Factors affecting attrition in graduate surgical education

This study was undertaken to identify characteristics of residents who left their training program before the end of the program. A survey was sent to 248 Program Directors in the United States, after institutional review. Anonymous responses were received from 27 (11%) programs. Data was received on 166 residents, including 111 males and 55 females. The group included 146 categorical residents and 20 preliminary residents. Of these, 60 residents left in the middle of the year and 105 left at the end of the year. Of the 164 residents for whom data was reported, 30 (21%) used counseling services. Of 110 residents who left before 2004, 54 (49%) left to choose another specialty. In 2004, of 25 residents who left, 13 (52%, P > 0.05) pursued training in another specialty, and in 2005 of 31 residents who left, 23 (74%, P < 0.025) chose another specialty. Significantly more residents who started a career in surgery after 2004 left to train in another specialty. This may be due to implementation of work hour restrictions in 2003 leading residents to enter surgery who would not have done so previously. Strategies for better retention of matched residents are necessary to reverse this worrisome trend.