UK undergraduate and postgraduate breast surgery training interest and exposure: Are future doctors prepared to meet workforce demands? A national study by the PLASTICS UK Research Collaborative.

Abstract

Breast surgery encompasses oncoplastic, reconstructive and aesthetic procedures, with UK training delivered through both general surgery and plastic surgery pathways. Despite this, limited national data exist on medical student and early postgraduate exposure to breast surgery or their understanding and interest in the specialty. This study evaluates undergraduate and early postgraduate exposure, perceptions and career interest, and examines how factors such as clinical experience and training level influence these outcomes. A national cross-sectional online survey was conducted among UK medical students and postgraduate year 1-2 doctors between 1st April and 29th June 2025 following ethical approval. The questionnaire was disseminated via student and doctor collaborators using JISC Online Surveys. Statistical analysis included chi-squared tests, Mann-Whitney U tests, Kruskal-Wallis tests and Spearman's Rank correlation. A total of 1507 responses were received. Interest in breast surgery declined with advancing training level (p<0.001). Female respondents expressed significantly higher interest than male respondents (p=0.005). Awareness of the training pathways improved with seniority (p<0.001) but remained low overall. Perceptions of which speciality commonly performs core procedures varied significantly by training level for wide local excision, cancer excision and reconstruction (p<0.05). Observing or assisting in breast surgery was associated with higher specialty knowledge and interest (p<0.001), with a positive correlation between exposure and interest (r=0.30, p<0.001). Undergraduate clinical exposure and mentorship were the strongest contributors to career interest. UK doctors appear to show declining interest in breast surgery as they advance from university to early clinical practice. Women have greater interest in the career than men. There is generally poor understanding of the UK breast surgery training pathway. Overall clinical exposure to breast surgery is low with most medical students and doctors having not observed (50.5%) or assisted (71.7%) any breast operations. Improving clinical exposure, mentorship and dedicated support to accessing breast surgery training pathways are crucial to promote workforce planning and future recruitment to breast surgery.