the sims 3 research medical career

Lizzielilyy

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How to Save a Life: The Sims 3 Medical Career Guide

The Hospital could always use some caring Sims who have a sharp logical mind, a steady hand, and a willingness to put in long, erratic, and often inconvenient hours. Be prepared, because contributing to the wellness of others starts at the bottom of the bed pan!

Time to scrub up and dig in, if your Sim wants to save lives and cure diseases they should show up to the Hospital bright and early.

Overview of the Medical Career Track in The Sims 3

Curious which career pays best? Check out this post comparing all avenues and which ones will make your Sims richest!

Becoming an Expert in Your Field

The Medical career is one full of promise, both financial and intellectual. However, the hours are rarely the same from one level to the next and there will be points when shifts merge into one another once your Medical Intern starts responding to emergencies off the job. You will be notified if your Sim is on call so that you can expect an alert, most likely in the middle of the night. Interns will also start bringing home Medical Journals which need to be read between shifts to guarantee that next promotion.

There are many perks with this career such as once they reach Level 5 they get a few very useful interactions. They can deliver Good, and later Great, Medical Advice to expecting Sims and also Brag About Being a Doctor. My personal favourite, is that this Sim can Determine Gender of Baby on pregnant Sims. This can be particularly useful if you are trying to have multiples with a mix of genders. Strangely enough, a pregnant doctor cannot determine the gender of their own baby but maybe their boss can? It’s particularly helpful to befriend a Medical Sim for this benefit alone. If you’re in Sunset Valley you’ll want to meet Jamie Jolina or Geoffrey Landgraab, and in Riverview it’s Jebidiah Wilson or Shirley Lin.

Since this career can be so unpredictable and stressful, your Sim will be rewarded when they reach the top of their field. At Level 10 they will work a normal 9am-2pm shift and will have the option to Play Golf throughout their shift, bringing them home in a great mood.

Playing the Good Doctor in an Active Career

If you have The Sims 3 Ambitions, the Medical career got an upgrade to provide opportunities to be a more active part of the community. Your Sim will receive in-work opportunities such as Vaccination Clinics and Free Clinics which take them to local venues and require your Sim to perform an action on the Sims that line up for their services. While these are all optional extras, Medical Outreach programmes are a must. Your Sim will leave work, head to a rabbit hole and, so long as they are done and back in the Hospital before their shift ends, their performance will increase to 100% guaranteeing a same-day promotion!

While out and about Medical Sims may need to help people in town who fall unwell. You will receive a notification from the Sim wishing a doctor was around, if you click their profile on the notification it will centre the camera on them. Select Give Medical Attention to help them and earn a performance boost. Your Sim can also provide follow ups with their patients via phone or house call by using the phone. They can also prescribe experimental medication to their friends and family as well as try it themselves with varied results.

The Best Traits, Lifetime Rewards, and Lifetime Wish for your Sim!

The World Renowned Surgeon Lifetime Wish requires reaching Level 10 of this career track. Chess Legend would make use of the high Logic Skill. Geniuses do well in this career track. and Bookworms will read the medical journals at an accelerated rate.

Lifetime rewards can be purchased with lifetime happiness points and the ones to look out for if you’re embarking on this career are:

Entrepreneurial Mindset – 10,000 (The Sims 3 Ambitions) Sims with an Entrepreneurial Mindset earn Experience more quickly and tend to reach the top of their careers more quickly.

Fast Learner – 15,000 Learn and improve skills faster than a galloping llama!

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Medic Career

Update Log:

This career has been a work-in-progress for a little over two years now and I think it’s about time I stop nit-picking over it and release it!

Only the Base Game and University Life are needed for this career to work as intended. It was made on Patch 1.69. The career is in English and supports Russian , French , Dutch and Portuguese (Brazilian) translations. I’ve included translation instructions at the bottom of this post.

The Medic Career is a bit more unique than the other careers I’ve done. It’s got three branches; Surgeon, General Practitioner and Psychiatrist. More on the branch split below.

This career requires the Nraas Careers Mod to show up in game.

The career has 2 levels before the first branch split; the Surgeon branch has a further 5 levels; the General Practitioner has a further 4 levels and the Psychiatrist branch has a further 5 levels. Important information about the branch split: The split branch in this career is a little different so please read this section carefully. There are 2 split branch messages that will come up. After your sim completes the Post Graduate Medic level (Level 2), there will be a split branch message. The options are for Surgeon/Psychiatrist or General Practitioner (GP). This branch will actually be asking you to choose between GP or Surgeon. If you choose GP, you have one level (Junior Doctor) before you get an identical split branch message . This is asking you to pick between GP or Psychiatrist. There is currently no known way to get a different message to show up, so this is a little confusing.

In short, if you want your Sim to become a Psychiatrist, they need to pick GP at the first split and Psychiatrist/Surgeon at the second. To access the Psychiatrist path, they must pick the GP path first .

If you’re still confused, please let me know and I can try to explain it clearer.

There are uniforms for all levels of the career. You can edit career outfits with Patch 1.31 and above so I highly recommend using this feature to set your own uniforms. For your male sims, I recommend THESE coats by spladoum.

There are 16 opportunities with this career, spread across the three branches. Details on the opportunities in this career can be found here .

Your sim may receive a bonus on Snowflake Day if Seasons is installed. There are no bosses at the top levels.

