Cutting Ties: General Surgery Residents Have Higher Attrition Rates Than Residents in Other Surgical Training Programs

Margaret Sundel; Cassandra Cairns; Stephen M Kavic

doi:10.1016/j.jsurg.2024.04.004

Cutting Ties: General Surgery Residents Have Higher Attrition Rates Than Residents in Other Surgical Training Programs

J Surg Educ. 2024 May 14:S1931-7204(24)00198-3. doi: 10.1016/j.jsurg.2024.04.004. Online ahead of print.

Authors

Margaret Sundel¹, Cassandra Cairns¹, Stephen M Kavic²

Affiliations

¹ University of Maryland Medical Center, 22 S Greene Street, Baltimore, Maryland.
² University of Maryland School of Medicine, 22 S Greene Street, Baltimore, Maryland. Electronic address: skavic@som.umaryland.edu.

PMID: 38749817
DOI: 10.1016/j.jsurg.2024.04.004

Abstract

Objective: Attrition rates among general surgery residents are notoriously high relative to other specialties. The aim of this study was to compare annual resident attrition rates between general surgery and other surgical subspecialties and to examine these trends in recent years.

Design: This was a retrospective study performed using Accreditation Council for Graduate Medical Education (ACGME) Data Resource Books from 2012-2022. Annual attrition rate and average ten-year attrition rate were calculated for general surgery and surgical specialties. Differences were assessed by Pearson chi-square test.

Setting: All ACGME accredited residency programs in the United States were included.

Results: General surgery residencies had a significantly higher average annual attrition rate (3.3%) than all other surgical specialties studied except thoracic surgery. Most attrition among general surgery residents was voluntary and these rates did not appear to be affected by the COVID-19 pandemic.

Conclusions: Attrition among general surgery residents is higher than in other surgical specialties, suggesting that early specialization may be protective against resident attrition.

Keywords: COVID; attrition; general surgery; sub specialization; surgery residency.