Global Surgery Awareness and Career Aspirations Among Medical Students in Sudan: A University-Based Cross-Sectional Study

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Osman, Abdullatif Yasir H. Eissa, Eilaf Yassen, Manasik Mamoun, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7640148/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background Surgical care in Sudan is limited by many factors, rendering a large proportion of the population at risk for preventable death and disabilities. Global surgery can guide resource allocation and provide innovative solutions to problems unique to Sudan’s setting. However, there is limited knowledge regarding medical students' interest in the field. This study aims to determine the perception of global surgery among medical students in Khartoum University, Sudan. Method A cross-sectional study was conducted among fifth- and sixth-year medical students in Khartoum University. The study employed a stratified sampling technique to select study participants, where each academic year was considered a stratum. The data were collected via a self-administered online questionnaire on Google Forms. Data analysis was done using SPSS v. 25. Results The study included 183 students, 123 (72.13%) of whom were females, and 106 (57.92%) were sixth-year students. Only 26 (14.21%) of students had been exposed to the global surgery field. Among those without previous exposure to global surgery, 83 (45.36%) were interested in being exposed to the field. Regarding career prospects, 24 students were interested in global surgery. Students with previous exposure to global surgery had a higher interest in pursuing it as a career (p-value 0.001), with 30.8% stating they agree or strongly agree compared to 10.2% among students without previous exposure. Linear regression revealed that students' age (β = 0.129, p = 0.043), their familiarity with global surgery (β = 0.186, p = 0.005), and perception regarding the feasibility of global surgery (β = 0.606, p < 0.001) were positive predictors of career interest in global surgery. Conclusion This study highlights a gap in exposure and interest in global surgery. It also highlights the association between exposure to global surgery and career prospects. Incorporating global surgery education into medical curricula could help develop specialised expertise in the field. Such integration can strengthen the surgical healthcare system and help address persistent challenges in Sudan. Also, educational initiatives must prioritise enhancing students’ confidence and belief in the feasibility of global surgery in resource-limited settings. Figures Figure 1 Figure 2 Introduction In low- and middle-income countries (LMIC), death rates are high from common easily treated conditions such as appendicitis, hernias, road traffic accidents, breast cancers and more [ 1 ], which demonstrates the significant contribution of surgical conditions to the global burden of diseases [ 2 ]. More than two-thirds of the world lacks access to safe, timely, and affordable surgical care [ 3 ]. In 2014, the Lancet Commission on Global Surgery (LCoGS) was established to address the knowledge gaps, action gaps, and policy gaps regarding surgical care. It defined global surgery as: “an area for study, research, practice, and advocacy that seeks to improve health outcomes and to achieve health equity for all people requiring surgical care, with a special emphasis on underserved populations and populations in crisis.” [ 1 , 4 ]. Although deaths from surgically treated conditions are more than those from HIV, tuberculosis (TB), and malaria combined [ 5 ], global surgery has long been unrecognised in the global health sector, described by Paul Farmer in 2008 as “the neglected stepchild of global health” [ 6 ]. Global surgery is a crucial topic in meeting the SDGs, as it contributes to achieving SDG 1: “end poverty”, SDG 3: “universal health coverage” SDG 8: “promote decent work and economic growth”, and others [ 7 ]. Access to surgical treatment has been ranked as a top priority by both the World Bank (WB) Disease Control Priorities Project and the World Health Organisation Global Initiative for Emergency and Essential Surgical Care; both organisations promote improved surgical education and research, a larger surgical workforce, and increased surgical efficiency to meet the global need [ 8 ]. Building surgical capacity requires investment in numerous areas. One of the most important areas is increasing the surgical workforce [ 9 ]. To reach global surgery goals, LCoGS recommended increasing the surgical workforce to 20 surgical care providers per 100,000 population [ 1 ]. Still, in some LMICs, the proportion is 40 times lower than the recommended [ 10 ], and this extremely low rate can be attributed mainly to the scarcity of trained staff [ 11 ]. Academic global surgery has been trending since 2015 [ 12 ]; hence, various important questions were answered to put evidence for global surgery theories [ 13 ]. Despite advancements in the scientific literature, tracking and reporting the six core surgical indicators remain limited [ 1 , 14 ]. India, among a few other LMICs, conducted a systematic evaluation of their status and concluded the need to focus on high-quality data reporting. They also stated that it's hard to reach global surgery goals by 2030 [ 15 ]. Medical students represent the next generation across all medical fields, with their career perceptions influenced by several factors [ 16 ]. A crucial determinant is the curriculum they are exposed to throughout their personal, institutional, and cultural interactions in medical school [ 17 ]. Therefore, exposing students to global surgery may enhance the likelihood of them pursuing a profession in this under-resourced field. Data are scarce regarding the degree to which academic curricula and courses expose students to surgical education [ 8 ]. Nevertheless, emerging statistics indicate that medical school courses have not kept pace with students' expanding interests [ 18 ]. Integrating global surgery early in the medical curriculum can boost students' interest and understanding, helping expand the global surgical workforce [ 8 ]. Limited pre-clerkship exposure to surgical fields misses chances to influence career choices. An ideal program should include operating room observation, simulation, and realistic insights into surgery [ 19 ]. Methodology This study was an observational descriptive cross-sectional study. It took place at the University of Khartoum, Faculty of Medicine, located on Al-Qaser St., Khartoum, Sudan. It is the only medical school in Sudan to reach 100 years of age, and with its antiquity, it is also ranked first in the country’s ranking of medical schools. The educational system in the faculty consists of six academic years, with the last two years focused on clinical education. The total number of registered students at the faculty is approximately 2300 students from all over Sudan. Study Population: All students registered in the fifth and sixth academic years at the Faculty of Medicine, University of Khartoum, at the time of data collection. All fifth- and sixth-year medical students were included in the study. Sampling: The sample size was calculated using the online sample calculator (for known population sizes) at calculator.net as 244. Afterwards, 10% was added to allow for non-responders, giving a final sample size of 268. Participants were selected from a sampling frame using stratified random sampling (probability sampling); each academic year was considered a stratum, and students within each year were selected using an online random number generator. Despite implementing two reminder rounds to increase participation, the number of students who responded was 183 (response rate = 68.2%). Data tool and technique: Data were collected using self-administered closed-structured questionnaires assembled from published literature [ 3 , 4 ]. Face and content validity for the questionnaire were obtained from a consultant in community medicine. In addition, cognitive interviews were conducted with 15 recent graduates (5.6% of the sample size). Based on the feedback received, only minor adjustments were made to enhance clarity and improve the overall validity of the questionnaire. Questionnaires were distributed via online platforms. Distribution was mainly through Telegram, which is the official communication platform used by the students for academic updates. For participants not available on Telegram, the questionnaire link was shared via WhatsApp. Participant eligibility was verified using official registration records obtained from the Faculty Academic Office. Additionally, we collaborated with batch representatives to verify participant identities using phone numbers and Telegram usernames and data were collected by a faculty student to ensure verification. The questionnaire consisted of the following categories: demographic data, four exposure questions, seven knowledge questions, four attitude questions and two questions about career perspective. Knowledge questions were exclusive to students with prior exposure to Global Surgery. Questions included demographic data, binary questions, a Likert scale and multiple-choice questions aimed at collecting data on the study variables. Study variables included age, gender, academic year, exposure to global surgery, knowledge regarding global surgery, attitude towards global surgery, and career prospects. Data analysis: Data were entered, cleaned, coded, and analysed using IBM SPSS ver.25. Study population characteristics were presented using frequencies, percentages, mean and standard deviation (descriptive statistics for univariate analysis). Chi-square was used to explore the association between dependent and independent categorical data. The Shapiro-Wilk test was used to explore normality, continuous and ordinal data; afterwards, Man Whitney was used to explore the association between variables. Linear regression was used to determine the predictors of career prospects in global surgery. P-value was considered significant if < 0.05 at a confidence interval 95%. Results In total, the sample included 183 students, 123 (72.13%) of whom were females. Fifth-year students were 77 (42.08%) and sixth year students were 106 (57.92%) (Table 1 ). Table 1 Demographics N % Gender Male 51 27.87% Female 132 72.13% Age 21–23 108 59.02% 24–27 71 38.80% More than 27 4 2.19% Academic year Fifth 106 57.92% Sixth 77 42.08% Only 26 (14.21%) of students reported exposure to the global surgery field. Among these students, 13 reported being exposed through their seniors or fellow students, and 15 (8.20%) expressed interest in further exposure. According to the students, their most preferred exposure source was extracurricular activities and the hospital (Table 2 ). The most recognised global surgery indicator among students was access to timely surgery, with 11 (6.01%) students selecting it. Among students without prior exposure to global surgery, 83 (45.36%) reported an interest in exposure to the field. Their preferred source of exposure was faculty lectures and clinical rounds (Table 2 ). Table 2 Exposure and Interest in Global Surgery No Yes N % N % Exposure to global surgery 157 85.79% 26 14.21% Exposure