There are 4 custom tones: Study Medical Practices, which builds the Logic skill Comfort Patients, which builds the Charisma skill Begin Taking Notes, which builds the Writing skill Research Ailments, which builds the Science skill.

With Ambitions installed, sims may fall ill on a community lot if your sim is present. Your sim receives a boost to job performance if they treat them. Your sim can also be on call some nights.

Career Levels

1. Medical Assistant ~ In your last year at University, it’s been recommended that you take a job as an assistant in the local practise to learn the ropes of the real medical world. As an assistant, you’re going to be keeping the surgery and each consultation room well stocked with instruments to keep the practise running smoothly. You’ll be allowed to sit in on consultations with the doctors and as long as you keep your notes in order, and respect that doctor-patient confidentiality clause, you’ll be ready for your graduation! §20/hour Hours: 8.00am – 6.30pm Days To Work: Monday, Tuesday, Wednesday, Thursday, Friday

2. Post-Graduate Medic ~ University is behind you and you feel a sense of pride in how far you’ve come and what you have accomplished. As a post-graduate, you’re needing to get a feel for a real medical environment beyond the confines of the labs at the University. You’ll shadow one of the doctors on duty and get a feel for the job. If you’re lucky, you may be allowed a patient or two of your own. Good luck! §25/hour Hours: 8.00am – 6.30pm Days To Work: Monday, Tuesday, Wednesday, Friday, Saturday

Surgeon Branch 3. Ward Doctor ~ Dispensing medicines, changing dressings and taking temperatures. The life of the Ward Doctor is yours. This is the opportunity to work on that bedside manner as you’re in charge of one of the wards at the hospital and it’s important you know the ailments of all your patients and dispense the treatments accordingly. Be prepared for the occasional nervy patient – you’re going to need all the tact and diplomacy you can muster! §55/hour Hours: 7.00am – 5.00pm Days To Work: Monday, Tuesday, Wednesday, Friday

4. Surgical Assistant ~ Done are the days of prowling the wards and conversing with the patients. As a Surgical Assistant, you’re in the operating theatre more than you’re out and in your time, you’re seeing a lot of operations take place. Just hand the surgeons the instruments they need, keep them sterilised and you’ll have no problem clawing your way to the next step in your career. §85/hour Hours: 9.00am – 6.30pm Days To Work: Monday, Tuesday, Wednesday, Thursday, Friday

5. Anaesthetist ~ You’ve grown quite accustomed to the operating theatre and as the anaesthetist, your job has become even more vital to the successful running of the hospital. You’ve learnt a lot about the various types of anaesthetic and as such, you’re expected to administer the correct dosage to the patient. Get this wrong, and it’s goodbye medical career. §120/hour Hours: 9.00am – 6.30pm Days To Work: Monday, Wednesday, Thursday, Friday

6. Surgeon ~ Another day, another round of operations, both minor and major. Everything you’ve ever observed in the theatre is going to matter now. You’ve got a team of assistants to help and from time to time, you’ll work with the Head Surgeon during important, rare and special operations. You can’t ever be too careful in this line of work, so make sure you’re well rested before you come into work each day! §245/hour Hours: 8.00am – 6.30pm Days To Work: Monday, Tuesday, Thursday, Friday

7. Head Surgeon ~ As the Head Surgeon at the hospital, it’s become very important that you never make mistakes! You’ve acquired a loyal, competent team of surgeons, anaesthetists and assistants to work amicable with during your surgeries and as long as you keep up to date with the latest medical journals, you can’t go wrong. So sit back, rest for the weekend and smile. You’ve reached the top of your career and you deserve to take some holiday! §360/hour Hours: 11.00am – 8.30pm Days To Work: Tuesday, Thursday, Friday

General Practitioner Branch 3. Junior Doctor ~ Your first independent role in the surgery! As the Junior doctor, you’re allowed your own patients and you’ve been assigned your own consultation room upstairs, along the corridor and four doors along to the right. It’s given you a taste of the life of a doctor in general practise so you’d better make sure you know your stuff. §32/hour Hours: 8.00am – 6.00pm Days To Work: Monday, Tuesday, Thursday, Saturday

4. General Practitioner ~ With your own patients, your appointment book gets filled quickly. You’ve gathered the reputation as a patient and caring doctor and this is something you’ve come to pride. That gentle charismatic charm pays off and with a little more determination on your part, there seems to be no reason why you can’t reach the top eventually. So let’s keep going! §55/hour Hours: 8.00am – 5.30pm Days To Work: Monday, Tuesday, Thursday, Friday, Saturday

5. Head Doctor ~ The Head Doctor doesn’t have to work every day. But with the pay rise you’ve just received, it’s not going to matter. The Head Doctor often sees the most patients and routinely refers patients to other, more specialised, doctors for tests and further examinations. Just be sure not to refer all your patients – you do still need some to look after! §155/hour Hours: 9.00am – 5.30pm Days To Work: Monday, Tuesday, Friday

6. General Practice Manager ~ The Manager in this particular surgery no longer has to see patients but you still choose to as this is your life’s work. The practice has been the cornerstone of your career and now the running of it is in your hands and your hands alone. As and when you can, you still see patients and your charming demeanour means the surgery has been voted the Most Friendly in the whole SimCity region. Congratulations are in order! §285/hour Hours: 9.00am – 4.00pm Days To Work: Monday, Tuesday, Thursday, Friday

