Determinants of subspecialty training intention among general surgeons in Türkiye: A national survey.

Abstract

Objective This study aimed to evaluate, at a national level, the individual, professional, and institutional factors associated with the intention to pursue subspecialty training among general surgery residents and surgeons across a range of career stages in Türkiye. Material and Methods This descriptive cross-sectional survey was conducted online between December 10 and 25, 2025. The questionnaire, developed via Google forms, was distributed through professional email lists and national/regional WhatsApp groups. A total of 195 responses were received; after excluding five incomplete questionnaires, 190 participants were analyzed. Data were summarized using descriptive statistics. Group comparisons were performed using chi-square and Fisher's exact tests. Multivariable logistic regression analysis was used to identify independent predictors of subspecialty training intention. Statistical significance was set at p<0.05. Results Among participants, 20.5% intended to pursue subspecialty training, 24.2% were undecided, and 55.3% did not. In bivariable comparisons (yes vs. no, undecided excluded), intention was associated with shorter professional experience (≤5 years; p<0.001), workplace violence exposure (p<0.001), higher monthly on-call burden (p=0.003), absence of children (p=0.016), and single marital status (p=0.035). In multivariable analysis (Firth penalized logistic regression), professional experience ≤5 years (odds ratio 7.51) and workplace violence exposure (odds ratio 3.44) were the only independent predictors. Many participants reported negative perceptions regarding workload, on-call burden, and insufficient institutional support. Conclusion The intention to pursue subspecialty training among general surgeons in Türkiye is relatively low and is independently associated with shorter professional experience and exposure to workplace violence. Decision-making is shaped by both individual factors and working conditions, indicating a multidimensional process that should be considered in workforce planning and training policy.