National Orthopedic Residency Attrition: Who Is At Risk?

Bauer, Jennifer M.; Holt, Ginger E.

doi:10.1016/j.jsurg.2016.03.010

Cited by 41 publications

(33 citation statements)

References 27 publications

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“…The data do not exist however to determine whether URMs have a higher attrition rate than the population at large because the Accreditation Council for Graduate Medical Education (ACGME) does not report the race/ethnicity in their attrition data. Bauer et al did not find a significant risk of attrition based on resident minority status 25 ; however, at baseline, there was a significant difference in the number of URM residents in their respondent pool, compared with what was reported by the ACGME in the same academic year (20.3% vs. 35.3%, p < 0.001). Their results therefore may not be reflective of the true URM attrition rate; more research needs to be performed on this topic.…”

Section: Discussionmentioning

confidence: 87%

Barriers to Increasing Diversity in Orthopaedics

et al. 2020

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Background: There are little data to explain why the surgical subspecialty of orthopaedic surgery struggles with improving the racial/ethnic composition of its workforce. The current work sought to determine what orthopaedic residency program directors and coordinators believe are the barriers to improving diversity at their own programs. Methods: Between November 17, 2018, and April 1, 2019, a 17-question survey was electronically distributed to the program directors and coordinators of 155 allopathic orthopaedic surgery residency programs. Seventy-five of 155 programs (48.4%) responded to the survey. A p-value of < 0.05 was used to determine statistical significance. Results: The most commonly stated barriers to increasing diversity within the orthopaedic surgery programs were the following: “We do not have enough minority faculty, which may deter the applicants” (69.3%), “We consistently rank minority applicants high but can never seem to match them” (56%), and “Not enough minorities are applying to our program” (54.7%). Programs with higher percentages of underrepresented minority (URM) faculty had higher percentages of URM residents (p = 0.001). Programs participating in the Nth Dimensions and/or Perry Initiative programs had a higher percentage of URM faculty as compared to the residency programs that did not participate in these programs (p = 0.004). URM residents represented 17.5% of all residents who resigned and/or were dismissed in the 10 years preceding the survey while also only representing 6% of all orthopaedic residents during the same time period. Conclusions: From the orthopaedic residency program perspective, the greatest perceived barrier to increasing the racial/ethnic diversity of residents in their program is their lack of URM faculty. Surveyed programs with more URM faculty had more URM residents, and programs participating in Nth Dimensions and/or Perry Initiative programs had a higher percentage of URM faculty.

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Section: Discussionmentioning

confidence: 87%

Barriers to Increasing Diversity in Orthopaedics

et al. 2020

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“…It was found that female medical students did not apply to orthopedics residency due to the potential of a hostile work environment [13]. A 2016 study found that women are three times more likely to leave orthopedic residency compared to men and that sexual harassment and sex discrimination are major factors in this decision [23]. Another study found that one in three women in academic medicine reports having personally experienced sexual harassment [24].…”

Section: Hostile Work Environmentmentioning

confidence: 99%

Academic Gender Disparity in Orthopedic Surgery in Canadian Universities

Yue

Khosa

2020

Cureus

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Introduction Academic medicine is notorious for being "male-dominated." We hypothesized that there were significant and quantifiable levels of gender disparity in academic orthopedic surgery, and this article attempts to quantify the extent of the existing disparity. Also, we examined the research productivity of academic faculty in orthopedic surgery and its correlation with academic ranks and leadership positions. Methods Our study design was cross-sectional in nature. We searched the Canadian Resident Matching Service (CaRMS) to compile a list of medical schools that offer orthopedic surgery training for residency. A total of 713 academic orthopedic surgeons met our inclusion criteria. Of the 713 orthopedic surgeons, 518 had an H-index score available on Elsevier's Scopus (Elsevier, Amsterdam, Netherlands). The gender, academic rank, leadership position, and H-index were compared. Data analysis was done with Statistical Package for the Social Sciences (SPSS; IBM, Armonk, NY). The binomial negative regression was used to compare the average H-index between men and women at each rank. Results Our study results reveal that academic orthopedic surgery in Canada is male-dominated, with men holding 87% of the academic positions. Female academic orthopedic surgeons held lower academic ranks, such as assistant professor or lecturer. Women orthopedic surgeons had lower H-index scores compared to their counterparts in ranks above the assistant professor. Our findings imply that research productivity and the ratio of average H-index scores comparing men to women (HM/HF) grow larger with each academic rank. At a 90% confidence level, women were less likely to hold leadership positions than men at an odds ratio (OR) of 0.52 [90% confidence interval (CI): 0.29-0.925, p: 0.03]. There were no significant differences in Hindex between men and women for departmental leadership positions. Conclusion Women were underrepresented in number, rank, and academic productivity (H-index). We offer possible factors that may have contributed to this finding as well as potential solutions.

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“…The loss of a resident prior to completion of training can negatively affect fellow trainees and program leadership, may hinder future recruitment efforts, and may negatively affect patient care. [1][2][3][4][5][6] There are few studies within emergency medicine (EM) to shed light on the phenomenon, especially as it relates to the percentage of residency programs impacted and program-specific factors that are associated with resident attrition. The majority of existing data on residency attrition arises from other specialties, such as general surgery, obstetrics and gynecology (OB-GYN), and their surgical subspecialties, 2,3,7,8 which focus on attrition rates and residentspecific factors associated with attrition.…”

Section: Introductionmentioning

confidence: 99%

Rate of Programs Affected by Resident Attrition and Program Factors Associated With Attrition in Emergency Medicine

Brockberg

Mittelman

Dugas

et al. 2019

Journal of Graduate Medical Education

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Background Resident attrition negatively affects residents and programs. The incidence of attrition in emergency medicine (EM) and program-specific factors associated with attrition remain unclear. Objective We quantified the percentage of EM residencies affected by attrition between 2007 and 2016 and identified program-specific factors associated with attrition. Methods We performed a retrospective analysis of data derived from the American Medical Association National Graduate Medical Education Census. We defined attrition as any postgraduate who left their residency training program prior to completion. We calculated the percentage of residency programs that experienced attrition and the overall incidence of attrition. We used Fisher's exact tests, Wilcoxon rank sum tests, and t tests, as well as multivariable logistic regression, to identify program-specific factors associated with attrition. Results Between 2007 and 2016, 139 EM residency programs (82%) experienced attrition of at least 1 resident. An average of 23% of EM training programs experienced attrition annually. The incidence of EM resident attrition averaged 0.85% per year. Program-specific factors associated with attrition include 4-year residencies ( P = .031), programs with medium class size ( P = .0003), more female residents ( P = .002), and more female faculty ( P = .003). After analysis, only medium class size (compared to small) was associated with attrition (odds ratio = 4.96, 95% confidence interval 1.65–14.91). Conclusions Between 2007 and 2016, while the incidence of resident attrition in EM was low (< 1%), the majority of programs experienced resident attrition. Medium class size (7 to 12 residents) was the only program-specific factor associated with increased attrition.

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National Orthopedic Residency Attrition: Who Is At Risk?

Cited by 41 publications

References 27 publications

Barriers to Increasing Diversity in Orthopaedics

Barriers to Increasing Diversity in Orthopaedics

Academic Gender Disparity in Orthopedic Surgery in Canadian Universities

Rate of Programs Affected by Resident Attrition and Program Factors Associated With Attrition in Emergency Medicine

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