Psychiatrist Branch 3. Junior Doctor ~ Your first independent role in the surgery! As the Junior doctor, you’re allowed your own patients and you’ve been assigned your own consultation room upstairs, along the corridor and four doors along to the right. It’s given you a taste of the life of a doctor in general practise so you’d better make sure you know your stuff. §32/hour Hours: 8.00am – 6.00pm Days To Work: Monday, Tuesday, Thursday, Saturday

4. Psychiatry Student ~ The world of psychiatry has fascinated you since your University days and you’ve been granted the opportunity to make this work your own. As a student, you’re going to study the workings of the sim mind and sit in on seminars and workshops from some of the best psychiatrists in SimCity. So crack open those notebooks and start studying again! §70/hour Hours: 8.00am – 6.30pm Days To Work: Monday, Tuesday, Wednesday, Thursday, Friday

5. Junior Psychiatrist ~ With the oak desk, floor-to-ceiling bookshelves and plush carpeting, you wonder where you are. Then you realise; you’re in your very own office! As a Junior Psychiatrist, you’ve got your own group of patients and you run seminars every so often to help them cope with their individual issues. However, any particularly complicated issues and you need to refer them to one of your senior colleagues. But at least you’re on the ladder! §150/hour Hours: 8.00am – 6.30pm Days To Work: Monday, Tuesday, Wednesday, Thursday

6. Psychiatrist ~ You’ve got a loyal group of patients who are delighted with the progress they’ve made. You’ve written some books on the subject of psychiatry but have yet to see them in print. But it is clear – your career is going incredibly well. You organise seminars and workshops for your patients and they never feel alone in their suffering. The practise manager is very pleased with your methods and success rates. Keep up the stellar performance! §285/hour Hours: 8.00am – 6.30pm Days To Work: Monday, Tuesday, Wednesday, Thursday

7. Psychiatry Practice Manager ~ The practice has been successful and in the last few years, that’s been down to you. You’ve now been offered the opportunity to become the manager and while it means cutting down on the number of patients you can see, nothing stops you from eventually having your own company. The sky is the limit now! §365/hour Hours: 9.00am – 5.30pm Days To Work: Monday, Tuesday, Wednesday

Translating

I’m not fluent enough in any other languages to translate, so if you’re interested in translating this career into your own language, then please download this Language Strings file and open the filed up in Notepad.

<KEY>Gameplay/Excel/Careers/CareerList:Example</KEY> <STR> Translate This Text </STR>

Do that for the entire file, then email it to me at: [email protected] and let me know which language you’re translating into 🙂

I’ve fully tested this career but if you do have any issues, or questions about the splitting of the branches, please don’t hesitate to let me know and I’ll answer as soon as possible 🙂

Credits go to: Twallan for creating the Careers mod The NRaas team for keeping the mods going dudeyochill from ModtheSims for the initial thoughts and testing for three branches in a career. Finally, Victor , Secret X , Lessien Vardamir and Doctsim for the translations!

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Sims 3 Doctor Profession: A Detailed Guide to the Sims 3 Medical Business

The Sims 3 doctor profession is for Sims who are ambitious and ready for a fast-paced life. Ideally, those in this profession will be striving to achieve World Renowned Surgeon. To have the doctor career track, The Sims 3 Ambitions is necessary.

Best Traits for Doctors

Sims who want to be a doctor should choose certain traits. Having these traits will make the journey to MD and World Renowned Surgeon a little easier. The genius trait is probably a given, but many overlook it. This trait will make learning the necessities a bit easier and makes gaining logic faster. Doctors can also benefit from the charismatic trait and the ambitious trait. These two traits will help make the doctor more likable and help him earn things like promotions and raises. Ambition also increases wish-related lifetime happiness points. Doctors will work a lot so the workaholic trait can be useful to help him get through those long days and stay in a good mood. The good trait and bookworm trait are also beneficial, but more so the bookworm trait. This is because reading is a necessary part of the medical career track if a Sim hopes to get past level four. The insane trait is sometimes appropriate as well.

Career Levels in Medicine

Sims begin their career in medicine as an organ donor earning $22 an hour. Next comes bed pan cleaner earning $25 an hour. As Sims

progress, they will work toward becoming a paramedic earning $28 an hour. At level four is medical intern earning $33 hour. Level five is resident earning $78 an hour. Next comes trauma. Sims working in trauma earn $102 an hour. Once a Sims gets to level seven, he will be a gene therapist earning $192 an hour. At level eight, she will be an infectious disease researcher earning $210 an hour. Next, comes neurosurgeon earning $225 an hour. Lastly is World Renowned Surgeon earning $480 an hour. At level 10, Sims can determine a pregnant Sims’ baby’s gender and he also receives a $460 pension.

Getting the Job

To begin a the Sims 3 doctor profession a Sim should head to the hospital and apply. Before an aspiring doctor even starts his first day, it is a good idea to get started on building up logic . Logic is critical in the Sims 3 medical business.

Lifetime Wishes

World Renowned Surgeon is really the only lifetime wish associated with the Sims 3 doctor profession. This is as high as a Sim can go in the Sims 3 medical business. Sims will need to through all of the nine other career levels in medicine and get to level 10 in logic. Sims will also have to ensure they are always boosting their mood. Research is also a critical factor. Reading medical journals is how a Sim completes research. He would do this just how he does a book. Sims get the journals from work and bring them home.

