Who are they? Attendees of surgical interest events 

Background Surgical interest groups provide networking and educational opportunities to students and trainees interested in pursuing surgery. Increased understanding of the barriers and perceptions of this group would inform targeted supportive strategies to increase accessibility and retainment in surgery from early on in the career journey. Summary of Work Collaborating with a student surgical interest group, we hosted a large-scale, international online surgical interest event. Attendees filled out a questionnaire to quantify their interests and perceptions towards surgery.  Summary of Results There were a total of 192 respondents from 40 countries. The most respondents were from the USA (22.9%), the UK (19.3%), Libya (7.8%), and Burundi (7.3%). The respondents were highly diverse - 24.0% White, 22.9% Asian, 17.2% Black, 12.5% Hispanic/Latino, and 12.5% Middle-Eastern/Northern African. The majority of respondents were medical students (74.5%). 86.8% of respondents were women. Survey respondents reported a high interest in surgery (8.87 out of maximum 10 ± 1.73). However, despite reporting high confidence in their ability to become surgeons (7.20 ± 2.26), they reported they felt they faced significant barriers (7.35 ± 2.33). On average, they reported low feelings of preparedness for surgical placement (5.71 ± 2.49) and a low opinion on the ease of obtaining work-life balance (4.58 ± 2.31). Having role-model surgeons was considered very important (8.73 ± 1.54). Additionally, diversity in surgery was rated as extremely important (9.02 ± 1.67). On average, men responded more positively than women on their confidence to become a surgeon [8.21 (1.79) men vs 7.02 (2.29) women], while men responded less strongly on the importance of diversity in surgery [9.23 (1.37) women vs 7.50 (2.64) men]. Discussion Overall, this very diverse population of medical students and trainee doctors reported high interest in surgery and high confidence in their ability to be surgeons. However, they simultaneously reported that they faced significant barriers, citing lack of role models, lack of feelings of preparedness, and racial and gender biases. These findings are consistent with the fact that this was a self-selected group interested in surgery and suggests this cohort has high levels of determination and ‘grit’ when it comes to their career choice. Additionally, women rated feelings of barriers higher and confidence to become surgeons lower compared to men. Conclusion Key points to be addressed include low feelings of preparedness for surgical placement, the importance of having role-model surgeons, and the high value given to having diversity in surgery. Additionally, targeted interventions towards disadvantaged subgroups such as women are warranted.