source Faculty lectures/clinical rounds 18 9.84% 8 4.37% Seniors/ Fellow students 13 7.10% 13 7.10% Social media 14 7.65% 12 6.56% Extracurricular activities 21 11.48% 5 2.73% Online courses 24 13.11% 2 1.09% Research 24 13.11% 2 1.09% Interest in further exposure 11 6.01% 15 8.20% Preferred exposure source (among exposed) Faculty lectures/clinical rounds 7 3.83% 8 4.37% Social media 6 3.28% 9 4.92% Extracurricular activities 5 2.73% 10 5.46% Online courses 7 3.83% 8 4.37% Research 9 4.92% 6 3.28% Hospital 5 2.73% 10 5.46% Interest in exposure to global surgery 74 40.44% 83 45.36% Preferred exposure source (among unexposed) Faculty lectures/clinical rounds 14 7.65% 68 37.16% Social media 58 31.69% 24 13.11% Extracurricular activities 41 22.40% 41 22.40% Online courses 58 31.69% 24 13.11% Research 53 28.96% 29 15.85% Hospital 30 16.39% 52 28.42% Knowledge regarding Global surgery indicators Access to timely surgery 15 8.20% 11 6.01% Specialist surgical workforce 22 12.02% 4 2.19% Surgical volume 22 12.02% 4 2.19% Perioperative mortality rate 21 11.48% 5 2.73% Risk of impoverishing expenditure 21 11.48% 5 2.73% None 14 7.65% 12 6.56% Knowledge statements were correctly labelled as true by most students. However, there was a lack of knowledge regarding c-section outcomes in Africa and the global surgery's broad impact on SDGs (Table 3 ). Table 3 Knowledge Regarding Global Surgery False I don’t know True N % N % N % Surgical treatments cost a lot more than medical treatments 2 1.09% 5 2.73% 19 10.38% Surgical pathologies lead to handicaps and contribute to the impoverishment of our nation 3 1.64% 6 3.28% 17 9.29% Lack of universal health coverage contributes to impoverishing Sudanese people. 1 0.55% 7 3.83% 18 9.84% 9 of the 13 sustainable development goals are affected by surgical pathologies 3 1.64% 17 9.29% 6 3.28% Ceasarized women are more likely to die if they are from Africa 4 2.19% 13 7.10% 9 4.92% 5 billion people do not have access to quality surgical care on time 3 1.64% 9 4.92% 14 7.65% The majority of students (55.74%, N = 102) believed that global surgery is relevant. While most students were unsure about the mandatory inclusion of global surgery in the curriculum, 123 (67.21%) confirmed their interest in additional non-mandatory sources (Table 4 ). Table 4 Attitude Regarding Global Surgery No Maybe Yes N % N % N % Do you think global surgery is a relevant topic for medical students to know about? 7 3.83% 74 40.44% 102 55.74% Should there be timetabled teaching (i.e. mandatory in curriculum) related to global surgery during medical school? 28 15.30% 100 54.64% 55 30.05% Would you like additional (i.e. not mandatory in curriculum) resources about global surgery? 60 32.79% 0 0.00% 123 67.21% General surgery was the most preferred career prospect, chosen by 63 students, followed by obstetrics & gynaecology (37) and anaesthesia (34). Meanwhile, 24 students were interested in global surgery as a career, and 71 students strongly disagreed with its feasibility (Table 5 ). Table 5 Career Prospective Strongly disagree Disagree Neutral Agree Strongly agree N % N % N % N % N % I’m interested in pursuing a career in surgery 44 24.04% 35 19.13% 41 22.40% 35 19.13% 28 15.30% I’m interested in pursuing a career in anaesthesia 47 25.68% 47 25.68% 55 30.05% 26 14.21% 8 4.37% I’m interested in pursuing a career in obstetrics & gynaecology 58 31.69% 42 22.95% 46 25.14% 27 14.75% 10 5.46% I’m interested in pursuing a career in global surgery 47 25.68% 41 22.40% 71 38.80% 18 9.84% 6 3.28% For me, it’s feasible to pursue a career in global surgery 33 18.03% 38 20.77% 76 41.53% 29 15.85% 7 3.83% I’m familiar with what global surgery means as a career 77 42.08% 52 28.42% 36 19.67% 12 6.56% 6 3.28% The majority of students (41.6%, N = 67) identified the lack of established career paths in global surgery as a barrier for them. Meanwhile, ethical issues concerning surgical care provision in resource-limited settings were the least frequently perceived barrier (Table 6 ). Table 6 Barriers to pursuing a career in global surgery N % Increased length of training No 97 60.2% Yes 64 39.8% Lack of established career paths in global surgery No 94 58.4% Yes 67 41.6% Lack of surgical role models and mentorship in global health No 100 62.1% Yes 61 37.9% Constrained time to travel abroad during career No 114 70.8% Yes 47 29.2% Difficulty with providing appropriate care for patients living in rural areas (limited-resources and infrastructure) No 99 61.5% Yes 62 38.5% Ethical issues with providing surgical care in resource-limited communities No 130 80.7% Yes 31 19.3% Financial constraints No 99 61.5% Yes 62 38.5% None No 137 85.1% Yes 24 14.9% None of the demographic variables showed a statistically significant association with exposure to global surgery. Exposure to global surgery had a moderately strong association with interest in the field (Cramer's V = 0.316, p value = 0.001). Students who reported prior exposure expressed a higher interest in global surgery as a future career (Table 7 ). Table 7 Comparison of Demographics and Global Surgery Interest Between Exposed and Unexposed Student Groups Exposure to global surgery P value Cramer’s V Not exposed (N = 157) Exposed (N = 26) Gender 0.722 1 0.026 Male 43 27.4% 8 30.8% Female 114 72.6% 18 69.2% Academic year 0.979 1 0.002 Sixth 66 42.0% 11 42.3% Fifth 91 58.0% 15 57.7% Interest in pursuing global surgery 0.001 1 0.316 Strongly disagree 39 24.8% 8 30.8% Disagree 39 24.8% 2 7.7% Neutral 63 40.1% 8 30.8% Agree 14 8.9% 4 15.4% Strongly agree 2 1.3% 4 15.4% Age Mean (SD) 23.48 (1.180) 23.42 (1.137) 0.657 2 1 Chi-square test 2 Man-Whitney test Among perceived barriers, constrained time to travel abroad and financial constraints were significantly associated with interest in pursuing global surgery (p-value < 0.05). Students who saw these two categories as barriers had a higher interest in global surgery. Table 8 Comparison between perceived barriers to pursuing global surgery and interest in the field Interest in pursuing global surgery P value Mean SD Increased length of training 0.107 No 1.40 1.00 Yes 1.69 1.17 Lack of established career paths in global surgery 0.443 No 1.47 1.14 Yes 1.58 0.97 Lack of surgical role models and mentorship in global health 0.058 No 1.39 1.09 Yes 1.72 1.02 Constrained time to travel abroad during career 0.030* No 1.41 1.10 Yes 1.77 0.96 Difficulty with providing appropriate care for patients living in rural areas 0.358 No 1.57 1.04 Yes 1.44 1.13 Ethical issues with providing surgical care in resource-limited communities 0.059 No 1.59 1.08 Yes 1.19 0.98 Financial constraints 0.042* No 1.38 1.06 Yes 1.73 1.07 None 0.221 No 1.56 1.09 Yes 1.25 0.94 Multiple linear regression was used to assess whether interest in pursuing a career in global surgery is predicted by familiarity with what global surgery means as a career, number of perceived barriers, exposure, feasibility of pursuing a career in global surgery, gender, age and academic year. The overall model was statistically significant, F(7,153) = 22.412, p-value = 0.000. The model explained a substantial proportion of the variance in interest in a global surgery career, with an adjusted R 2 of 0.484. Students with a higher interest in global surgery as a career were older, more familiar with the field, and perceived it as more feasible (Table 9 ). Table 9 Determinants of Career Prospects in Global Surgery Variables t β CI 95% p value Age 2.04 0.13[0.00-0.25] 0.043* Gender 0.41 0.06[-0.23-0.35] 0.685 Academic year -0.43 -0.07[-0.38-0.24] 0.669 Exposure -1.31 -0.23[-0.57-0.11] 0.191 Number of perceived Barriers 1.46 0.05[-0.02-0.11] 0.148 Feasibility of pursuing a career in global surgery 8.69 0.61[0.47–0.74] 0.000* Familiarity of global surgery career 2.86 0.19[0.06–0.31] 0.005* Discussion Awareness and Knowledge Gaps in Global Surgery: This study revealed significant deficiencies in global surgery awareness and knowledge among medical students at the University of Khartoum, with only 14.21% reporting exposure to the field. This finding aligns with international evidence showing limited global surgery education in medical curricula globally. Comparable studies from Belgium reported similar exposure rates at 24.7%, while the ISOMERS international survey found only 17.7% of final-year medical students globally had exposure to global surgery [ 3 ]. The knowledge assessment in our study demonstrated concerning gaps, with the most recognised global surgery indicator being "access to timely surgery", identified by only 6.01% of students. This poor knowledge base is consistent with findings from Cameroon, where medical students achieved a mean global surgery evaluation score of 47.4%, and Belgian studies showing only 13–44% of students could correctly answer global surgery knowledge questions. These findings underscore the global nature of insufficient global surgery education in medical curricula [ 20 ]. The limited awareness in Sudan is particularly concerning given the country's healthcare challenges. Sudan faces a significant strain on its healthcare system due to ongoing conflicts, with two-thirds of medical centres non-functional and severe shortages of healthcare workers, particularly in surgical specialities. The healthcare workforce shortage has been exacerbated by brain drain, with over half of Sudanese physicians currently practising abroad, creating an urgent need for domestic surgical workforce development [ 21 ]. The Knowledge-Exposure Relationship and Its Implications: Our findings demonstrated a moderately strong association between exposure to global surgery and career interest (Cramer's V = 0.316, p = 0.001), suggesting that early exposure plays a crucial role in shaping career aspirations. This relationship aligns with educational theory, indicating that early academic exposure has a significant influence on career choices. International evidence supports this relationship, with studies showing that medical students' global surgery career aspirations are strongly correlated with their exposure levels [ 2 ](4). Our study revealed that age, familiarity and feasibility perception were the predictors of career prospects in global surgery (p = 0.043, p > 0.001 and p > 0.001), explaining 48.4% of the variance in career interest. This finding highlights the importance of addressing perceived barriers to global surgery careers, particularly in LMIC contexts where students may perceive greater obstacles to international surgical work. Barriers to Global Surgery Career Development: Students identified constrained time to travel abroad and financial constraints as barriers significantly associated with global surgery interest (p < 0.05). Paradoxically, students who perceived these barriers showed higher interest in global surgery careers, suggesting that awareness of challenges does not necessarily diminish interest when coupled with adequate exposure and education. These barriers reflect broader systemic issues in LMICs, where medical graduates face economic pressures and limited resources for international experiences. However, global surgery encompasses local and national equity initiatives, not just international work, indicating a need for better education about the field's scope and local applications [ 22 ]. Educational