Opportunities in Medicine

Sims receive a variety of opportunities. These usually require that they leave the hospital, perform the task and then immediately

get back to work. Vaccination clinics involve the doctor having four hours to provide as many vaccinations as he possibly can. He is paid per vaccination.

During a medical outreach, the doctor will head to a random rabbit hole and spend a few hours there. A rabbit hole works as a community building and it a massive object. Sims can visit it, but are not playable.

After a doctor finishes his day at the hospital, he may check in on a patient by making a house call. Doctors can earn extra cash this way. To make house calls, doctors should call the hospital. They will be assigned a patient and then visit them to perform all necessary treatment.

Free clinics are similar to vaccination clinics. They last four hours and doctors should treat as many patients as possible. He is paid per patient he cures.

When a doctor Sim is out and about, she may encounter an emergency. For example, when having dinner, if another diner is choking, she should assist.

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How do I increase my research stat?

Pc 3ds android blackberry ds ios (iphone/ipad) macintosh playstation 3 wii windows mobile xbox 360, the sims 3 (pc).

• Recently my Sim required a research skill when she became a medical intern. However, I don't know how to increase the research points as I am required to. Does anyone know how? p0tat0_phun - 14 years ago - report

Accepted Answer

• to improve the research trait from the medical profession you have to read the medical books that they send home with you after work. just check your Sim's inventory BaleFire77 - 14 years ago - report 5   10

Top Voted Answer

• The maximum level of research status is good. It will never go more than that. Since we just given a book a day. You can search for it in inventory, it will always new every time you go home from work. hylm - 14 years ago - report 14   2

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The Sims Wiki

Game guide : deciding the best career.

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This tutorial is to help players determine which career will be best to suit the Sims in The Sims 3 . Essentially, what job suits with a Sim depends on their traits , which simply determine their lifetime wish , and their current wish .

• 2 Lifetime Wish
• 4 Lifetime Rewards

If profit and earnings is what the players are really looking for, the simple answer is the Medical career. The top of Medical career (World Renowned Surgeon) has the highest earnings per week, while Military (Astronaut) has the lowest earnings per week, as Sims only work once per week.

Lifetime Wish [ ]

Almost all careers in all branches as well as professions have Lifetime Wishes, with the exception of Education , Daycare , Band , Art Appraiser , Video Game Developer , and Sports Agent . If the players are willing to fulfill Sims' lifetime wish, following it will be the best option for them.

Some other Lifetime Wishes can also determine the job for Sims as self-employed:

• Alchemist: Alchemy Artisan
• Angler: Presenting the Perfect Private Aquarium
• Band: Golden Tongue / Golden Fingers, Master of the Arts, One Sim Band
• Bot Builder: More than a Machine
• Gardener: The Perfect Garden, Greener Gardens
• Horseman: Jockey
• Inventor: Descendant of da Vinci, Monster Maker
• Nectar Maker: Bottomless Nectar Cellar
• Painter: Illustrious Author, Master of the Arts, Visionary, Descendant of da Vinci
• Photographer: World-Class Gallery, Visionary
• Scuba Diver: Deep Sea Diver
• Sculptor: Descendant of da Vinci
• Writer: Illustrious Author, Professional Author

Thus, when a Sim doesn't have a lifetime wish for a particular career or even skill career , consider employing them in the preceding careers. Of course, players are free to do one's will.

Other than Lifetime Wish, traits will also help determine the suitable jobs. Here are the traits that will be helpful for certain careers:

• Astronomer : Genius (Astrophysicist branch), Athletic (Space Explorer branch)
• Bot Arena : Bot Fan
• Business : Schmoozer , Supernatural Skeptic
• Criminal : Athletic , Evil , Genius (Evil branch), Kleptomaniac , Rebellious
• Culinary : Natural Cook , Schmoozer
• Journalism : Bookworm , Charismatic , Supernatural Skeptic
• Law Enforcement :   Artistic (Forensic Analyst branch), Athletic (Special Agent branch), Brave , Genius , Supernatural Skeptic
• Medical : Genius
• Military : Brave , Handy , Athletic
• Music : Artistic , Genius (Symphonic branch), Virtuoso , Rebellious
• Political : Charismatic , Supernatural Skeptic
• Professional Sports : Athletic
• Science : Green Thumb , Angler , Handy
• Education : Charismatic , Genius
• Film : Charismatic , Star Quality , Rebellious
• Fortune Teller : Charismatic , Genius (Scam Artist branch), Supernatural Fan (Mystic branch)
• Art Appraiser : Artistic , Avant Garde
• Sports Agent : Charismatic
• Video Game Developer : Artistic (Game Artist branch), Computer Whiz , Genius (Game Engineer branch)
• Architectural Designer : Artistic , Perceptive
• Firefighter : Brave , Daredevil , Handy , Athletic
• Ghost Hunter : Genius
• Investigator : Perceptive , Genius
• Stylist : Artistic , Charismatic
• Daycare : Family-Oriented , Nurturing
• Acrobat : Athletic , Natural Born Performer , Daredevil
• Magician : Natural Born Performer , Social Butterfly
• Singer : Diva , Natural Born Performer , Virtuoso
• Lifeguard : Athletic , Charismatic , Loves the Outdoors , Loves To Swim
• Alchemist: Supernatural Fan , Gatherer
• Angler: Angler
• Band: Virtuoso
• Bot Builder: Bot Fan
• Gardener: Green Thumb , Gatherer , Eco-Friendly , Loves the Outdoors
• Horseman: Equestrian
• Inventor: Eccentric
• Nectar Maker: (None)
• Painter: Artistic , Perfectionist
• Photographer: Photographer's Eye
• Scuba Diver: Loves To Swim
• Sculptor: Savvy Sculptor
• Writer: Bookworm , Artistic , Loner , Hates the Outdoors , Couch Potato , Perfectionist

Lifetime Rewards [ ]

Some lifetime rewards are very helpful with Sims' jobs, depending on what they do for their living. Most of these rewards have impact to some careers, while no benefits in other careers.

