Prevalence and Causes of Attrition Among Surgical Residents

Khoushhal, Zeyad; Hussain, Mohamad A.; Greco, Elisa; Mamdani, Muhammad; Verma, Subodh; Rotstein, Ori D.; Tricco, Andrea C.; Al‐Omran, Mohammed

doi:10.1001/jamasurg.2016.4086

Cited by 207 publications

(127 citation statements)

References 62 publications

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“…Surgeon wellness during residency and throughout a surgical career has become a priority, and this may encourage interest in surgery among students who are undecided. 133,134 One approach to ensuring wellness among surgical trainees is the restriction of duty hours, which was found in our review to have a beneficial impact on student experience of surgery and mixed impact on student pursuit of a career in surgery. 85,88,104 However, duty hour restriction is controversial, and results from prominent studies, such as the FIRST trial, illuminate the nuanced balance between duty hour policies and surgical trainee well-being.…”

Section: Discussionmentioning

confidence: 93%

A systematic review of the factors affecting choice of surgery as a career

Peel

Schlachta

Alkhamesi

2018

cjs

182

129

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A systematic review of the factors affecting choice of surgery as a careerBackground: Interest in surgical careers among medical students has declined over the past decade. Multiple explanations have been offered for why top students are deterred or rejected from surgical programs, though no consensus has emerged. Methods:We conducted a review of the literature to better characterize what factors affect the pursuit of a surgical career. We searched PubMed and EMBASE and performed additional reference checks. Agency for Healthcare Research and Quality (AHRQ) and Newcastle-Ottawa Education scores were used to evaluate the included data.Results: Our search identified 122 full-text, primary articles. Analysis of this evidence identified 3 core concepts that impact surgical career decision-making: gender, features of surgical education, and student "fit" in the culture of surgery. Conclusion:Real and perceived gender discrimination has deterred female medical students from entering surgical careers. In addition, limited exposure to surgery during medical school and differences between student and surgeon personality traits and values may deter students from entering surgical careers. We suggest that deliberate and visible effort to include women and early-career medical students in surgical settings may enhance their interest in carreers in surgery.Contexte : On constate que l'intérêt pour une carrière en chirurgie a décliné chez les étudiants en médecine depuis une dizaine d'années. Plusieurs raisons ont été invoquées pour expliquer le désintérêt des étudiants talentueux à l'égard des programmes de chirurgie ou leur rejet de ces programmes, sans qu'on en arrive à un consensus.

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Section: Discussionmentioning

confidence: 93%

A systematic review of the factors affecting choice of surgery as a career

Peel

Schlachta

Alkhamesi

2018

cjs

182

129

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“…Trainees report stress regarding the physical risks posed by having to care for COVID-positive patients 24,25 as well as the potential impact that COVID restrictions may have on future career prospects. 26 Neurosurgical residency is demanding, 27,28 and although overall attrition rates are below average (11% between 2005 and 2010 vs. 18% for general surgery residents), 29,30 it has been noted that low operative volume and outside social stressors are associated with higher rates of burnout. 31 This situation raises concern for increased resident burnout rates during the COVID crisis.…”

Section: Resident Wellnessmentioning

confidence: 99%

Letter to the Editor “Changes to Neurosurgery Resident Education Since Onset of the COVID-19 Pandemic”

et al. 2020

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“…Although there have been publications on higher attrition rates for females in surgical training programs where males are the majority in training and occupation (17), to our knowledge, no outcomes have been previously reported that similarly more males tend to drop-out from training programs where women outnumber men. This highly interesting result might by explained from social identity theory.…”

Section: Discussionmentioning

confidence: 62%

“…The attrition rate of surgical specialties in particular gains attention in the literature, particularly in the United States (22,17,6). The meta-analysis on prevalence and causes of attrition among surgical residents, performed by Zeyad Khoushhal and his colleagues sheds light on one particular nding: attrition is signi cantly higher among female trainees compared to males (25% and 15% respectively) (17). There has been a particular literature review on gender differences in the learning and teaching of surgery (9).…”

Section: Introductionmentioning

confidence: 99%

Gender differences in attrition rates of hospital-based medical specialty programs: attributable to gender composition of the clinical specialty?

Butterman¹,

Slenter²,

Velden

et al. 2020

Preprint

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Background Since 1999 the Advisory Committee on Medical Manpower Planning (ACMMP) advises the Dutch government on the medical workforce capacity and the intake in training programs, as to achieve or maintain a balance on the labour market. One of the key parameters the ACMMP uses when calculating the required intake in training programs, is the attrition rate. Methods In total 11,579 trainees enrolled in hospital-based programs from January 1 st 2003 until 31 st of December 2012, for 26 specialisms. To explore possible explanations for the gender differences in attrition rate per specialty, additional information was gathered: the percentage of males per program, the total number of specialists in training, the duration of the training and the percentage of males currently working in that specialty. Results One training program was excluded, due to the small size of that training program (62 trainees) and the large outliers it produced. Regression analyses were done, showing significant explanations of the variation in the difference between male and female attrition rates (Y1), for the proportion of males working in the profession per 01-01-2003 (R 2 : .545, F(27,60), p<.000), the proportion of males in training per 01-01-2003 (R 2 : .417, F(16,01), p<.000) and a small effect for the relationship with the total attrition rate for each training program (R 2 : .163, F(4,46), p<.046). There was also a significant effect for the duration of the specialty training (R 2 : .299, F(9,85), p<.005). A Kruskal-Wallis test was preformed to analyse the difference in attrition by type of specialty. The difference between the types of specialisms were significant (H=6,66, p.0,036). Conclusions Attrition rates in Dutch hospital-based specialty programs differ between males and females in a way that more males tend to drop-out from training when the specialty is dominated by women and, importantly, vice versa as well. The relationships found needs to be explored, in particular as the duration and nature of the specialty training seem to interact with gender ratios in the training programs and occupations longer training programs tend to have more males on them. Furthermore, more insight is needed in the selection and identification processes among residents in specialty training.

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Prevalence and Causes of Attrition Among Surgical Residents

Abstract: General surgery programs have relatively high attrition, with female residents more likely to leave their training programs than male residents. Residents most often relocate or switch to another specialty after the first postgraduate year owing to lifestyle-related issues.

Cited by 207 publications

References 62 publications

A systematic review of the factors affecting choice of surgery as a career

A systematic review of the factors affecting choice of surgery as a career

Letter to the Editor “Changes to Neurosurgery Resident Education Since Onset of the COVID-19 Pandemic”

Gender differences in attrition rates of hospital-based medical specialty programs: attributable to gender composition of the clinical specialty?

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