Whatever happened to the General Surgery graduating class of 2001?

Nationally approximately 20% of all categorical General Surgery (GS) residents do not complete their GS training. We ranked 57 applicants in the National Residency Match Program (NRMP) in 1996 and matched our final eighth candidate with slot 22. Although clinically stellar, 4 of these 8 residents (50%) opted to switch to different medical specialties. We pondered if other programs had difficulties with the 1996 applicant pool and hypothesized that perhaps higher ranked applicants have greater attrition rates.

Programs in which our ranked applicants matched were contacted and asked for feedback on trainee performance, research time, attrition, and future plans.

Four applicants did not match in GS. Fifty-three surgical interns (46 men, 7 women) in 1996 are now 23 chief residents, 18 senior residents (16 did research time, 1 did an intensive care unit fellowship, and 1 required a year of remediation), and 12 non-GS trainees (orthopedic surgery = 3, anesthesiology = 3, ENT = 1, family medicine = 1, internal medicine = 1, radiology = 1, pathology = 1, and Ph.D. researcher = 1). Clinical performance was similar for both GS trainees and those who dropped out. Residents dropped out after the PG-1 year (n = 7), PGY-2 (n = 3), and 1 each after PGY-3 and PGY-4. Higher ranked applicants were no more likely to drop out than were lower ranked applicants.

Of Mayo Clinic-Rochester-ranked GS categorical applicants in 1996, 23% dropped out of GS. Eleven of 12 dropouts selected a different field of medicine to finish their training. Attrition remains common and problematic both nationally and in individual programs.