A Strategy to Reduce General Surgery Resident Attrition

Wasserman, Molly A.

doi:10.1001/jamasurg.2015.4607

Cited by 18 publications

(14 citation statements)

References 7 publications

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“…This may also enhance our understanding of the processes involved in residents’ retention because job crafting is a mediator between both, situational and personal predictors, and work engagement at the individual and organizational levels [ 41 , 42 ]. In practice, this perspective could be input for the call for research about attrition in surgical training from a positive side [ 43 ].…”

Section: Introductionmentioning

confidence: 99%

Taking control: Is job crafting related to the intention to leave surgical training?

et al. 2018

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ObjectiveThe intention to leave surgical training, hereinafter referred as proxy of “attrition,” is associated with poor well-being in the workplace. Attrition is suggested to diminish when residents possess job-crafting skills, that is, the ability to redefine their job in meaningful ways and maximize well-being at work by increasing structural and social resources and challenges and decreasing hindering demands. However, the evidence supporting this relationship is scant. This study sought to: 1) investigate to what extent residents possess job-crafting skills and compare residents’ levels of job-crafting skills across years of residency training; 2) investigate the relationship between job crafting, well-being as measured by burnout and work-engagement rates, and the intention to leave; and 3) compare the levels of job-crafting skills and well-being between residents with and without serious intentions to leave.MethodsThis cross sectional study was conducted in fifteen residency programs in Colombia. Surgical residents completed different questionnaires including the Dutch Job Crafting Scale (DJCS), MBI-Human Services Survey (MBI-HSS), Utrecht Work Engagement Scale (UWES-17) and an adapted version of the Nurse Turnover Intention Scale (NTIS). The objectives were addressed by independent analyses of variance (ANOVA), structural equation modeling techniques (SEM) and independent t-tests, respectively.ResultsA total of 202 residents participated. Residents generally scored high on their job-crafting skills to increase structural and social resources as well as challenging demands, but were less positive about their skills to reduce hindering demands. No differences across years of training were found. Job crafting correlated positively with work-engagement, which was inversely related to the intention to leave. Conversely, job crafting correlated negatively with burnout, which bore a positive relationship to the intention to leave. Residents with serious intentions to leave exhibited lower levels of most job-crafting skills and work-engagement, compared to those without such intentions.ConclusionsThis study adds evidence that attrition is a process mediated by residents’ well being at work, which can be molded by their job-crafting endeavors. Future research is needed to evaluate the effectiveness of interventions aimed at cultivating resident’s job-crafting abilities in order to reduce attrition.

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Section: Introductionmentioning

confidence: 99%

Taking control: Is job crafting related to the intention to leave surgical training?

et al. 2018

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“…To ensure that this limited resource is allocated justly and effectively, it is incumbent upon programs to enroll those applicants who are likely to successfully complete residency training. Although other specialties have studied the factors surrounding attrition, EM has not investigated how often attrition occurs among its trainees and for what reasons 7–9. This study’s primary objective was to examine national rates of resident attrition in Accreditation Council for Graduate Medical Education (ACGME)-accredited EM programs between 2006 and 2016.…”

Section: Introductionmentioning

confidence: 99%

Why Residents Quit: National Rates of and Reasons for Attrition Among Emergency Medicine Physicians in Training

