Determinants of surgical specialty interest among clinical-year medical students in Syria: a multicenter cross-sectional study

BACKGROUND: Surgical workforce recruitment remains a global concern, particularly given persistent gender disparities in surgical specialties. In Syria, evidence on medical students' surgical career intentions remains limited. This study assessed planned surgical specialty interest and associated demographic, educational, exposure-related, mentorship, and gender/social perception factors among fourth-, fifth-, and sixth-year medical students. METHODS: A cross-sectional online survey was conducted among medical students in Syria between January and May 2026. The Arabic questionnaire assessed sociodemographic characteristics, surgical exposure, mentorship, specialty preferences, perceived determinants of specialty choice, and surgery-related perceptions. The primary outcome was planned entry into a surgical specialty versus non-surgical or undecided preference. Data were analyzed using bivariate tests and multivariable binary logistic regression. RESULTS: A total of 680 students were included; 350 were female (51.5%), and the median age was 23 years (IQR, 22-24). Overall, 252 students (37.1%) planned to enter a surgical specialty. Males were more likely than females to plan a surgical specialty (47.0% vs. 27.7%, p < 0.001). In the adjusted model, females without hijab (AOR = 0.445, 95% CI: 0.290-0.684, p < 0.001) and females with hijab (AOR = 0.313, 95% CI: 0.198-0.494, p < 0.001) had lower odds of surgical specialty interest compared with males. Observing surgeries for more than 20 h (AOR = 3.054, 95% CI: 1.405-6.639, p = 0.005) and having a surgeon mentor (AOR = 2.342, 95% CI: 1.537-3.568, p < 0.001) were associated with higher odds of surgical interest. CONCLUSION: Surgical specialty interest among Syrian medical students was associated with sex/hijab status, operative exposure, mentorship, and university. Structured surgical exposure, formal mentorship, and visible role models may support more informed and equitable surgical career choice.