All rabbit hole careers are quite simple and straightforward. Professional Slacker enables Sims to slack off without reducing their performance as well as the risk of being demoted. Office Hero makes Sims build their relationship with coworkers while at work twice as fast. Multi-Tasker will also be helpful, and Vacationer enables Sims to take any day-offs as they please.

All professions or active careers from Ambitions , Generations , as well as Showtime can earn bigger weekly stipends with Professional Simoleon Booster . Entrepreneurial Mindset enables Sims to earn performance / experience faster.

Different Lifetime Rewards give different impacts and benefits for different self-employment careers , but some also have global benefits. Suave Seller is useful for Sims who work as Angler, Gardener, Inventor, Nectar Maker, Painter, Photographer, and Sculptor, because this reward has direct impact from crafted objects sold in consignment store .

Meanwhile, these rewards are only useful for the following careers.

• Super Green Thumb : Gardener
• Acclaimed Author : Writer
• Extra Creative : Painter
• Efficient Inventor : Inventor
• Artisan Crafter : Sculptor
• The Next Big Thing : Band
• Super Nanny : Daycare
• Engaging , That Was Deliberate : Singer, Acrobat, and Magician
• Better Mixologist : Mixologist (While this is technically not a self-employment career, this reward is useful for Sims who mix drinks for living)
• Lungs of Steel : Scuba Diver
• 1 Trait (The Sims 4)
• 2 Career tracks
• 3 The Sims 4

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January 2018

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• Published: 26 April 2024

Impact of medical school experiences on the career choice of neurosurgery: a cross- sectional study from Pakistan

• Muhammad Shakir 1 ,
• Hammad Atif Irshad 2 ,
• Eisha Abid Ali 3 ,
• Amna Adil 4 ,
• Ahmed Altaf 1 &
• Syed Ather Enam 5  

BMC Medical Education volume  24 , Article number:  465 ( 2024 ) Cite this article

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Pakistan grapples with the issue of an inadequate neurosurgery workforce but the reasons for such a disparity remain uncertain. Previous studies have highlighted how various factors including medical school experiences have an impact on career choice, but no study has delved into the impact of medical school exposure among Pakistani medical students, especially for the field of neurosurgery. This study aims to evaluate the impact of neurosurgery exposure, mentorship, and interest groups on medical students' decision to pursue neurosurgery.

A national cross-sectional survey was conducted in Pakistan, collecting data from medical students, interns, and medical officers over a one-month period. Ethical approval was obtained from the Ethical Review Committee at Aga Khan University, Pakistan. The data was analyzed using SPSS version 26.

Out of 2618 participants, 38.0% were male and 62.0% were female, with an average age of 21.82 years (± 2.65). Among them, only 358 (13.6%) were interested in pursuing neurosurgery as a career, while the remaining 2,260 (86.3%) were not. More females (58.9%) than males (41.1%) expressed interest in pursuing neurosurgery as their intended career. Most medical students interested in pursuing neurosurgery were in the early years of their medical school (1st Year: 19.6%, 2nd Year: 26.0%, 3rd Year: 20.9%). In our study, students from public sector institutions (52.2%) showed more interest in neurosurgery as a career choice compared to those from private sector institutions (44.1%). The main deterrents for choosing neurosurgery were intense training (42.2%), work-life balance (39.9%), limited residency slots (56.7%), medical knowledge (34.1%), and surgical skills (36.6%).

This study highlights the need for increased student engagement to inculcate the decision to pursue neurosurgery among medical students in Pakistan. A significant gap is highlighted, with the majority of interested students in early years. Public sector students show higher interest than their private sector counterparts. However, barriers like intense training, limited residency slots, and work-life balance concerns influence career choice. Targeted interventions like mentorship programs are crucial for fostering future neurosurgeons and advancing patient care and research. By addressing the identified disparities in experiences and promoting a supportive educational environment, it is possible to cultivate a future generation of skilled and dedicated neurosurgeons who can contribute to advancements in patient care and research in the field.

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Introduction

The global need for neurosurgical care is expanding and according to the World Federation of Neurosurgical Societies (WFNS), a minimum neurosurgery workforce density should be 1 per 200,000 population for optimum access to neurosurgical care. Pakistan faces a significant shortage of neurosurgeons, with only an estimated 212, reported in 2016 by WFNS [ 1 ]. This glaring deficit in the field contributes to the growing burden of neurosurgical care. The global increase in numbers compared to the decline in our charts is alarming and could stem due to multiple factors. These could be attributed to the lack of exposure, limited presence of neurosurgeon mentors, coupled with a shortage of comprehensive training courses, limited residency slots and the omission of it from the curriculum in pre-clinal years, collectively lead to failure in attracting and providing quality experiences to medical students [ 2 , 3 ].

