptions as common and differing by respondent gender across several domains, while explicitly noting that interest in surgery did not differ significantly.

What makes these findings resonate beyond a single medical school is the consistency of the underlying pattern with global data. Across many health systems, women now constitute half or more of medical school entrants, yet surgical specialties continue to recruit proportionally fewer women than nonsurgical fields such as pediatrics, family medicine, or internal medicine. Explanatory hypotheses have ranged from lifestyle considerations and family planning to exposure during clinical rotations, mentorship gaps, and implicit bias in selection processes. The Turkish study contributes a specific mechanism to this conversation: it is not that women lack ambition or aptitude for surgery, but that they perceive the surgical world as one where leadership is harder to attain, discrimination is more likely, and working conditions are less compatible with the lives they envision. Perception, in this framing, functions as a filter that operates before formal career decisions are made.

The implications for medical educators and policymakers are concrete. If perceptions of bias and barriers are deterring talented students from surgical careers, then interventions should target the educational environment itself. The authors suggest that addressing gender bias and promoting inclusive educational environments may help achieve more balanced representation in surgical fields. Practical measures could include ensuring that students of both genders encounter visible female surgical faculty and residents during rotations, implementing structured mentorship programs that connect aspiring surgeons with role models who have navigated similar challenges, reviewing rota and call schedules for flexibility, and establishing clear channels for reporting discrimination. Because the study found that perceptions differed by respondent gender, such interventions should be designed with input from female students themselves, who evidently perceive obstacles that their male classmates do not.

There is also a patient-care dimension to this research that extends beyond workforce equity. If students believe that gender shapes which doctors patients trust, and if specialties like obstetrics and gynecology and urology are perceived through a gendered lens, then the composition of the physician workforce directly affects access and comfort for patients. A balanced surgical workforce, in which patients can find surgeons of any gender in every specialty, would dissolve these perceived constraints and allow specialty choice to rest on aptitude, passion, and skill rather than on stereotype. The study’s finding that a substantial proportion of students believe gender influences specialty preference indicates how deeply these assumptions run, even among the youngest members of the profession.

Ultimately, this research reframes a familiar question. Instead of asking why women do not choose surgery in numbers matching their male classmates, it asks what students of both genders believe about gender and surgery, and finds that those beliefs differ in ways that matter. Interest in the operating room appears roughly comparable across genders once statistical noise is accounted for, but the perceived terrain surrounding a surgical career is anything but equal. Changing that terrain, through inclusive training environments, visible role models, and honest confrontation of discrimination and inflexible working conditions, may prove far more effective than exhorting individual students to be bolder. As surgical specialties confront workforce shortages and the profession seeks to draw on the full talent pool of modern medical school graduates, studies like this one illuminate precisely where the invisible gates stand, and by extension, where they must be opened.

Subject of Research: The influence of gender perception on surgical specialty preferences among medical students

Article Title: The role of gender perception in surgical specialty preferences among medical students: a cross-sectional study

Article References: Olgun, P. S., Görgülü, E., & Olgun, A. O. (2026). The role of gender perception in surgical specialty preferences among medical students: a cross-sectional study. BMC Medical Education. https://doi.org/10.1186/s12909-026-10528-9

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10528-9

Keywords: medical students, surgical specialties, gender perception, career choice, medical education, obstetrics and gynecology, urology, leadership, discrimination, cross-sectional study, workforce equity, Turkey