Attrition rates in neurosurgery residency: analysis of 1361 consecutive residents matched from 1990 to 1999

Abstract

OBJECT The objective of this study is to determine neurosurgery residency attrition rates by sex of matched applicant and by type and rank of medical school attended. METHODS The study follows a cohort of 1361 individuals who matched into a neurosurgery residency program through the SF Match Fellowship and Residency Matching Service from 1990 to 1999. The main outcome measure was achievement of board certification as documented in the American Board of Neurological Surgery Directory of Diplomats. A secondary outcome measure was documentation of practicing medicine as verified by the American Medical Association DoctorFinder and National Provider Identifier websites. Overall, 10.7% (n = 146) of these individuals were women. Twenty percent (n = 266) graduated from a top 10 medical school (24% of women [35/146] and 19% of men [232/1215], p = 0.19). Forty-five percent (n = 618) were graduates of a public medical school, 50% (n = 680) of a private medical school, and 5% (n = 63) of an international medical school. At the end of the study, 0.2% of subjects (n = 3) were deceased and 0.3% (n = 4) were lost to follow-up. RESULTS The total residency completion rate was 86.0% (n = 1171) overall, with 76.0% (n = 111/146) of women and 87.2% (n = 1059/1215) of men completing residency. Board certification was obtained by 79.4% (n = 1081) of all individuals matching into residency between 1990 and 1999. Overall, 63.0% (92/146) of women and 81.3% (989/1215) of men were board certified. Women were found to be significantly more at risk (p < 0.005) of not completing residency or becoming board certified than men. Public medical school alumni had significantly higher board certification rates than private and international alumni (82.2% for public [508/618]; 77.1% for private [524/680]; 77.8% for international [49/63]; p < 0.05). There was no significant difference in attrition for graduates of top 10–ranked institutions versus other institutions. There was no difference in number of years to achieve neurosurgical board certification for men versus women. CONCLUSIONS Overall, neurosurgery training attrition rates are low. Women have had greater attrition than men during and after neurosurgery residency training. International and private medical school alumni had higher attrition than public medical school alumni.

Impact of a Residency-Integrated Wellness Program on Resident Mental Health, Sleepiness, and Quality of Life

“…In addition to being a threat to the resident physician, physician burnout and depression, reported in the majority (47%-70%) of resident physicians across diverse specialties, is a known contributor to suboptimal patient care. [11][12][13][14][15][16][17][18] We have implemented a voluntary wellness initiative for the residents of the Department of Neurosurgery at the Medical University of South Carolina. This quality improvement NEUROSURGERY VOLUME 84 | NUMBER 2 | FEBRUARY 2019 | 341 Downloaded from https://academic.oup.com/neurosurgery/article-abstract/84/2/341/5087899 by guest on 09 June 2020 initiative encourages and educates participants on the importance of a balanced lifestyle emphasizing exercise, nutrition, teamwork, and mental health.…”

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

“…In conjunction with the recently published cohort of women in neurosurgery from 1990 to 1999, this study details a 20-year period describing the trends for enrollment and retention of women in neurosurgery. 19 The number of women who matched in neurosurgery increased from 146 of 1361 residents (10.7%) during the 1990s to 240 of 1992 (12%) during the 2000s. Although a small overall increase by decade, the number of women matching into neurosurgery appears to be increasing with time.…”

“…Quantification of attrition rates in neurosurgery sorted by gender have only recently become available for those who trained more than 15 years ago (1990s cohort). 19 Trends in recent enrollment and retention of women in neurosurgery are useful benchmarks to build upon established data and to continue to monitor established priorities of organized neurosurgery. 4 The purpose of this paper was to perform an analysis of the subsequent decade to ascertain if these attrition rates have changed as more women have entered into neurosurgery, to identify the at-risk period for attrition, and to analyze alternative career paths to improve our recruitment and retention strategies.…”

Diversity in Neuromodulators: Where We Are and Where We Need to Go

“…The percentage of men and women entering medical school is essentially equivalent, while women make up 35% of anesthesiology residents, 21% of pain management residents, and 15% of neurosurgery residents (1)(2)(3)(4)(5). Beyond residency, the presence of women in neuromodulation decreases further.…”