The effect of syncope on the career choices of medical students

Dear Sir

I read the article by Weinberg et al. (2015) with interest on tips for medical students to maximise their learning during surgery and particularly noted point seven, regarding the avoiding syncope. While they described the important effect this issue has on student learning it is also important to note its impact on the career choices of medical students.

Syncope is an unpleasant event that occurs not infrequently during theatre, often due to the long periods of standing still that are required during procedures. Rudnicki et al. (2013) found that medical students who experience syncopal events are less likely to opt for a surgical speciality. The reasons for this are likely to be multifactorial, including the wish to avoid the unpleasant symptoms of syncope, the appreciation that fainting while performing a procedure is potentially dangerous and perhaps also due to the wish to avoid subsequent embarrassment. This is supported by evidence suggesting that surgeons experience lower rates of syncopal episodes than the general population, suggesting a degree of self-selection. Given the increased rate of syncope in young women compared with men perhaps this is also an issue with regards to the under-representation of women in surgical careers.

It has been recommended by the studies looking at the rates of syncope in medical students that teaching on how to avoid such incidences should be given. Given the significant effect syncope appears to be having on determining which students pursue a surgical career, and the relatively simple steps that can be taken to avoid syncope in most people (through eating appropriately and moving when possible) it seems appropriate that such teaching should become standard in surgical rotations.

Declaration of interest: The author reports no conflicts of interest. The author alone is responsible for the content and writing of the article.