In Pakistan, medical students enter the clinical care arena from the third year of medical school [ 4 ]. Through this clinical training phase, also known as clerkship, develop initial impressions regarding various specialties. These impressions are based on experiences they have had and are linked to hands-on experience, patient interaction, effective mentorship, positive opinion of teacher role models, approachable staff, salary structure, and general perception in the community [ 5 ]. Students rotate across various specialties but very few institutions offer rotation for subspecialties, especially surgical specialties like neurosurgery. Consequently, missing out on exposure to numerous specialties that they could have a potential interest in [ 6 ].

Human beings carry a wealth of memories, emotions, and associations learned from their past encounters [ 7 ]. These experiences serve as a foundation for interpreting, evaluating potential risks and making future judgments [ 8 ]. In context to this, studies from across the globe have highlighted that medical students who had positive experience in a particular field during undergraduate rotations ended up pursuing it, suggesting that experiential influences play a crucial role in shaping specialty decisions [ 5 , 9 , 10 , 11 , 12 ]. Therefore, the objective of our study is to provide an outlook on the student perspective of selecting neurosurgery as a career in Pakistan. The aim of this study is to assess whether exposure to neurosurgery, meaningful mentorship, interest groups or university societies plays a role in influencing students to pursue a career in neurosurgery.

Materials and methods

A cross-sectional survey was conducted among medical students, interns, and medical officers in Pakistan over a one-month period. Ethical approval was obtained from the Ethical Review Committee (ID: 2023–8484-24,189) at the Aga Khan University, Pakistan. The study targeted current medical students and recent graduates from both private and public sectors in Pakistan.

Sample size and population

To determine the sample size, previous literature suggested comprising of medical students was considered [ 13 ]. Using the OpenEpi website, a minimum sample size of 383 was calculated with a 5% precision value and 95% confidence interval [ 14 ].

Eligibility criteria

The survey targets current medical students and recent graduates from both private and public sectors in Pakistan. Inclusion criteria include individuals currently enrolled in Pakistani medical schools or those who have graduated within the last five years. Participants may belong to private or public medical institutions and must voluntarily consent to participate in the study. Current medical students must be enrolled in any year of their medical program, while recent graduates must have completed their medical degree within the specified timeframe. Exclusion criteria include individuals not meeting the specified enrollment or graduation criteria, and those who do not consent to participate. Additionally, participants previously involved in similar surveys within the past year are excluded.

Data collection tool and coding

Data was collected using a self-designed online questionnaire, formulated by the research team in collaboration with faculty specializing in student surveys and neurosurgery research at the Aga Khan University. The questionnaire covered demographics, institute details, neurosurgery opportunities, perceptions, barriers, career choices, and reasons for pursuing a career in neurosurgery. A pilot study with 50 medical students was conducted to validate the questionnaire, and necessary modifications were made based on their feedback.

Sampling technique

As a national survey in Pakistan, there were no official platforms for medical students to access the survey. To address this, an ambassadorship program was created by the research team, ensuring equal distribution of data collectors from all provinces. Various methods, including online platforms, face-to-face interactions, and dissemination within surgery and neurosurgery interest groups in medical colleges, were used for data collection.

Statistical analysis

Data analysis was performed using IBM Statistical Package for Social Sciences (SPSS) version 26. Descriptive statistics were used to report demographic characteristics, with normally distributed continuous data presented as mean ± standard deviation and categorical data presented as frequencies and percentages (n; %). Chi-squared tests were used to analyze survey responses and identify any significant differences between subgroups. A p -value < 0.05 was considered significant.

Out of the 2,618 participants in our study, 358 individuals (13.6%) had neurosurgery as their choice of career, while 2,260 participants (86.3%) did not. More females answered neurosurgery as their intended career, with 58.9% of female participants expressing interest compared to 41.1% of males. A greater proportion of intention to pursue was found in earlier medical school years. Specifically, the percentages of interest were 19.6% in the 1st year, 26.0% in the 2nd year, and 20.9% in the 3rd year. Students from public sector institutions displayed a higher level of interest in career choice of neurosurgery, with 52.2% expressing intention to pursue as a career, compared to 44.1% of students from private sector institutions. Demographic characteristics are outlined in Table  1 .

The correlation of different sources of exposure to neurosurgery in medical school life with the career choice of medical students is summarized in Table  2 . We found that 64.8% of medical students have neurosurgery in their curriculum and among them almost 70% of the medical students are inclined to choose neurosurgery as a future career ( p  = 0.036). Out of 72.7% respondents who agreed to having a medical school/hospital associated neurosurgery department, 73.5% and 72.5% had neurosurgery as their career choice and do not have neurosurgery as their choice of career, respectively. A greater proportion of respondents (53.6%) with a neurosurgery training program in their institute were found in the neurosurgery as a career choice group. The highest (61%) rate of selecting neurosurgery as field of specialization was found among those students who did not rotate in neurosurgery as compared to students (27.9%) who rotated in neurosurgery and this difference was found to be significant ( p  < 0.001).

Amongst students opting for neurosurgery as a career, our study identifies deterrents towards neurosurgery. The main deterrents identified were the perceived intensity of training (42.2%), concerns regarding work-life balance (39.9%), limited availability of residency slots (56.7%), perceived gaps in medical knowledge (34.1%), and the need for strong surgical skills (36.6%). As seen in Fig.  1 .

