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J Surg Educ. 2014 Jul-Aug;71(4):560-6. doi: 10.1016/j.jsurg.2013.11.010. Epub 2014 Jan 8.

Perception of undergraduate pediatric surgery clerkship in a developing country.

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Sub-department of Paediatric Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria. Electronic address:
Sub-department of Paediatric Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria.



Medical students' perception of their clerkship may influence their choice of ultimate career. In most medical schools, pediatric surgery clerkship (PSC) is not compulsory. This study evaluates the perception of PSC by students and determines the importance of this on the choice of pediatric surgery as a career.


We surveyed 2009 and 2010 graduating medical classes of University of Nigeria, Nsukka, using self-administered questionnaires. The clerkship evaluation was assessed using a 3-point scale (1 = poor and 3 = excellent). Students who had PSC were analyzed to compare their rating of pediatric surgery vis-à-vis other clinical clerkships and determine the effect of the clerkship on their ultimate choice of a career.


Overall response rate was 70.3% (275/391), and 119 (43.3%) had PSC. For overall quality, PSC rated (2.16) compared with general surgery (2.04), internal medicine (2.11), obstetrics and gynecology (2.13), and pediatrics (2.37). Aspects of PSC that rated poorly include opportunity to participate in direct patient care, feedback on performance during clerkship, ability to manage problem in a general medical setting, and experience in learning history-taking skills and interpretation of laboratory data. Among the students who had PSC, 14 (11.8%) selected pediatric surgery as a specialty choice compared with 13 (8.3%) who did not have PSC (p = 0.457). Of those that had PSC, pediatric surgery was selected as a career by 2 of 19 (10.5%), 6 of 63 (9.5%), and 6 of 37 (16.2%) who rated PSC as poor, just right, and excellent, respectively. The decision to select pediatric surgery was influenced mostly by clerkship experience in 37% (10/27) and personal satisfaction in 40.7% (11/27). Improvement in the quality of PSC may involve more participation of the students in direct patient care (n = 54; 45.4%) and enhancement in student-faculty interaction (n = 31; 26.1%).


PSC may have a good rating in our setting. Nonetheless, improving the quality and experience of the clerkship through a well-thought-out curriculum modification may enhance interest in pediatric surgery as a career choice.


Interpersonal and Communication Skills; Practice-Based Learning and Improvement; Professionalism; career; clerkship; developing country; pediatric surgery; undergraduate

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