ENERAL SURGERY RESIDENCY training is facing formidable pressures 1,2 and is likely to undergo considerable changes in the coming decade. 3,4 These pressures include diminished attraction to surgery as a profession, 4 increasing interest in surgical subspeciali z a t i o n w i t h 7 0 % o f r e s i d e n t s completing fellowships in 2004, 5,6 and estimated attrition rates of 17% to 26% among categorical general surgery residents (residents who have guaranteed positions in a 5-year training program). 3,7,8 These attrition rates are higher than other medical residencies 2 and have persisted 9 despite major reforms such as elimination of the pyramidal system of residency training. 1 At the same time, a substantial shortage of general surgeons is predicted. 5,10-12 Strategies responding to these complex and competing challenges can be informed by understanding general surgery residents' atti

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Attrition rates are high despite mandated work hour reductions; 1 in 5 GS categorical residents resigns, and most pursue nonsurgical careers. Demographic factors, aside from postgraduate year do not appear predictive. Residents are at risk for attrition early in training and during research, and this could afford educators a target for intervention.

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These findings suggest that, although thyroidectomy is considered safe, significant racial disparities exist in clinical and economic outcomes. In part, inequalities result from racial differences in access to experienced surgeons; more data are needed with regard to racial differences in thyroid biology and surveillance to explain the balance of observed disparities.