Integration and Curriculum Development: Despite limited exposure, 55.74% of students believed global surgery was relevant for medical education, and 67.21% wanted additional resources, indicating substantial demand for global surgery education. This demand mirrors international trends, with 94.4% of Belgian students agreeing on the relevance of global surgery education, and 80.4% of students in the ISOMERS study wanting additional global surgery resources [ 3 ]. The preferred exposure sources identified by students included faculty lectures/clinical rounds (37.16%) and hospital-based learning (28.42%), suggesting integration into formal curriculum structures would be most effective. This aligns with evidence from successful global surgery education programs that combine theoretical knowledge with practical clinical exposure [ 23 ]. International examples demonstrate successful integration strategies. Swedish medical schools have implemented comprehensive global surgery courses combining theoretical modules with clinical rotations, while hybrid educational partnerships between high-income and LMIC institutions have shown success in delivering equitable global surgery education. These models could inform curriculum development at the University of Khartoum [ 24 ]. Implications for Global Surgery Development in Sudan: The findings have significant implications for global surgery development in Sudan's challenging healthcare context. With Sudan experiencing severe healthcare system disruption due to ongoing conflict, building local surgical capacity through education becomes even more critical. The study suggests that medical students represent an untapped resource for strengthening Sudan's surgical workforce if provided with appropriate education and exposure [ 25 ]. Academic global surgery programs can address multiple challenges simultaneously. Research demonstrates that well-designed global surgery education programs can increase surgical workforce interest, improve understanding of health equity principles, and develop skills relevant to resource-limited settings. For Sudan, where healthcare infrastructure faces significant challenges, training students in global surgery principles could help develop practitioners better equipped to work effectively in resource-constrained environments [ 26 ]. The strong interest in further exposure (45.36% of unexposed students) represents significant potential for workforce development. International evidence shows that structured global surgery education can increase career interest and improve clinical competencies. Given Sudan's acute need for surgical workforce development, capitalising on this interest through curriculum integration could yield substantial benefits for healthcare system strengthening [ 27 ]. Strategic Recommendations for Implementation: Based on the findings and international evidence, several strategic approaches emerge for implementing global surgery education at the University of Khartoum: Formal curriculum integration should begin with incorporating global surgery principles into existing surgical and public health courses, following successful models from Korean medical schools, where 71.9% have integrated global health lessons within courses. This approach allows gradual introduction without requiring entirely new course structures [ 28 ]. Multi-modal Educational Approaches should combine theoretical knowledge with practical exposure, similar to successful programs that integrate virtual conferences, case-based learning, and clinical experiences. Given Sudan's infrastructure challenges, virtual and hybrid learning approaches could offer a cost-effective means of education delivery [ 27 ](10). Local context adaptation must emphasise that global surgery encompasses local health equity initiatives, not just international work. This framing is particularly relevant for Sudan, where domestic surgical needs are substantial. Education should highlight how global surgery principles apply to improving surgical care delivery within Sudan's healthcare system [ 29 ]. Research and advocacy integration can provide students with meaningful engagement opportunities while contributing to Sudan's healthcare knowledge base. International examples show that student involvement in global surgery research enhances learning outcomes while building evidence for policy development [ 30 ]. Limitations and Future Research Directions: This study focused on a single institution, which limits the generalizability of the findings across Sudan's medical education landscape. Future research should examine global surgery awareness across multiple Sudanese medical schools and explore implementation strategies tailored to different institutional contexts. The study's cross-sectional design offers a snapshot of current awareness but cannot evaluate the long-term influence of global surgery education on career decisions and clinical practice. Longitudinal studies tracking students throughout their careers would provide valuable evidence on the enduring effects of global surgery education. Additionally, the study did not evaluate faculty preparedness or institutional capacity for implementing global surgery education. Future research should explore these factors to develop practical implementation strategies. Conclusion This study uncovers significant gaps in global surgery awareness and knowledge among Sudanese medical students, alongside considerable interest in further learning about the field. The strong link between exposure and career interest, coupled with high demand for additional education, indicates that integrating global surgery into the curriculum could effectively address Sudan's surgical workforce challenges and promote healthcare equity. The findings align with international evidence showing the necessity for systematic global surgery education in medical curricula. For Sudan, which faces severe healthcare system issues, developing medical graduates with global surgery competencies could help create more resilient and equitable surgical care systems. The study provides evidence-based support for integrating global surgery education into medical curricula, with implications that extend beyond individual career growth to broader enhancements in the healthcare system. By bridging the knowledge gaps identified and leveraging existing student interest, medical schools can help shape the next generation of healthcare professionals prepared to tackle surgical care inequalities both locally and worldwide. Declarations Funding: The research presented in this paper was solely funded by the authors. Conflicts of interest: All authors declare that there are no conflicts of interest to disclose. Availability of data and material: Data supporting the findings of this study are available from the corresponding author upon reasonable request Ethics approval: This study was conducted in accordance with the Declaration of Helsinki. Ethical approval to conduct and publish this research was obtained from the Department of Community Medicine, Faculty of Medicine, University of Khartoum, and the approval number “COMMED 2022-94-44” was assigned to the study. Informed consent: All participants in this study were required to provide informed consent and express their willingness to participate in the study. Consent for publication: All participants in this study provided informed consent expressing their agreement to publish this study. Acknowledgements: Special thanks to Dr. Suaad Mohammed (Department of Community Medicine, University of Khartoum) for her guidance and feedback; Dr.Mohammed Anwar & Dr. Duha Alrasheed for their valuable inputs during data analysis, and Dr. Rofida Salah, for her unwavering support. Declaration of AI use: The authors declare that they did not use any AI tool. Registration details: Not Applicable. Clinical trial number: Not Applicable. References Meara JG, Leather AJM, Hagander L, Alkire BC, Alonso N, Ameh EA et al. Global Surgery 2030: Evidence and solutions for achieving health, welfare, and economic development. The Lancet [Internet]. 2015 Aug 8 [cited 2025 Aug 7];386(9993):569–624. 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Evaluating the collection, comparability and findings of six global surgery indicators. British Journal of Surgery [Internet]. 2019 Jan 1 [cited 2025 Aug 7];106(2):e138–50. Available from: https://pubmed.ncbi.nlm.nih.gov/30570764/ Zadey S, Iyer H, Nayan A, Shetty R, Sonal S, Smith ER et al. Evaluating the status of the Lancet Commission on Global Surgery indicators for India. The Lancet Regional Health - Southeast Asia [Internet]. 2023 Jun 1 [cited 2025 Aug 7];13. Available from: https://pubmed.ncbi.nlm.nih.gov/37383563/ Anand R, Sankaran PS. Factors influencing the career preferences of medical students and interns: A cross-sectional, questionnaire-based survey from India. J Educ Eval Health Prof [Internet]. 2019 Jun 5 [cited 2025 Aug 7];16. Available from: https://pubmed.ncbi.nlm.nih.gov/31117329/ Ladha FA, Pettinato AM, Perrin AE. Medical student residency preferences and motivational factors: a longitudinal, single-institution perspective. BMC Med Educ [Internet]. 2022 Dec 1 [cited 2025 Aug 7];22(1). Available from: https://pubmed.ncbi.nlm.nih.gov/35300656/ National, collaborative evaluation of medical student and faculty perspectives on global. surgery - Survey of undergraduate respondents on global surgery education (SURGE): A cross-sectional study. Int J Surg [Internet]. 2021 Sep 1 [cited 2025 Aug 7];93:106049. Available from: https://pubmed.ncbi.nlm.nih.gov/34418568/ Gawad N, Moussa F, Christakis GT, Rutka JT. Planting the SEAD: Early comprehensive exposure to surgery for medical students. J Surg Educ [Internet]. 2013 Jul [cited 2025 Aug 7];70(4):487–94. Available from: https://pubmed.ncbi.nlm.nih.gov/23725936/ Rennie N, Degraeuwe E, Deltour C, Senhaji MS, Vandenheede M, Berrevoet F et al. Students’ perspectives on global surgery and its integration into formal medical education. medRxiv [Internet]. 2023 Jan 4 [cited 2025 Aug 7];2023.01.03.23284155. Available from: https://www.medrxiv.org/content/ 10.1101/2023.01.03.23284155v1 Badri R, Dawood I. The implications of the Sudan war on healthcare workers and facilities: a health system tragedy. Confl Health [Internet]. 2024 Dec 1 [cited 2024 Jul 6];18(1). Available from: https://pubmed.ncbi.nlm.nih.gov/38494471/ Parepalli SA, Kamath A, Khundkar R. The incorporation of global healthcare teaching into the core medical school curriculum. Trop Doct [Internet]. 2021 Jan 1 [cited 2025 Aug 7];52(1):218. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8892055/ Kühner S, Ekblad S, Larsson J, Löfgren J. Global surgery for medical students – is it meaningful? A mixed-method study. PLoS One [Internet]. 2021 Oct 1 [cited 2025 Aug 7];16(10 October). Available from: https://pubmed.ncbi.nlm.nih.gov/34618809/ Alayande BT, Hughes Z, Fitzgerald TN, Riviello R, Bekele A, Rice HE. With equity in mind: Evaluating an interactive hybrid global surgery course for cross-site interdisciplinary learners. PLOS Global Public Health [Internet]. 2023 May 1 [cited 2025 Aug 7];3(5). Available from: https://pubmed.ncbi.nlm.nih.gov/37141197/ Khogali A, Homeida A. Impact of the 2023 armed conflict on Sudan’s healthcare system. Public Health Challenges [Internet]. 