Public Release: 

High attrition rate among residents in general surgery programs

The JAMA Network Journals

An analysis of more than 20 studies finds that the overall rate of attrition among general surgery residents was 18 percent and that the most common causes of attrition was uncontrollable lifestyle and choosing to join another specialty, according to a study published online by JAMA Surgery.

Despite the introduction of national regulations on resident duty hour restrictions in 2003, resident attrition remains a significant issue, particularly in general surgery training programs; however, there are wide discrepancies in the prevalence and causes of attrition reported among surgical residents in previous studies. Mohammed Al-Omran, M.D., M.Sc., F.R.C.S.C., of St. Michael's Hospital, Toronto, and colleagues conducted a review and meta-analysis to determine the estimate of attrition prevalence among general surgery residents. The researchers identified 22 studies that met criteria for inclusion in the analysis.

The studies reported on residents (n = 19,821) from general surgery programs. The pooled estimate for the overall attrition prevalence among general surgery residents was 18 percent, with significant between-study variation. Attrition was significantly higher among female compared with male (25 percent vs 15 percent) general surgery residents, and most residents left after their first postgraduate year (48 percent). Departing residents often relocated to another general surgery program (20 percent) or switched to anesthesia (13 percent) and other specialties. The most common reported causes of attrition were uncontrollable lifestyle (range, 12 percent-88 percent) and transferring to another specialty (range, 19 percent-39 percent).

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"Future studies should focus on developing interventions to limit resident attrition," the authors conclude.

(JAMA Surgery. Published online December 14, 2016.doi:10.1001/jamasurg.2016.4086. This study is available pre-embargo at the For The Media website.)

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