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Attrition of Categorical General Surgery Residents: Results of a 20 Year Audit
Walter E Longo, John H. Seashore, Andrew J Duffy, Robert Udelsman
Department of Surgery, Yale School of Medicine, New Haven, CT

Objective: To evaluate the incidence of attrition of categorical general surgery residents and the fate of those who left the general surgery training program.
Design: Defined cohort of categorical general surgery residents
Setting: University Hospital Residency Training Program
Patients: We retrospectively reviewed the files of all general surgery residents at the Yale University School of Medicine-Yale New Haven Hospital Surgery Program who began as categorical interns from July 1, 1986 to June 30, 2006. Ninety-nine residents were identified.
Interventions: N/A
Main Outcome Measures: Attrition of residents was divided into withdrawls (changed specialty), transfers (transferred to a different program in general surgery) and dismissals (dismissed from the program).
Results: Among the 99 residents who began as categorical interns from 1986-2006, 66/99 (67%), were females. Thirty/99 (30%) failed to complete the general surgery training program. Twenty-one/30 (70%) withdrew, 5/30 (17%) transferred and 4/30 (13%) were dismissed. Attrition occurred prior to entering the third clinical year in 17/30 (87%). Two/30 (7%) left graduate medical education. Thirteen/21 (62%) who withdrew entered primary care or another non-surgical specialty while 7/21 (38%) matriculated into a surgical subspecialty. The attrition rate was 40% (12/30) since the academic year 2000. The overall annual attrition rate for the past twenty years was 6.7 %.
Conclusions: Attrition in our general surgery training remains low. Most who leave remain in graduate medical education and transfer to a different specialty. The overwhelming majority leave prior to beginning their third clinical year. Although our 6.7% annual attrition rate remains favorable (national attrition rate in general surgery 5.8%), we must continue to analyze the root causes and solutions.


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