2023 Dec 1 [cited 2025 May 26];2(4):e134. Available from: /doi/pdf/10.1002/puh2.134 Peck GL, Hanna JS, Scott EM, Mehta D, Model Z, Sarma D et al. A longitudinal surgical systems strengthening research program for medical students: the exploration of a model for global health education. Glob Health Res Policy [Internet]. 2021 Dec 1 [cited 2025 Aug 7];6(1):1–9. Available from: https://ghrp.biomedcentral.com/articles/ 10.1186/s41256-021-00214-2 Corriero AC, Silva Correia IF, Park KB, Kinnear J, Miranda BH. Evaluating the impact of a virtual international global surgery conference as a means for global surgery and health education. Heliyon [Internet]. 2022 Dec 1 [cited 2025 Aug 7];8(12):e11842. Available from: https://www.sciencedirect.com/science/article/pii/S2405844022031309 Kim S, Kyung SY, Park IB, Park KH. What Are the Current Status and Educational Needs of Global Health Education in Medical Schools? A Nationwide Survey in Korea. Korean Medical Education Review [Internet]. 2023 Oct 31 [cited 2025 Aug 7];25(3):258–72. Available from: https://doi.org/10.17496/kmer.23.020 Charani E, Cunnington AJ, Yousif AEHA, Seed Ahmed M, Ahmed AEM, Babiker S et al. In transition: current health challenges and priorities in Sudan. BMJ Glob Health [Internet]. 2019 Aug 21 [cited 2025 Aug 7];4(4):1723. Available from: https://gh.bmj.com/content/4/4/e001723 Fallah PN, Jayaram A, Hauser BM. Moving the Needle on Global Surgery Education in the US. J Surg Educ [Internet]. 2021 Nov 1 [cited 2025 Aug 7];78(6):1780–2. Available from: https://www.sciencedirect.com/science/article/abs/pii/S1931720421001021 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 02 Dec, 2025 Reviews received at journal 30 Nov, 2025 Reviewers agreed at journal 10 Nov, 2025 Reviews received at journal 09 Nov, 2025 Reviewers agreed at journal 07 Nov, 2025 Reviewers invited by journal 30 Oct, 2025 Editor invited by journal 09 Oct, 2025 Editor assigned by journal 09 Oct, 2025 Submission checks completed at journal 09 Oct, 2025 First submitted to journal 17 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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08:47:05","extension":"xml","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":139928,"visible":true,"origin":"","legend":"","description":"","filename":"774eb66000334c7e81ed9e9590cf68fa1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7640148/v1/165a991920aa73527e1b74fb.xml"},{"id":95805875,"identity":"da561c3c-3293-4984-8819-419bfdc00bfa","added_by":"auto","created_at":"2025-11-13 08:47:03","extension":"html","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":151132,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7640148/v1/f51519c773626092a5c35468.html"},{"id":95806069,"identity":"c9eb9608-129a-4b8f-8ae4-11166d26ff54","added_by":"auto","created_at":"2025-11-13 08:47:14","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":13751,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCareer Prospects of participating students (N=183)\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7640148/v1/3a094a1a59ce89029d13c9f1.png"},{"id":95805913,"identity":"fdf42e91-4015-46a6-b3aa-dbddaaa650d6","added_by":"auto","created_at":"2025-11-13 08:47:05","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":8789,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eComparison of Global Surgery Interest Between Exposed and Unexposed Student Groups. (Not Exposed N=157, Exposed N=26)\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7640148/v1/5bebb1bd88737abba683f1e2.png"},{"id":95818726,"identity":"8ae6cb05-3ab1-45bf-887d-98a8517006b7","added_by":"auto","created_at":"2025-11-13 10:31:35","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1746429,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7640148/v1/a629863d-e28d-4a5b-afb7-632cc127ef5b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Global Surgery Awareness and Career Aspirations Among Medical Students in Sudan: A University-Based Cross-Sectional Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn low- and middle-income countries (LMIC), death rates are high from common easily treated conditions such as appendicitis, hernias, road traffic accidents, breast cancers and more [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], which demonstrates the significant contribution of surgical conditions to the global burden of diseases [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. More than two-thirds of the world lacks access to safe, timely, and affordable surgical care [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In 2014, the Lancet Commission on Global Surgery (LCoGS) was established to address the knowledge gaps, action gaps, and policy gaps regarding surgical care. It defined global surgery as: \u0026ldquo;an area for study, research, practice, and advocacy that seeks to improve health outcomes and to achieve health equity for all people requiring surgical care, with a special emphasis on underserved populations and populations in crisis.\u0026rdquo; [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAlthough deaths from surgically treated conditions are more than those from HIV, tuberculosis (TB), and malaria combined [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], global surgery has long been unrecognised in the global health sector, described by Paul Farmer in 2008 as \u0026ldquo;the neglected stepchild of global health\u0026rdquo; [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Global surgery is a crucial topic in meeting the SDGs, as it contributes to achieving SDG 1: \u0026ldquo;end poverty\u0026rdquo;, SDG 3: \u0026ldquo;universal health coverage\u0026rdquo; SDG 8: \u0026ldquo;promote decent work and economic growth\u0026rdquo;, and others [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Access to surgical treatment has been ranked as a top priority by both the World Bank (WB) Disease Control Priorities Project and the World Health Organisation Global Initiative for Emergency and Essential Surgical Care; both organisations promote improved surgical education and research, a larger surgical workforce, and increased surgical efficiency to meet the global need [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eBuilding surgical capacity requires investment in numerous areas. One of the most important areas is increasing the surgical workforce [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. To reach global surgery goals, LCoGS recommended increasing the surgical workforce to 20 surgical care providers per 100,000 population [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Still, in some LMICs, the proportion is 40 times lower than the recommended [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], and this extremely low rate can be attributed mainly to the scarcity of trained staff [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAcademic global surgery has been trending since 2015 [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]; hence, various important questions were answered to put evidence for global surgery theories [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Despite advancements in the scientific literature, tracking and reporting the six core surgical indicators remain limited [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. India, among a few other LMICs, conducted a systematic evaluation of their status and concluded the need to focus on high-quality data reporting. They also stated that it's hard to reach global surgery goals by 2030 [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eMedical students represent the next generation across all medical fields, with their career perceptions influenced by several factors [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. A crucial determinant is the curriculum they are exposed to throughout their personal, institutional, and cultural interactions in medical school [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Therefore, exposing students to global surgery may enhance the likelihood of them pursuing a profession in this under-resourced field. Data are scarce regarding the degree to which academic curricula and courses expose students to surgical education [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Nevertheless, emerging statistics indicate that medical school courses have not kept pace with students' expanding interests [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIntegrating global surgery early in the medical curriculum can boost students' interest and understanding, helping expand the global surgical workforce [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Limited pre-clerkship exposure to surgical fields misses chances to influence career choices. An ideal program should include operating room observation, simulation, and realistic insights into surgery [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003eThis study was an observational descriptive cross-sectional study. It took place at the University of Khartoum, Faculty of Medicine, located on Al-Qaser St., Khartoum, Sudan. It is the only medical school in Sudan to reach 100 years of age, and with its antiquity, it is also ranked first in the country\u0026rsquo;s ranking of medical schools. The educational system in the faculty consists of six academic years, with the last two years focused on clinical education. The total number of registered students at the faculty is approximately 2300 students from all over Sudan.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStudy Population:\u003c/h2\u003e\u003cp\u003eAll students registered in the fifth and sixth academic years at the Faculty of Medicine, University of Khartoum, at the time of data collection. All fifth- and sixth-year medical students were included in the study.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eSampling:\u003c/h3\u003e\n\u003cp\u003eThe sample size was calculated using the online sample calculator (for known population sizes) at calculator.net as 244. Afterwards, 10% was added to allow for non-responders, giving a final sample size of 268. Participants were selected from a sampling frame using stratified random sampling (probability sampling); each academic year was considered a stratum, and students within each year were selected using an online random number generator. Despite implementing two reminder rounds to increase participation, the number of students who responded was 183 (response rate\u0026thinsp;=\u0026thinsp;68.2%).\u003c/p\u003e\n\u003ch3\u003eData tool and technique:\u003c/h3\u003e\n\u003cp\u003eData were collected using self-administered closed-structured questionnaires assembled from published literature [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Face and content validity for the questionnaire were obtained from a consultant in community medicine. In addition, cognitive interviews were conducted with 15 recent graduates (5.6% of the sample size). Based on the feedback received, only minor adjustments were made to enhance clarity and improve the overall validity of the questionnaire. Questionnaires were distributed via online platforms. Distribution was mainly through Telegram, which is the official communication platform used by the students for academic updates. For participants not available on Telegram, the questionnaire link was shared via WhatsApp. Participant eligibility was verified using official registration records obtained from the Faculty Academic Office. Additionally, we collaborated with batch representatives to verify participant identities using phone numbers and Telegram usernames and data were collected by a faculty student to ensure verification.