2021 BOA Medical Student Essay Prize Winner

Sully Uppal is the winner of the 2021 BOA Medical Student Essay Prize and a fifth year medical student at the University of Oxford. His interest in T&O began after his visits to A&E following rugby matches in school and was solidified by his placements on the other side of the stretcher. Sully sits as the Medical Student Representative on the BOA Education and Careers Committee as well as the BOA Representative on the executive committee of the newly formed British Orthopaedic Medical Students Association.

Essay Summary

Picking a specialty to pursue is a decision that most medical students spend years mulling over. With such a wide array of differing specialties, each with their unique pros and cons, the dynamics of this decision are incredibly multifaceted. So why do people choose Trauma and Orthopaedics? As we often hear in the world of medicine and surgery, a systematic approach is useful when dealing with complex questions. To that end, I used the COM-B framework, an approach taken from behavioural science, to categorise the different factors that influence a potential T&O applicant.

The COM-B framework is based on the interplay of three key components: capability, opportunity and motivation. Within these categories, influential factors can either drive interest, or act as barriers that impede it. Within the bracket of ‘capability’, the literature suggests that perceptions of manual dexterity drive interest, whereas the ability to manage the physical and psychological demands of the career pose a barriers. Factors more external to the potential applicant are encapsulated within ‘opportunity’. This category contains some of the largest drivers of interest, including positive role models and participatory surgical experiences. However, there are also large barriers such as the stereotypical perceptions of a ‘boy’s club’ environment within the field. Both of these categories coalesce in ‘motivation’, which energises and directs action towards the pursuit of a career in T&O. Here, the evidence points toward plans for the future as well as other lifestyle factors having the largest impact.

The mixture of drivers and barriers faced by medical students is often unique to their personal circumstances, but exploring them systematically allows us to better understand why people may choose this path. The framework uncovered that surgeons in the field can have a significant influence upon this decision by providing positive learning experiences and inspiring the next generation of T&O surgeons.

You can read Sully’s winning essay on the Transient Journal at www.boa.ac.uk/T-JTO where we will be featuring the highest ranked essays throughout December.