Factors associated with general surgery residents' desire to leave residency programs: A multi-institutional study

Edward Gifford, Joseph M Galante, Amy H. Kaji, Virginia Nguyen, M. Timothy Nelson, Richard A. Sidwell, Thomas Hartranft, Benjamin Jarman, Marc Melcher, Mark Reeves, Christopher Reid, Garth R. Jacobsen, Jonathan Thompson, Chandrakanth Are, Brian Smith, Tracey Arnell, Oscar J. Hines, Christian De Virgilio

Research output: Contribution to journalArticle

62 Scopus citations

Abstract

IMPORTANCE General surgical residency continues to experience attrition. To date, work hour amendments have not changed the annual rate of attrition.

OBJECTIVE To determine how often categorical general surgery residents seriously consider leaving residency.

DESIGN, SETTING, AND PARTICIPANTS At 13 residency programs, an anonymous survey of 371 categorical general surgery residents and 10-year attrition rates for each program. Responses from those who seriously considered leaving surgical residency were compared with those who did not.

MAIN OUTCOMES AND MEASURES Factors associated with the desire to leave residency.

RESULTS The survey response rate was 77.6%. Overall, 58.0%seriously considered leaving training. The most frequent reasons for wanting to leave were sleep deprivation on a specific rotation (50.0%), an undesirable future lifestyle (47.0%), and excessive work hours on a specific rotation (41.4%). Factors most often cited that kept residents from leaving were support from family or significant others (65.0%), support from other residents (63.5%), and perception of being better rested (58.9%). On univariate analysis, older age, female sex, postgraduate year, training in a university program, the presence of a faculty mentor, and lack of Alpha Omega Alpha status were associated with serious thoughts of leaving surgical residency. On multivariate analysis, only female sex was significantly associated with serious thoughts of leaving residency (odds ratio, 1.2; 95%CI, 1.1-1.3; P =.003). Eighty-six respondents were from historically high-attrition programs, and 202 respondents were from historically low-attrition programs (27.8%vs 8.4%10-year attrition rate, P =.04). Residents from high-attrition programs were more likely to seriously consider leaving residency (odds ratio, 1.8; 95%CI, 1.0-3.0; P =.03).

CONCLUSIONS AND RELEVANCE A majority of categorical general surgery residents seriously consider leaving residency. Female residents are more likely to consider leaving. Thoughts of leaving seem to be associated with work conditions on specific rotations rather than with overall work hours and are more prevalent among programs with historically high attrition rates.

Original languageEnglish (US)
Pages (from-to)948-953
Number of pages6
JournalJAMA Surgery
Volume149
Issue number9
DOIs
StatePublished - Sep 1 2014

ASJC Scopus subject areas

  • Surgery

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    Gifford, E., Galante, J. M., Kaji, A. H., Nguyen, V., Nelson, M. T., Sidwell, R. A., Hartranft, T., Jarman, B., Melcher, M., Reeves, M., Reid, C., Jacobsen, G. R., Thompson, J., Are, C., Smith, B., Arnell, T., Hines, O. J., & De Virgilio, C. (2014). Factors associated with general surgery residents' desire to leave residency programs: A multi-institutional study. JAMA Surgery, 149(9), 948-953. https://doi.org/10.1001/jamasurg.2014.935