\u003c/p\u003e\u003cp\u003eThe questionnaire consisted of the following categories: demographic data, four exposure questions, seven knowledge questions, four attitude questions and two questions about career perspective. Knowledge questions were exclusive to students with prior exposure to Global Surgery. Questions included demographic data, binary questions, a Likert scale and multiple-choice questions aimed at collecting data on the study variables. Study variables included age, gender, academic year, exposure to global surgery, knowledge regarding global surgery, attitude towards global surgery, and career prospects.\u003c/p\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003eData analysis:\u003c/h2\u003e\u003cp\u003eData were entered, cleaned, coded, and analysed using IBM SPSS ver.25. Study population characteristics were presented using frequencies, percentages, mean and standard deviation (descriptive statistics for univariate analysis). Chi-square was used to explore the association between dependent and independent categorical data. The Shapiro-Wilk test was used to explore normality, continuous and ordinal data; afterwards, Man Whitney was used to explore the association between variables. Linear regression was used to determine the predictors of career prospects in global surgery. P-value was considered significant if\u0026thinsp;\u0026lt;\u0026thinsp;0.05 at a confidence interval 95%.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eIn total, the sample included 183 students, 123 (72.13%) of whom were females. Fifth-year students were 77 (42.08%) and sixth year students were 106 (57.92%) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDemographics\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e27.87%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e132\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e72.13%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e21\u0026ndash;23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e108\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e59.02%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e24\u0026ndash;27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e38.80%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMore than 27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.19%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAcademic year\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFifth\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e106\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e57.92%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSixth\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e42.08%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eOnly 26 (14.21%) of students reported exposure to the global surgery field. Among these students, 13 reported being exposed through their seniors or fellow students, and 15 (8.20%) expressed interest in further exposure. According to the students, their most preferred exposure source was extracurricular activities and the hospital (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The most recognised global surgery indicator among students was access to timely surgery, with 11 (6.01%) students selecting it.\u003c/p\u003e\u003cp\u003eAmong students without prior exposure to global surgery, 83 (45.36%) reported an interest in exposure to the field. Their preferred source of exposure was faculty lectures and clinical rounds (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eExposure and Interest in Global Surgery\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eN\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eN\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eExposure to global surgery\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e157\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e85.79%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e14.21%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eExposure source\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFaculty lectures/clinical rounds\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.84%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e4.37%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSeniors/ Fellow students\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7.10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e7.10%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocial media\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7.65%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e6.56%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExtracurricular activities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11.48%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.73%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOnline courses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e13.11%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.09%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResearch\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e13.11%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.09%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eInterest in further exposure\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.01%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e8.20%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePreferred exposure source (among exposed)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFaculty lectures/clinical rounds\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.83%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e4.37%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocial media\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.28%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e4.92%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExtracurricular activities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.73%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5.46%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOnline courses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.83%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e4.37%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResearch\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4.92%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3.28%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.73%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5.46%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eInterest in exposure to global surgery\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40.44%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e45.36%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePreferred exposure source (among unexposed)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFaculty lectures/clinical rounds\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7.65%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e37.16%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocial media\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31.69%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e13.11%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExtracurricular activities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22.40%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e22.40%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOnline courses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31.69%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e13.11%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResearch\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28.96%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e15.85%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16.39%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e28.42%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eKnowledge regarding Global surgery indicators\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAccess to timely surgery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.20%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e6.01%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSpecialist surgical workforce\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12.02%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.19%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSurgical volume\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12.02%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.19%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePerioperative mortality rate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11.48%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.73%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRisk of impoverishing expenditure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11.48%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.73%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7.65%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e6.56%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eKnowledge statements were correctly labelled as true by most students. However, there was a lack of knowledge regarding c-section outcomes in Africa and the global surgery's broad impact on SDGs (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eKnowledge Regarding Global Surgery\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eFalse\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003eTrue\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSurgical treatments cost a lot more than medical treatments\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.09%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.73%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e10.38%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSurgical pathologies lead to handicaps and contribute to the impoverishment of our nation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.64%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3.28%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e9.29%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLack of universal health coverage contributes to impoverishing Sudanese people.