A National Study of Attrition in General Surgery Training

Yeo, Heather; Bucholz, Emily M.; Sosa, Julie Ann; Curry, Leslie; Lewis, Frank R.; Jones, Andrew; Viola, Kate V.; Lin, Zhenqui; Bell, Richard H.

doi:10.1097/sla.0b013e3181f2789c

Cited by 160 publications

(144 citation statements)

References 27 publications

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“…The most frequently chosen residency was anesthesia (17%), which in conjunction with radiology is a trend also seen following attrition from general surgery training. 30 Our study demonstrated that a significant number of women remained within the neurosciences, pursuing neurology (15%) or neuroradiology (12%). We are aware of only 2 women who left medicine for other pursuits.…”

Section: 17mentioning

confidence: 99%

Positive trends in neurosurgery enrollment and attrition: analysis of the 2000–2009 female neurosurgery resident cohort

Renfrow

Rodriguez

Liu

et al. 2016

JNS

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Furthermore, women excel on clinical examinations in medical school. Women successfully secure residency positions in competitive fields of their choosing, filling 62% Residents were sorted by female gender, matched against graduation records, and if graduation was not reported from neurosurgery residency programs, an Internet search was used to determine the residents' alternative path. The primary outcome was to determine the number of women residents who did not complete neurosurgery training programs during 2000-2009. Secondary outcomes included the total number of women who matched into neurosurgery per year, year in training in which attrition occurred, and alternative career paths that these women chose to pursue. results Women comprised 240 of 1992 (12%) matched neurosurgery residents during 2000-2009. Among female residents there was a 17% attrition rate, compared with a 5.3% male attrition rate, with an overall attrition rate of 6.7%. The majority who left the field did so within the first 3 years of neurosurgical training and stayed in medicine-pursuing anesthesia, neurology, and radiology. coNclusioNs Although the percentage of women entering neurosurgical residency has continued to increase, this number is still disproportionate to the overall number of women in medicine. The female attrition rate in neurosurgery in the 2000-2009 cohort is comparable to that of the other surgical specialties, but for neurosurgery, there is disparity between the male and female attrition rates. Women who left the field tended to stay within medicine and usually pursued a neuroscience-related career. Given the need for talented women to pursue neurosurgery and the increasing numbers of women matching annually, the recruitment and retention of women in neurosurgery should be benchmarked and assessed.

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Section: 17mentioning

confidence: 99%

Positive trends in neurosurgery enrollment and attrition: analysis of the 2000–2009 female neurosurgery resident cohort

Renfrow

Rodriguez

Liu

et al. 2016

JNS

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“…Recent data suggest that although up to 58% of such residents were seriously considering abandoning their general surgery careers, the true figure for voluntary attrition remains between 17% and 26% over a 5-to 7-year residency program. [1][2][3] This figure, however, is still considerably greater than in most other specialties, and the majority of residents leaving general surgery tend to move into nonsurgical fields. [4][5][6] The reasons cited by those considering leaving have been primarily to do with a desire for an improved work-life balance both during and after residency.…”

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confidence: 82%

“…As discussed, up to 58% of general surgery residents may say they are thinking about leaving their program, but the true rate of those who actually leave is less than half of that figure. 1,2 Studies that target residents who have actually gone through the process of changing careers carry their own limitations, such as reduced numbers and the fact that they require those former residents still to be in contact and good relations with their former employers.…”

Section: Limitationsmentioning

confidence: 99%

Attitudes and factors contributing to attrition in Canadian surgical specialty residency programs

