Background The third-year surgical rotation is the first exposure medical students have to the fundamentals of surgical education. It is known that medical students come to the surgical clerkship with preconceived ideas, many of them negative and based on prior student feedback and hearsay. Methods An anonymous survey was conducted of third-year medical students while on the surgical clerkship. We sought to quantify student's experiences and expectations by assessing the students' confidence levels before and after the rotation. Results Over a 26 month period from July 2013–August 2015, 250 surveys were conducted. In terms of confidence gained on the surgical rotation, students reported a statistically significant (p < 0.01) increase in confidence in fifteen different areas of interest. However, in terms of expectations, students reported discordance between anticipated experience and actual experience. Students' responses indicate that students felt confident with their knowledge of diseases; however, they desire more involvement in complex patient care and procedural skills. Conclusions The third-year clerkship is the first exposure to surgery for many medical students. Surgical educators are tasked with providing a foundation for clinical medicine; however, students have expressed an expectation to be more involved with complex patient care and management.
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