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.55%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3.83%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e9.84%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e9 of the 13 sustainable development goals are affected by surgical pathologies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.64%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e9.29%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e3.28%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCeasarized women are more likely to die if they are from Africa\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.19%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e7.10%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e4.92%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u0026nbsp;billion people do not have access to quality surgical care on time\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.64%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e4.92%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e7.65%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe majority of students (55.74%, N\u0026thinsp;=\u0026thinsp;102) believed that global surgery is relevant. While most students were unsure about the mandatory inclusion of global surgery in the curriculum, 123 (67.21%) confirmed their interest in additional non-mandatory sources (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAttitude Regarding Global Surgery\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eMaybe\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDo you think global surgery is a relevant topic for medical students to know about?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.83%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e40.44%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e102\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e55.74%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eShould there be timetabled teaching (i.e. mandatory in curriculum) related to global surgery during medical school?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15.30%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e54.64%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e30.05%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWould you like additional (i.e. not mandatory in curriculum) resources about global surgery?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e32.79%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.00%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e123\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e67.21%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eGeneral surgery was the most preferred career prospect, chosen by 63 students, followed by obstetrics \u0026amp; gynaecology (37) and anaesthesia (34). Meanwhile, 24 students were interested in global surgery as a career, and 71 students strongly disagreed with its feasibility (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCareer Prospective\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"11\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eStrongly disagree\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eDisagree\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003eNeutral\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u003cp\u003eAgree\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c11\" namest=\"c10\"\u003e\u003cp\u003eStrongly agree\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eN\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eN\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003eN\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003eN\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u003cb\u003eN\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eI\u0026rsquo;m interested in pursuing a career in surgery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24.04%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e19.13%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e22.40%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e19.13%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e15.30%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eI\u0026rsquo;m interested in pursuing a career in anaesthesia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25.68%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e25.68%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e30.05%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.21%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e4.37%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eI\u0026rsquo;m interested in pursuing a career in obstetrics \u0026amp; gynaecology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31.69%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e22.95%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e25.14%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e14.75%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e5.46%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eI\u0026rsquo;m interested in pursuing a career in global surgery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25.68%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e22.40%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e38.80%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e9.84%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e3.28%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFor me, it\u0026rsquo;s feasible to pursue a career in global surgery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18.03%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e20.77%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e41.53%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e15.85%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e3.83%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eI\u0026rsquo;m familiar with what global surgery means as a career\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e42.08%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e28.42%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e19.67%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e6.56%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e\u003cp\u003e3.28%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe majority of students (41.6%, N\u0026thinsp;=\u0026thinsp;67) identified the lack of established career paths in global surgery as a barrier for them. Meanwhile, ethical issues concerning surgical care provision in resource-limited settings were the least frequently perceived barrier (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eBarriers to pursuing a career in global surgery\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIncreased length of training\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e60.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e39.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLack of established career paths in global surgery\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e58.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e41.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLack of surgical role models and mentorship in global health\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e62.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e37.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eConstrained time to travel abroad during career\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e114\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e70.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e29.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDifficulty with providing appropriate care for patients living in rural areas (limited-resources and infrastructure)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e61.5%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e38.5%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEthical issues with providing surgical care in resource-limited communities\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e130\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e80.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e19.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFinancial constraints\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e61.5%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e38.5%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNone\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e137\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e85.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eNone of the demographic variables showed a statistically significant association with exposure to global surgery. Exposure to global surgery had a moderately strong association with interest in the field (Cramer's V\u0026thinsp;=\u0026thinsp;0.316, p value\u0026thinsp;=\u0026thinsp;0.001). Students who reported prior exposure expressed a higher interest in global surgery as a future career (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of Demographics and Global Surgery Interest Between Exposed and Unexposed Student Groups\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e\u003cp\u003eExposure to global surgery\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCramer\u0026rsquo;s V\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eNot exposed (N\u0026thinsp;=\u0026thinsp;157)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eExposed (N\u0026thinsp;=\u0026thinsp;26)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.722\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.026\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27.4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e30.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e114\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e72.6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e69.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAcademic year\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.979\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSixth\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e42.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e42.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFifth\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e58.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e57.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eInterest in pursuing global surgery\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.316\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStrongly disagree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e30.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDisagree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNeutral\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e40.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e30.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAgree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8.9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15.4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStrongly agree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15.4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge Mean (SD)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e23.48 (1.180)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e23.42 (1.137)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.657\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003csup\u003e1\u003c/sup\u003e Chi-square test \u003csup\u003e2\u003c/sup\u003eMan-Whitney test\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eAmong perceived barriers, constrained time to travel abroad and financial constraints were significantly associated with interest in pursuing global surgery (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Students who saw these two categories as barriers had a higher interest in global surgery.