A comprehensive national survey on thoughts of leaving residency, alternative career paths, and reasons for staying in general surgery training

• Published in: The American journal of surgery 2020-02, Vol.219 (2), p.227-232
• Main Authors: Ellis, Ryan J., Holmstrom, Amy L., Hewitt, D. Brock, Engelhardt, Kathryn E., Yang, Anthony D., Merkow, Ryan P., Bilimoria, Karl Y., Hu, Yue-Yung
• Format: Article
• Language: English
• Subjects: Adult; Attitude of Health Personnel; Career Choice; Career development planning; Careers; Education; Education, Medical, Graduate - methods; Education, Medical, Graduate - trends; Female; General Surgery - education; Humans; Job Satisfaction; Logistic Models; Male; Males; Multivariate Analysis; Physicians, Women - psychology; Physicians, Women - statistics & numerical data; Polls & surveys; Professions; Response rates; Surgeons; Surgery; Surveys and Questionnaires; Training; United States
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2019.10.040

General surgery residencies continue to experience high levels of attrition. Survey of general surgery residents administered with the 2018 American Board of Surgery In-Training Examination. Outcomes were consideration of leaving residency, potential alternative career paths, and reasons for staying in residency. Among 7,409 residents, 930 (12.6%) reported considering leaving residency over the last year. Residents were more likely to consider other general surgery programs (46.2%) if PGY 2/3 (OR: 1.93, 95%CI 1.34–2.77) or reporting frequent duty hour violations (OR: 1.58, 95%CI 1.12–2.24). Consideration of other specialties (47.0%) was more likely if dissatisfied with being a surgeon (OR 2.86, 95%CI 1.92–4.26). Residents were more likely to consider leaving medicine (49.7%) if female (OR: 1.54, 95%CI 1.16–2.06) or dissatisfied with a surgical career (OR: 2.81, 95%CI 1.85–4.27). Common reasons for remaining in residency included a sense of too much invested to leave (65.3%) and career satisfaction (55.5%). Profiles of trainees considering leaving residency exist based on factors associated with alternative careers. This may be a target for future interventions to reduce attrition. •More than one in ten general surgery residents have considered leaving training in the last year.•Different resident profiles are associated with different potential alternative career paths.•Residents often stay in training due to continued satisfaction with surgery.