Factors Associated With General Surgery Residents’ Desire to Leave Residency Programs

Abstract

A majority of categorical general surgery residents seriously consider leaving residency. Female residents are more likely to consider leaving. Thoughts of leaving seem to be associated with work conditions on specific rotations rather than with overall work hours and are more prevalent among programs with historically high attrition rates.

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

“…When consulting the literature it seems that the word "lifestyle" is seldom actually defined in studies, and it is left to both the study participants and to those reading the ensuing paper to determine what aspect or aspects of "lifestyle" are being referred to. 1,6,7 Alleviating lifestyle issues cannot be as simple as merely reducing working hours, as the introduction of the 80-hour working week was met with a paradoxical increase in resident attrition from general surgical programs in the United States. 6 Similarly the introduction of a 16-hour maximum workday restriction in Quebec was met with a perceived reduction in quality of life by the affected residents and perceived deteriorations in the quality of care for patients and quality of training for residents by the professors involved.…”

“…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.…”

“…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.…”

“…[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. 1,5,7 Qualitative studies have suggested that prioritization of work provision over education, lack of perceived freedom to express concerns, lack of role models demonstrating an improved work-life balance and negative interactions with senior colleagues were all common themes among former surgical trainees who actually had left their programs. 8 A recently published study by our group has sought to determine whether or not the same phenomenon was occurring among residents in comparable Canadian general surgery programs.…”

Eliminating Mentors in Favor of Collaborators: Review and Challenge of Current Mentorship Literature

“…An example of negative correlation with mentorship is the survey of surgery residents who thought about leaving surgery residency (23). Having a mentor was actually correlated with the desire to leave surgery training.…”