Deterrents to pursuing neurosurgery according to participants

Out of 2618 respondents, a remarkable difference of 72.6% was seen among students considering neurosurgery as a choice of career with 358 students considering neurosurgery as a career choice while 2260 students didn't show any interest in pursuing the field.

The objectives of neurosurgery education in medical school are twofold: 1) to give all medical students fundamental concepts and key learning objectives related to neurosurgical disease; and 2) to offer suitable candidates a pathway of exploration, education, and mentorship to pursue further training in neurosurgery. In our study, 60.9% of participants could not get a chance to rotate in neurosurgery clerkship rotation and these were the students who wanted to pursue a career in the field. These factors restrict the students' exposure to the large and fascinating area of neurosurgery and put something of a "ceiling" on their comprehension of the neurosurgical field, which reduces the likelihood that they will choose neurosurgery as a career [ 15 ]. Our study revealed a surprising trend: the highest rate of interest in neurosurgery was found among students who had not rotated in the specialty, compared to those who had. This underscores the complex dynamics influencing career decisions. Real-world exposure to neurosurgery may temper idealistic perceptions, highlighting the sacrifices required. However, it is crucial to recognize these challenges as integral to the dedication demanded by the field, rather than deterrents.

We found that the year of study played a significant role with surprisingly, only 2.2% of students in their final year expressing an inclination towards the field, which is noteworthy because the final year of medical school is pivotal for making career choices [ 16 ]. The findings of this study are comparable to other studies where 76.96% of students changed their career preferences in their final year of medical school due to factors such as future marital plans, family considerations, early settlement, better income, and improved work conditions [ 17 ]. A similar study from the United States that initially proposed medical career plans can be changed due to parental responsibilities and childbearing students particularly among women who do not opt for neurosurgery as a career compared to their non-parent counterparts due to hectic work hours and intense training [ 17 ]. This finding warrants further exploration to understand the underlying factors influencing students' career decisions in this field. It is crucial to consider the potential impact of various factors such as personal experiences, exposure to neurosurgery, and the broader socio-cultural context within medical education. While some students may make informed decisions based on realistic exposure to the rigors and demands of neurosurgical practice, others may be dissuaded due to negative experiences, including instances of bullying, discrimination, or a problematic organizational culture.

Another study from Nigeria reported that students from the final year believed that early exposure had the potential to alter their initial decision of not pursuing a career in neurosurgery. It underscores the significance of creating a supportive learning environment and effective teaching methods during neurosurgical clerkships to foster interest [ 18 ].

The disparity in career choice preference could shed light on the pre-clinical experience of medical students in the country. Third year is often the start of clinical rotations in Pakistani medical schools and interestingly, we found in our study that among all the medical school years, the third-year cohort exhibited the highest percentage, approximately 24%, of disinterest in opting for neurosurgery as their future career path [ 19 ]. A discrepancy in medical student experiences in the field of neurosurgery was seen in our study. Our results showed that a significant number of students, around 60% did not rotate in neurosurgery and notably these were the students who wanted to opt for neurosurgery as a career. Another study from Pakistan highlights the impediments faced during clinical learning in the form of suboptimal clinical rotation planning, insufficient clinical orientation, poor supervision and lack of resources with a crippled feedback delivery system acting as barriers to effective clinical learning. However, due to a lack of adequate clinical rotation planning, students are distanced from several medical fields [ 20 ].

Similarly, a study from Saudi Arabia found that interest in neurosurgery as a specialization can be strengthened by enhancing the exposure of students and interns to the specialty during their medical school years. Spending a few days or weeks at the local neurosurgical unit, sitting in clinics, scrubbing in theaters, and joining the daily ward rounds would give students an accurate insight into the specialty and help them grasp what a career in this field might be like [ 21 ]. Furthermore, for students hailing from third-world countries, international health electives (IHEs) are significant to incorporate and experience clinically advanced and technologically sophisticated systems available to the first word medical student [ 22 ]. However, these results conflicted with the findings of a study which says that an early exposure to the operative room has improved the comprehension of neurosurgery, and it influenced decreasing the interest in the specialty as a career [ 10 ]. A study from Johns Hopkins Medical School also documented the impact of an early exposure on enhancing the under representation of medical students in surgery by proposing the introduction of a summer research program exclusively dedicated to facilitating research with robust and focused mentorship, yielding promising results [ 23 ].

Many students who rotated in neurosurgery availed the opportunity through electives (6.1%), which provided them with the gateway to customize their own learning experience [ 24 ]. This statistic emphasizes the significant potential and enthusiasm of students within this field. According to a study conducted in Pakistan, students believed that electives would help them in their career in terms of getting experience and a chance to explore more. They expected that it would improve their medical knowledge, professionalism, and enhance the quality of care they would be providing [ 22 ].

We also found that those who intend on pursuing neurosurgery had greater access to research through their institutions. The results of a study showed that medical students got more insight into neurosurgery specialty after attending the conference related to neurosurgery. Exposure to neurosurgeons through conferences and teaching provided by them positively influences medical students in choosing neurosurgery as a career [ 25 ]. Therefore, research is crucial at the undergraduate level and more exposure needs to be incorporated in Pakistani institutions.

