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March 2016

A Strategy to Reduce General Surgery Resident Attrition: A Resident’s Perspective

Author Affiliations
  • 1Department of Surgery, Northwestern University, Chicago, Illinois
JAMA Surg. 2016;151(3):215-216. doi:10.1001/jamasurg.2015.4607

Resident attrition from general surgery residency programs in the United States is high and has remained stably high for almost 20 years, despite elimination of the pyramidal residency program structure in 1996 and formal implementation of work-hour restrictions in 2003.1 Attrition rates of general surgery categorical residents range from 17% to 26% over a 5- to 7-year residency program, and this attrition rate is higher than for other medical specialties.2-4 Most attrition by general surgery categorical residents is voluntary in nature, with involuntary dismissal comprising less than 4% of total attrition.3-5 Commonly cited reasons for general surgery resident attrition include an undesirable lifestyle, sleep deprivation, excessive work hours, preference for another specialty, length of surgical training, and lack of formal mentorship.2-4 Female general surgery residents appear to be at increased risk for attrition,2,3 although this finding is less consistent.4 Thus, the ability to retain qualified general surgery residents remains a challenge.