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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 28, No 5, September/October 2017
294
AFRICA
The data collection was done using the semi-structured
questionnaire distributed to junior surgical residents who
were doing rotations in the different surgical specialities in
preparation for Part 1 of the examination of the Faculty of
Surgery, NPMCN or WACS [postgraduate year (PGY) 1–3] or
those who had completed their rotation but were yet to pass the
examination (PGY
>
3). We also used the opportunity provided
by the Integrated Clinical and Revision Course in Surgery
organised by WACS, between 6 and 9 September 2015 at Jos
University Teaching Hospital, Jos, to collect data from some of
our study population who we were unable to access.
A pilot study was carried out among 15 junior residents
in one of the tertiary institutions to improve reliability of the
research instruments. Additional inputs were provided by two
active cardiothoracic surgeons and two senior residents in
cardiothoracic surgery who were not part of the study.
The 56-item questionnaire was divided into four sections.
The first section included socio-demographic data (age, gender,
marital status, number of children and years spent in training).
The second section included statements on the overall interest
and exposure of the respondents in cardiothoracic surgery
(CTS) as medical students and junior surgical residents and the
influence of such rotation on their career. We also evaluated
their active participation in major cardiothoracic procedures
and the role of mentorship in their career. The relationship
between the age of the respondents, their marital status, level
of training, rotation in CTS in medical school and as a junior
surgical resident and the different categories of interest in CTS
was assessed.
The third section comprised statements evaluating the
importance of the following factors in decision of speciality
choice. These factors included type of procedures, job and
research opportunities, opportunities to teach surgery, exposure
to positive role models in the speciality, advice from colleagues,
length of training and one that allows time for family.
In the fourth section, the respondents were asked to identify
the shortcomings in practise of the different surgical specialities
with regard to challenges in equipment, challenges in training,
job dissatisfaction, income, unfriendly working atmosphere and
time-consuming job. They were also asked to identify the factors
that would most likely attract or reduce the interest of junior
residents to CTS.
We retrieved the questionnaires from 238 respondents,
accounting for a response rate of 61%. Quantitative statistics
assessment was performed using SPSS 16.0 statistical software
package (SPSS Inc; Chicago, IL). Categorical data were
calculated in frequencies and percentages and the chi-squared
test was used to test the level of significance. The level of
statistical significance was kept at
p
<
0.05.
Results
Out of 238 respondents who returned their questionnaires, 226
(95%) were males while 10 were females. The gender was not
specified in two respondents. One hundred and thirty-seven
respondents (57.6%) were in the age range between 31 and 35
years. The majority of respondents (66.8%) were in PGY-2 and
more than half of them (52.1%) were married (Table 1).
Our respondents were grouped into four categories; 8.4% (
n
=
20) of the respondents were committed to specialising in CTS,
28.6% (
n
=
68) had not yet chosen a speciality but were interested
in CTS, 38.7% (
n
=
92) had considered CTS at some point in their
career but would choose another speciality, and 24.4% (
n
=
58)
would neither choose nor were interested in CTS.
Among the cardiothoracic sub-specialities, the majority
(37%) believed that paediatric cardiac surgery was the most
exciting cardiothoracic sub-speciality. This was followed by adult
cardiac surgery (21.8%) and general thoracic surgery (20.2%).
A minority of respondents (8%) chose other cardiothoracic
sub-specialities.
Out of the 20 respondents who were committed to specialising
in CTS, 15% were in PGY-1, 50% were in PGY-2, 15% were in
PGY-3, while 20% were in PGY
>
3. Of all the 20 respondents
who believed that paediatric cardiac surgery was the most
exciting sub-speciality, 13 were committed to CTS.
The relationship between the different categories with regard
to interest in CTS with level of training (
p
<
0.001) and the
sub-speciality in CTS perceived as most exciting (
p
<
0.001) were
statistically significant. Age, marital status and rotation in medical
school did not have a relationship with interest in CTS (Table 2).
More than half of the respondents (58%) had identified a
mentor in surgery, of whom 7.6% were cardiothoracic surgeons.
Those who were committed to CTS were more likely to have
had a mentor than those who considered CTS but would choose
another speciality (52 vs 44%) or those who would neither
choose nor were interested in CTS.
One hundred and ten respondents (46.2%) undertook rotation
as medical students in a cardiothoracic unit/s managing minor
cardiothoracic cases. The average time spent in the rotation was
two weeks in 73.1% of respondents. Among those who rotated
in CTS, 72% believed that the rotation had a positive influence
in their surgical career generally.
Only 33.2% of respondents (
n
=
79) had undertaken posting
in CTS as junior surgical residents. In most instances, the posting
Table 1. Demographic variables
Demographics
Number
Percentage
Age (years)
26–30
59
24.8
31–35
137
57.6
36–40
35
14.7
41–45
7
2.9
Gender
Male
226
95
Female
10
4.1
Not specified
2
0.9
Marital status
Single
108
45.4
Married
124
52.1
Not specified
6
2.5
Number of children
1
47
19.7
2
29
12.2
3
15
6.3
4
9
3.8
>
4
1
0.4
Level of training
PGY-1
40
16.8
PGY-2
119
50
PGY-3
48
20.2
PGY
>
3
31
13