Decline in popularity of general surgery as a career choice in North America: review of postgraduate residency training selection in Canada, 1996-2001.

There has been a perception that fewer medical students are currently pursuing careers in general surgery. To investigate the validity of this premise we reviewed the Canadian Residency Matching Service (CaRMS) database from 1996 to 2001 and identified recent trends in graduates' selections. Three surgical specialties--general surgery, orthopedic surgery, obstetrics and gynecology--were chosen for analysis as "poor lifestyle" specialties. They were compared to anesthesia, diagnostic radiology, and ophthalmology, which were chosen as representative "good lifestyle" specialties. Linear regression and chi-square analyses were performed to identify significant changes in applications to each specialty. A negative trend in first-choice applications to all three "poor lifestyle" specialties was observed, whereas all three "good lifestyle" specialties experienced increased first-choice applicants. Potential factors influencing medical student residency selection are discussed, emphasizing the reduced number of first-choice applicants to general surgery.