General surgery resident remediation and attrition: a multi-institutional study

Area of Science:

• Medical Education
• Surgical Training
• Resident Assessment

Background:

• Remediation and attrition are significant concerns in surgical residency programs.
• Understanding predictors of these outcomes is crucial for program improvement.

Purpose of the Study:

• To determine the rates and predictors of remediation and attrition among general surgery residents.
• To identify factors associated with successful program completion after remediation.

Main Methods:

• Retrospective analysis of 348 categorical general surgery residents over 11 years.
• Examined rates of remediation and attrition, and associated demographic and academic predictors.
• Statistical analysis included univariate and multivariable regression.

Main Results:

• 31% of residents required remediation, most often for medical knowledge deficits.
• Remediation was associated with honors in surgery and lower USMLE Step 1 scores.
• Attrition rate was 15.8%, with only 2 cases due to failed remediation; remediation was not a predictor of attrition.

Conclusions:

• A substantial proportion of general surgery residents require remediation, primarily due to medical knowledge deficiencies.
• Lower USMLE Step 1 scores are predictive of remediation needs.
• Most residents who undergo remediation successfully complete their programs, highlighting the need for improved pre-residency preparation.