[Curriculum for Practical Surgical Education during Internships - with a Strategy for New Perspectives]

Background: It seems that the experience gained in the courses of surgical training in medical education does not really motivate students for surgery in Germany. Inspired by this problem the Department of Surgery of the Klinikum rechts der Isar, Technical University of Munich has developed a substantial reform for the internship since 2009 with the aim of not only improving the quality of education significantly, but also the attractiveness and thus the fascination for the subject.

Methods: Based on the slogan "We want to awaken your fascination for surgery" a structured and standardised training of all students in their internship regardless of the ward or section and local conditions was developed. For this purpose a completely new curriculum was steadily implemented into clinical practice, based on the following four basic principles: (i) integration and perception in the clinic, (ii) central and peripheral maintenance, (iii) systematic and individual training, (iv) evaluation and feedback at all levels. To analyse the effectiveness of the reform, standardised evaluations by students and faculty were carried out regularly.

Results: To date, since the beginning of the reform in 2009, there has been an approximately linear increase in the number of students in the PJ surgery. The daily systematic courses showed a good to excellent rating in all formats. The comparison showed a clear increasing trend in all the values, in particular, the "integration into the overall hospital" significantly improved (mean, 4.7 vs. 5.5, p = 0.003). However, the point "motivating for surgery" (mean, 3.3) remains at a low level. But also medical educators were satisfied with the new curriculum for the internship students (mean, 4.5).

Conclusion: The reform was adopted universally in a very positive manner and the current data support the need for such a reform. Overall, the reform showed a positive development of the internship training in the surgical department of the faculty. The satisfaction of the students and teachers could be increased by gradual implementation of the reform. Even if a lot of individual aspects gain a higher acceptance, the main concern, the inspiration of the "fascination" of the central surgical field, the training in the operating room, seems to succeed only partially.