Interestingly, students who expressed an interest in neurosurgery were notably absent from any neuroscience interest groups (43.0%). On the other hand, among those who were not interested in neurosurgery, a smaller percentage lacked participation in such groups (38.5%). This suggests that when individuals have a genuine passion for neurosurgery, they tend to proactively seek out opportunities and experiences, even in the absence of formal interest groups or structured support.

Deterrents that are reported in our study are a longer training period, limited exposure, and residency positions. Work life balance was considered the most important factor in discouraging medical students from choosing neurosurgery [ 26 ]. In a cross-sectional study at Nepal, it is seen that long training and inadequate facilities for treatment were the few reasons for medical students to become repellent from neurosurgery [ 27 ]. Less availability of mentors also played a part in restraining medical students from neurosurgery [ 28 ]. The already less available number of neurosurgical residents and consultants in Pakistan leads to production of less mentors to guide the aspiring students about neurosurgery, hence creating a paradoxical cycle [ 29 ]. A study by Sandeepa showed that effective leadership and workshops for surgical residents may not only create better future surgeon educators but may also increase the number of students pursuing surgical training [ 30 ].

In addition to addressing student motivation, future studies should delve deeper into the systemic challenges limiting the advancement of neurosurgery in Pakistan. Structural deficiencies such as the lack of standardized training programs, insufficient supervision, and the absence of a robust research culture are significant barriers that must be overcome. Furthermore, addressing the financial constraints and inconsistent selection criteria for neurosurgery training is crucial to fostering a conducive environment for aspiring neurosurgeons. By advocating for systemic reforms and proposing practical solutions to these challenges, we can pave the way for a more robust and sustainable neurosurgical workforce in Pakistan.

Recommendations

Based on our findings we propose the establishment of university-based interest groups to cultivate students' interest, along with increased faculty involvement in leading educational initiatives and collaborative research efforts. Furthermore, the creation of both national and international associations could facilitate early exposure to neurosurgery for medical students. Additionally, modifying the curriculum to enhance its implementation and addressing stigmas associated with pursuing the field could serve as effective initiatives.

Limitations

The limitation of our study is that our study is a web-based survey, thereby reducing the reliability of responses and interpretation of questions and thus our sample size is not the equal representative of all the provinces of Pakistan. Moreover, results were not reported by institutions, and so some of the institutes might be overrepresented in our sample. Although we sampled 2618 participants, representing approximately 2.5% of the total medical student population in Pakistan, this sample size may not fully capture the diversity of perspectives within the entire population. Being a cross-sectional study, we were also unable to comment on how experiences over the years of medical school impacted the outcome of career choice and therefore our hypothesis requires a follow-up cohort and qualitative study to also incorporate subjective perspectives. Due to the self-reporting nature of the survey, there may be response bias and the possibility of social desirability bias influencing participant responses. Additionally, some medical students may lack clinical exposure to neurosurgery, which could bias their career choice towards or away from neurosurgery based on incomplete information or experiences.

This study sheds light on the impact of medical experience on the career choice of neurosurgery among medical students and the factors that influence their interest in this field. Based on the findings of our study, it is evident that there are diverse factors influencing medical students' decisions regarding pursuing neurosurgery as a career. While a proportion of student’s express interest in neurosurgery, a significant number do not, citing various deterrents such as the perceived intensity of training, work-life balance concerns, limited residency slots, and challenges related to medical knowledge and surgical skills. Furthermore, our study highlights the need for further exploration into the impact of exposure to neurosurgery during medical education, particularly in evaluating the quality of rotations and understanding students' perceptions and experiences. By addressing these factors and fostering a supportive learning environment, medical educators and policymakers can better equip aspiring neurosurgeons and improve the overall landscape of neurosurgical practice in Pakistan.

Availability of data and materials

Available from the corresponding author.

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Acknowledgements

The authors would like to thank Neurosurgery Interest Group (NSIG) for their help in disseminating the survey.

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Muhammad Shakir & Ahmed Altaf

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University College of Medicine and Dentistry, Lahore, Pakistan

Eisha Abid Ali

Rawalpindi Medical University, Rawalpindi, Pakistan

Section of Neurosurgery, Department of Surgery, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan

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MS: Conceptualization, Methodology, Supervision, Writing- Reviewing and Editing, Project administration, Validation; HAI: Conceptualization, Methodology, Supervision, Writing- Reviewing and Editing, Project administration; EAA: Writing- Original draft preparation, Writing- Reviewing and Editing, Supervision, Visualization, Validation; A. Adil: Investigation, Writing-Original Draft, Writing-Review and Editing Data Curation; A. Altaf: Writing-Review and Editing; SAE: Conceptualization, Writing-Review and Editing, Supervision, Project administration. All authors reviewed and approved the manuscript for submission.

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Correspondence to Muhammad Shakir .

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Ethical approval was obtained from the Ethical Review Committee (ID: 2023–8484-24189) at the Aga Khan University, Pakistan. This study was conducted in accordance with the Declaration of Helsinki (1975) and its future amendments. Informed consent was also taken from all participants and participation in the study was entirely voluntary, with participants being free to withdraw from the study at any time without consequences.

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Shakir, M., Irshad, H.A., Ali, E.A. et al. Impact of medical school experiences on the career choice of neurosurgery: a cross- sectional study from Pakistan. BMC Med Educ 24 , 465 (2024). https://doi.org/10.1186/s12909-024-05452-9

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DOI : https://doi.org/10.1186/s12909-024-05452-9

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