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison between perceived barriers to pursuing global surgery and interest in the field\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eInterest in pursuing global surgery\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSD\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIncreased length of training\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.107\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLack of established career paths in global surgery\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.443\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLack of surgical role models and mentorship in global health\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.058\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eConstrained time to travel abroad during career\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.030*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDifficulty with providing appropriate care for patients living in rural areas\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.358\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEthical issues with providing surgical care in resource-limited communities\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.059\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFinancial constraints\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.042*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNone\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.221\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eMultiple linear regression was used to assess whether interest in pursuing a career in global surgery is predicted by familiarity with what global surgery means as a career, number of perceived barriers, exposure, feasibility of pursuing a career in global surgery, gender, age and academic year.\u003c/p\u003e\u003cp\u003eThe overall model was statistically significant, F(7,153)\u0026thinsp;=\u0026thinsp;22.412, p-value\u0026thinsp;=\u0026thinsp;0.000. The model explained a substantial proportion of the variance in interest in a global surgery career, with an adjusted R\u003csup\u003e2\u003c/sup\u003e of 0.484. Students with a higher interest in global surgery as a career were older, more familiar with the field, and perceived it as more feasible (Table\u0026nbsp;\u003cspan refid=\"Tab9\" class=\"InternalRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab9\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 9\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDeterminants of Career Prospects in Global Surgery\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003et\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eβ CI 95%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.13[0.00-0.25]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.043*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.06[-0.23-0.35]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.685\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAcademic year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.07[-0.38-0.24]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.669\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExposure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-1.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.23[-0.57-0.11]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.191\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNumber of perceived Barriers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.05[-0.02-0.11]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.148\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFeasibility of pursuing a career in global surgery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.61[0.47\u0026ndash;0.74]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.000*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFamiliarity of global surgery career\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.19[0.06\u0026ndash;0.31]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.005*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003eAwareness and Knowledge Gaps in Global Surgery:\u003c/h2\u003e\u003cp\u003eThis study revealed significant deficiencies in global surgery awareness and knowledge among medical students at the University of Khartoum, with only 14.21% reporting exposure to the field. This finding aligns with international evidence showing limited global surgery education in medical curricula globally. Comparable studies from Belgium reported similar exposure rates at 24.7%, while the ISOMERS international survey found only 17.7% of final-year medical students globally had exposure to global surgery [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe knowledge assessment in our study demonstrated concerning gaps, with the most recognised global surgery indicator being \"access to timely surgery\", identified by only 6.01% of students. This poor knowledge base is consistent with findings from Cameroon, where medical students achieved a mean global surgery evaluation score of 47.4%, and Belgian studies showing only 13\u0026ndash;44% of students could correctly answer global surgery knowledge questions. These findings underscore the global nature of insufficient global surgery education in medical curricula [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe limited awareness in Sudan is particularly concerning given the country's healthcare challenges. Sudan faces a significant strain on its healthcare system due to ongoing conflicts, with two-thirds of medical centres non-functional and severe shortages of healthcare workers, particularly in surgical specialities. The healthcare workforce shortage has been exacerbated by brain drain, with over half of Sudanese physicians currently practising abroad, creating an urgent need for domestic surgical workforce development [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eThe Knowledge-Exposure Relationship and Its Implications:\u003c/h3\u003e\n\u003cp\u003eOur findings demonstrated a moderately strong association between exposure to global surgery and career interest (Cramer's V\u0026thinsp;=\u0026thinsp;0.316, p\u0026thinsp;=\u0026thinsp;0.001), suggesting that early exposure plays a crucial role in shaping career aspirations. This relationship aligns with educational theory, indicating that early academic exposure has a significant influence on career choices. International evidence supports this relationship, with studies showing that medical students' global surgery career aspirations are strongly correlated with their exposure levels [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e](4). Our study revealed that age, familiarity and feasibility perception were the predictors of career prospects in global surgery (p\u0026thinsp;=\u0026thinsp;0.043, p\u0026thinsp;\u0026gt;\u0026thinsp;0.001 and p\u0026thinsp;\u0026gt;\u0026thinsp;0.001), explaining 48.4% of the variance in career interest. This finding highlights the importance of addressing perceived barriers to global surgery careers, particularly in LMIC contexts where students may perceive greater obstacles to international surgical work.\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eBarriers to Global Surgery Career Development:\u003c/h2\u003e\u003cp\u003eStudents identified constrained time to travel abroad and financial constraints as barriers significantly associated with global surgery interest (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Paradoxically, students who perceived these barriers showed higher interest in global surgery careers, suggesting that awareness of challenges does not necessarily diminish interest when coupled with adequate exposure and education.\u003c/p\u003e\u003cp\u003eThese barriers reflect broader systemic issues in LMICs, where medical graduates face economic pressures and limited resources for international experiences. However, global surgery encompasses local and national equity initiatives, not just international work, indicating a need for better education about the field's scope and local applications [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eEducational Integration and Curriculum Development:\u003c/h2\u003e\u003cp\u003eDespite limited exposure, 55.74% of students believed global surgery was relevant for medical education, and 67.21% wanted additional resources, indicating substantial demand for global surgery education. This demand mirrors international trends, with 94.4% of Belgian students agreeing on the relevance of global surgery education, and 80.4% of students in the ISOMERS study wanting additional global surgery resources [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The preferred exposure sources identified by students included faculty lectures/clinical rounds (37.16%) and hospital-based learning (28.42%), suggesting integration into formal curriculum structures would be most effective. This aligns with evidence from successful global surgery education programs that combine theoretical knowledge with practical clinical exposure [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eInternational examples demonstrate successful integration strategies. Swedish medical schools have implemented comprehensive global surgery courses combining theoretical modules with clinical rotations, while hybrid educational partnerships between high-income and LMIC institutions have shown success in delivering equitable global surgery education. These models could inform curriculum development at the University of Khartoum [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eImplications for Global Surgery Development in Sudan:\u003c/h2\u003e\u003cp\u003eThe findings have significant implications for global surgery development in Sudan's challenging healthcare context. With Sudan experiencing severe healthcare system disruption due to ongoing conflict, building local surgical capacity through education becomes even more critical. The study suggests that medical students represent an untapped resource for strengthening Sudan's surgical workforce if provided with appropriate education and exposure [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Academic global surgery programs can address multiple challenges simultaneously. Research demonstrates that well-designed global surgery education programs can increase surgical workforce interest, improve understanding of health equity principles, and develop skills relevant to resource-limited settings. For Sudan, where healthcare infrastructure faces significant challenges, training students in global surgery principles could help develop practitioners better equipped to work effectively in resource-constrained environments [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe strong interest in further exposure (45.36% of unexposed students) represents significant potential for workforce development. International evidence shows that structured global surgery education can increase career interest and improve clinical competencies. Given Sudan's acute need for surgical workforce development, capitalising on this interest through curriculum integration could yield substantial benefits for healthcare system strengthening [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eStrategic Recommendations for Implementation:\u003c/h2\u003e\u003cp\u003eBased on the findings and international evidence, several strategic approaches emerge for implementing global surgery education at the University of Khartoum:\u003c/p\u003e\u003cp\u003eFormal curriculum integration should begin with incorporating global surgery principles into existing surgical and public health courses, following successful models from Korean medical schools, where 71.9% have integrated global health lessons within courses. This approach allows gradual introduction without requiring entirely new course structures [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Multi-modal Educational Approaches should combine theoretical knowledge with practical exposure, similar to successful programs that integrate virtual conferences, case-based learning, and clinical experiences. Given Sudan's infrastructure challenges, virtual and hybrid learning approaches could offer a cost-effective means of education delivery [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e](10). Local context adaptation must emphasise that global surgery encompasses local health equity initiatives, not just international work. This framing is particularly relevant for Sudan, where domestic surgical needs are substantial. Education should highlight how global surgery principles apply to improving surgical care delivery within Sudan's healthcare system [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Research and advocacy integration can provide students with meaningful engagement opportunities while contributing to Sudan's healthcare knowledge base. International examples show that student involvement in global surgery research enhances learning outcomes while building evidence for policy development [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eLimitations and Future Research Directions:\u003c/h2\u003e\u003cp\u003eThis study focused on a single institution, which limits the generalizability of the findings across Sudan's medical education landscape. Future research should examine global surgery awareness across multiple Sudanese medical schools and explore implementation strategies tailored to different institutional contexts. The study's cross-sectional design offers a snapshot of current awareness but cannot evaluate the long-term influence of global surgery education on career decisions and clinical practice. Longitudinal studies tracking students throughout their careers would provide valuable evidence on the enduring effects of global surgery education. Additionally, the study did not evaluate faculty preparedness or institutional capacity for implementing global surgery education. Future research should explore these factors to develop practical implementation strategies.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study uncovers significant gaps in global surgery awareness and knowledge among Sudanese medical students, alongside considerable interest in further learning about the field. The strong link between exposure and career interest, coupled with high demand for additional education, indicates that integrating global surgery into the curriculum could effectively address Sudan's surgical workforce challenges and promote healthcare equity. The findings align with international evidence showing the necessity for systematic global surgery education in medical curricula. For Sudan, which faces severe healthcare system issues, developing medical graduates with global surgery competencies could help create more resilient and equitable surgical care systems. The study provides evidence-based support for integrating global surgery education into medical curricula, with implications that extend beyond individual career growth to broader enhancements in the healthcare system. By bridging the knowledge gaps identified and leveraging existing student interest, medical schools can help shape the next generation of healthcare professionals prepared to tackle surgical care inequalities both locally and worldwide.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research presented in this paper was solely funded by the authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of interest:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors declare that there are no conflicts of interest to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData supporting the findings of this study are available from the corresponding author upon reasonable request\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the Declaration of Helsinki. Ethical approval to conduct and publish this research was obtained from the Department of Community Medicine, Faculty of Medicine, University of Khartoum, and the approval number \u0026ldquo;COMMED 2022-94-44\u0026rdquo; was assigned to the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants in this study were required to provide informed consent and express their willingness to participate in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants in this study provided informed consent expressing their agreement to publish this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003eSpecial thanks to Dr. Suaad Mohammed (Department of Community Medicine, University of Khartoum) for her guidance and feedback; Dr.Mohammed Anwar \u0026amp; Dr. Duha Alrasheed for their valuable inputs during data analysis, and Dr. Rofida Salah, for her unwavering support.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of AI use:\u003c/strong\u003e The authors declare that they did not use any AI tool. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRegistration details:\u0026nbsp;\u003c/strong\u003eNot Applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number:\u0026nbsp;\u003c/strong\u003eNot Applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eMeara JG, Leather AJM, Hagander L, Alkire BC, Alonso N, Ameh EA et al. 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Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.17496/kmer.23.020\u003c/span\u003e\u003cspan address=\"10.17496/kmer.23.020\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCharani E, Cunnington AJ, Yousif AEHA, Seed Ahmed M, Ahmed AEM, Babiker S et al. In transition: current health challenges and priorities in Sudan. BMJ Glob Health [Internet]. 2019 Aug 21 [cited 2025 Aug 7];4(4):1723. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://gh.bmj.com/content/4/4/e001723\u003c/span\u003e\u003cspan address=\"https://gh.bmj.com/content/4/4/e001723\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFallah PN, Jayaram A, Hauser BM. Moving the Needle on Global Surgery Education in the US. J Surg Educ [Internet]. 2021 Nov 1 [cited 2025 Aug 7];78(6):1780\u0026ndash;2. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.sciencedirect.com/science/article/abs/pii/S1931720421001021\u003c/span\u003e\u003cspan address=\"https://www.sciencedirect.com/science/article/abs/pii/S1931720421001021\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7640148/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7640148/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eSurgical care in Sudan is limited by many factors, rendering a large proportion of the population at risk for preventable death and disabilities. Global surgery can guide resource allocation and provide innovative solutions to problems unique to Sudan\u0026rsquo;s setting. However, there is limited knowledge regarding medical students' interest in the field. This study aims to determine the perception of global surgery among medical students in Khartoum University, Sudan.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e\u003cp\u003eA cross-sectional study was conducted among fifth- and sixth-year medical students in Khartoum University. The study employed a stratified sampling technique to select study participants, where each academic year was considered a stratum. The data were collected via a self-administered online questionnaire on Google Forms. Data analysis was done using SPSS v. 25.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe study included 183 students, 123 (72.13%) of whom were females, and 106 (57.92%) were sixth-year students. Only 26 (14.21%) of students had been exposed to the global surgery field. Among those without previous exposure to global surgery, 83 (45.36%) were interested in being exposed to the field. Regarding career prospects, 24 students were interested in global surgery. Students with previous exposure to global surgery had a higher interest in pursuing it as a career (p-value 0.001), with 30.8% stating they agree or strongly agree compared to 10.2% among students without previous exposure. Linear regression revealed that students' age (β\u0026thinsp;=\u0026thinsp;0.129, p\u0026thinsp;=\u0026thinsp;0.043), their familiarity with global surgery (β\u0026thinsp;=\u0026thinsp;0.186, p\u0026thinsp;=\u0026thinsp;0.005), and perception regarding the feasibility of global surgery (β\u0026thinsp;=\u0026thinsp;0.606, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were positive predictors of career interest in global surgery.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThis study highlights a gap in exposure and interest in global surgery. It also highlights the association between exposure to global surgery and career prospects. Incorporating global surgery education into medical curricula could help develop specialised expertise in the field. Such integration can strengthen the surgical healthcare system and help address persistent challenges in Sudan. Also, educational initiatives must prioritise enhancing students\u0026rsquo; confidence and belief in the feasibility of global surgery in resource-limited settings.\u003c/p\u003e","manuscriptTitle":"Global Surgery Awareness and Career Aspirations Among Medical Students in Sudan: A University-Based Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-13 07:49:39","doi":"10.21203/rs.3.rs-7640148/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"261775683229826242830293960170978772880","date":"2025-12-03T02:37:35+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-30T19:15:39+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"160487968085982434746531026822589785939","date":"2025-11-10T15:54:22+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-09T20:18:15+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"156012996504851804875145095836550320570","date":"2025-11-07T17:40:58+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-30T17:07:52+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-09T06:28:05+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-09T05:10:33+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-09T05:08:14+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-09-17T12:12:03+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9f5dd077-b1ad-462d-9d87-de17b5a302a2","owner":[],"postedDate":"November 13th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-11-13T07:49:39+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-13 07:49:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7640148","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7640148","identity":"rs-7640148","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}