Adams¹,

Ginther²,

Neuls³

et al. 2017

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Background:We recently studied attrition in Canadian general surgical programs; however, there are no data on whether residents enrolled in other surgical residencies harbour the same intents as their general surgical peers. We sought to determine how many residents in surgical disciplines in Canada consider leaving their programs and why.Methods: An anonymous survey was administered to all residents in 9 surgical disciplines in Canada. Significance of association was determined using the Pearson χ 2 test. The Canadian Post-MD Education Registry (CAPER) website was used to calculate the response rate. Results:We received 523 responses (27.6% response rate). Of these respondents, 140 (26.8%) were either "somewhat" or "seriously" considering leaving their program. Residents wanting to pursue additional fellowship training and those aspiring to an academic career were significantly less likely to be considering changing specialties (p = 0.003 and p = 0.005, respectively). Poor work-life balance and fear of unemployment/ underemployment were the top reasons why residents would change specialty (55.5% and 40.8%, respectively), although the reasons cited were not significantly different between those considering changing and those who were not (p = 0.64). Residents who were considering changing programs were significantly less likely to enjoy their work and more likely to cite having already invested too much time to change as a reason for continuing (p < 0.001). Conclusion:More than one-quarter of residents in surgical training programs in Canada harbour desires to abandon their surgical careers, primarily because of unsatisfactory work-life balance and limited employment prospects. Efforts to educate prospective residents about the reality of the surgical lifestyle and to optimize employment prospects may improve completion rates.Contexte : Nous avons récemment étudié les taux d'attrition dans les programmes de chirurgie générale canadiens; toutefois, on ne dispose pas de données pour déterminer si les résidents inscrits dans d'autres programmes de chirurgie ont les mêmes intentions que leurs collègues de chirurgie générale. Nous avons voulu savoir combien de résidents des disciplines chirurgicales au Canada envisagent de quitter leur programme et pourquoi.Méthodes : Tous les résidents de 9 disciplines chirurgicales au Canada ont passé un sondage anonyme. La portée de la corrélation a été déterminée à l'aide du test χ 2 de Pearson. Le site Web du Répertoire canadien sur l'éducation post-MD (RCEP) a été utilisé pour calculer le taux de réponse.Résultats : Nous avons reçu 523 réponses (taux de réponse de 27,6 %). Parmi les répon-dants, 140 (26,8 %) envisageaient « peut-être » ou « sérieusement » de quitter leur programme. Les résidents qui souhaitaient suivre une formation de surspécialité et ceux qui aspiraient à une carrière universitaire étaient notablement moins susceptibles d'envisager un changement de programme (p = 0,003 et p = 0,005, respectivement). Les problèmes de conciliation travail-famille et la crainte ...

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“…These strategies are likely to become increasingly necessary, given that there have been reports of both decreasing numbers of candidates for surgical careers 23 and increasing attrition rates amongst surgical trainees in some countries. 24 It has been suggested that, in planning teaching experiences and in actually teaching, factors that are known to negatively influence the choice of surgery as a career should be worked on, as a way of improving recruitment. 25 Likewise, it has been suggested that medical students should be exposed to positive surgical experiences as early as possible.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of role models who influenced medical residents to choose surgery as a specialty: exploratory study

et al. 2017

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CONTEXT AND OBJECTIVE: Choosing a medical specialty and making decisions concerning a career are difficult processes for medical students and newly graduated physicians. This exploratory study aimed to investigate the influence of role models on the choice of surgery as a career, and to determine the most influential model characteristics. DESIGN AND SETTING: Qualitative analysis on responses to a self-administered questionnaire, in different teaching-learning settings. METHODS:Residents from all years of various surgical subspecialties in a university hospital were included in a survey about the factors that determined their choice of surgery. The questions included items on whether a role model had influenced them in choosing surgery, and the personal or professional characteristics of the models that had been most influential. The responses were subjected to qualitative content analysis. RESULTS: Sixty-four out of 96 medical residents participated. Fifty-three residents (82.8%) acknowledged the influence of role models. Sixteen model characteristics were indicated as important, with 136 mentions. Characteristics classified as technical skills (55%), such as "medical knowledge" and "manual dexterity" predominated over humanistic characteristics (35%), such as "patient-physician relationships" and "ethical behavior". However, this difference was not statistically significant (Fisher test, P = 0.11). There were no age differences regarding the proportions mentioning "technical" and "non-technical" attributes, but female residents mentioned significantly more technical skills than their male colleagues did. CONCLUSIONS: The influence of role models seems to be an important factor determining the choice of surgery as a career. The influential characteristics of the models include not only technical but also humanistic qualities.

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A National Study of Attrition in General Surgery Training

Cited by 160 publications

References 27 publications

Positive trends in neurosurgery enrollment and attrition: analysis of the 2000–2009 female neurosurgery resident cohort

Positive trends in neurosurgery enrollment and attrition: analysis of the 2000–2009 female neurosurgery resident cohort

Attitudes and factors contributing to attrition in Canadian surgical specialty residency programs

Characteristics of role models who influenced medical residents to choose surgery as a specialty: exploratory study

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