Lu¹,

Hartman²,

Druck³

et al. 2019

WestJEM

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Introduction Recruiting and retaining residents who will complete their emergency medicine (EM) training is vital, not only because residency positions are a limited and costly resource, but also to prevent the significant disruptions, increased workload, and low morale that may arise when a resident prematurely leaves a program. We investigated national rates of EM resident attrition and examined the reasons and factors associated with their attrition. Methods In this retrospective, observational study we used national data from the American Medical Association National Graduate Medical Education Census for all residents who entered Accreditation Council for Graduate Medical Education-accredited EM programs between academic years 2006–2007 and 2015–2016. Our main outcome was the annual national rate of EM resident attrition. Secondary outcomes included the main reason for attrition as well as resident factors associated with attrition. Results Compared to the other 10 largest specialties, EM had the lowest rate of attrition (0.8%, 95% confidence interval [CI] [0.7–0.9]), or approximately 51.6 (95% CI [44.7–58.5]) residents per year. In the attrition population, 44.2% of the residents were women, a significantly higher proportion when compared to the proportion of female EM residents overall (38.8%, p=0.011). A greater proportion of Hispanic/Latino (1.8%) residents also left their programs when compared to their White (0.9%) counterparts (p<0.001). In examining reasons for attrition as reported by the program director, female residents were significantly more likely than male residents to leave due to “health/family reasons” (21.5% vs 9.6%, p=0.019). Conclusion While the overall rate of attrition among EM residents is low, women and some under-represented minorities in medicine had a higher than expected rate of attrition. Future studies that qualitatively investigate the factors contributing to greater attrition among female and some ethnic minority residents are necessary to inform efforts promoting inclusion and diversity within the specialty.

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“…While the majority of positions at competitive surgery programs are filled each year, attrition in surgical specialties is particularly problematic with rates as high as 30% [ 2 ]. Uncontrollable lifestyle, lack of support, and length of training were all cited as factors for attrition; none of which have been shown to be predicted by the above-mentioned objective and subjective measures [ 3 , 4 ]. This prompts the need for further investigation into new assessment measures to predict the success, performance, and longevity of future residents and fellows.…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of Credit Score on Surgery Resident and Fellow Academic and Professional Performance

Berry¹,

Marotta²,

Savla³

et al. 2021

Cureus

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IntroductionSurgical specialties consistently remain among the most competitive residency and fellowship programs with some of the highest rates of unmatched applicants. Attrition in surgical specialties is as high as 30% and particularly problematic given the extended duration of training and limited number of positions. Applicants are traditionally evaluated using a streamlined set of objective metrics, such as board scores, class rank, leadership, letters of recommendation, research productivity, and volunteerism. Consumer credit scores have been shown to be predictors of personality and work performance, however, the literature has yet to explore consumer credit histories in the context of surgical resident and fellow performance. This study aims to determine whether consumer credit scores of surgery residents and fellows are predictive of academic and professional performance. MethodsThis is a multi-institutional observational survey study across all American Council of Graduate Medical Education and Royal College of Physicians and Surgeons accredited surgical residency and fellowship programs in the United States and Canada. Ninety-nine surgical residents and fellows with educational status of post-graduate year two or higher participated in this study. Dichotomous (yes or no) survey items were formulated to assess performance indicators in the domains of notable achievements and awards, research output, written examination performance, professionalism, and surgical/technical skills. Threedigit Fair Isaac Corporation (FICO) credit scores, a widely accepted consumer reporting score, were collected to avoid calculation variability between algorithms. ResultsSurgical residents and fellows reported credit scores between 611( fair) and 853 (exceptional) with a median (interquartile range) of 774 (715-833). The majority of participants 51.5%(51) reported very good credit scores. Those with higher credit scores (very good/exceptional) were 377% more likely to have one or more positive performance indicators OR (95% CI) = 3.77 (1.43-9.97). Similarly, residents with lower credit scores (fair/good) were only 40% more likely to have one or more negative performance indicators. The credit score has a moderate ability to distinguish between the presence and absence of positive performance indicators (area under the curve {AUC} = 0.70, p = 0.001). The use of 753 as a credit score cutoff is 78.9% sensitive and 52.4% specific for discerning surgery residents and fellows with one or more positive performance indicators. The credit score did not significantly discern those with negative performance indicators. ConclusionsWhile credit score was significantly functional in discerning those with and without positive performance indicators, sensitivity and specificity rates leave much to be desired. This study suggests credit score may have a utility as a companion to traditional metrics used in identifying candidates for surgery residencies and fellowships who will have positive performance in the domains of research productivi...

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A Strategy to Reduce General Surgery Resident Attrition

Cited by 18 publications

References 7 publications

Taking control: Is job crafting related to the intention to leave surgical training?

Taking control: Is job crafting related to the intention to leave surgical training?

Why Residents Quit: National Rates of and Reasons for Attrition Among Emergency Medicine Physicians in Training

Predictive Value of Credit Score on Surgery Resident and Fellow Academic and Professional Performance

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