Attrition from surgical residency training: perspectives from those who left

Tasce Bongiovanni; Heather Yeo; Julie A Sosa; Peter S Yoo; Theodore Long; Marjorie Rosenthal; David Berg; Leslie Curry; Marcella Nunez-Smith

doi:10.1016/j.amjsurg.2015.05.014

Attrition from surgical residency training: perspectives from those who left

Am J Surg. 2015 Oct;210(4):648-54. doi: 10.1016/j.amjsurg.2015.05.014. Epub 2015 Jul 8.

Authors

Tasce Bongiovanni¹, Heather Yeo², Julie A Sosa³, Peter S Yoo⁴, Theodore Long⁵, Marjorie Rosenthal⁶, David Berg⁷, Leslie Curry⁸, Marcella Nunez-Smith⁵

Affiliations

¹ Department of Surgery, University of California San Francisco School of Medicine, San Francisco, CA, USA; Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, 333 Cedar Street, PO Box 208088, New Haven, CT, USA; US Department of Veterans Affairs, Connecticut Healthcare System, West Haven, CT, USA. Electronic address: tasce.bongiovanni@yale.edu.
² Department of Surgery, New York Presbyterian-Weill Cornell Medical Center, New York, NY, USA.
³ Department of Surgery, Duke University School of Medicine, DUMC, Durham, NC, USA.
⁴ Department of Surgery, Yale University School of Public Health, New Haven, CT, USA.
⁵ Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, 333 Cedar Street, PO Box 208088, New Haven, CT, USA; Department of Internal Medicine, Yale University School of Public Health, New Haven, CT, USA.
⁶ Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, 333 Cedar Street, PO Box 208088, New Haven, CT, USA; Department of Pediatrics, Yale University School of Public Health, New Haven, CT, USA.
⁷ Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, 333 Cedar Street, PO Box 208088, New Haven, CT, USA; Department of Psychiatry, Yale University School of Public Health, New Haven, CT, USA.
⁸ Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, 333 Cedar Street, PO Box 208088, New Haven, CT, USA; Division of Health Policy and Administration, Yale University School of Public Health, New Haven, CT, USA.

PMID: 26238074
DOI: 10.1016/j.amjsurg.2015.05.014

Abstract

Background: High rates of attrition from general surgery residency may threaten the surgical workforce. We sought to gain further insight regarding resident motivations for leaving general surgery residency.

Methods: We conducted in-depth interviews to generate rich narrative data that explored individual experiences. An interdisciplinary team used the constant comparative method to analyze the data.

Results: Four themes characterized experiences of our 19 interviewees who left their residency program. Participants (1) felt an informal contract was breached when clinical duties were prioritized over education, (2) characterized a culture in which there was no safe space to share personal and programmatic concerns, (3) expressed a scarcity of role models who demonstrated better work-life balance, and (4) reported negative interactions with authority resulting in a profound loss of commitment.

Conclusions: As general surgery graduate education continues to evolve, our findings may inform interventions and policies regarding programmatic changes to boost retention in surgical residency.

Keywords: Career choice; General surgery/education; Internship and residency/manpower.

MeSH terms

Adult
Career Choice*
Female
General Surgery / education*
Humans
Internship and Residency*
Interprofessional Relations
Job Satisfaction
Male
Motivation
Organizational Culture
Qualitative Research
Student Dropouts / psychology*