High dropout rate among general surgery residents

There’s a high dropout rate among residents in general surgery programs.

More so than other medical specialties, there’s a high dropout rate among residents in general surgery programs.

A review of 22 studies on residents from general surgery programs found an overall attrition rate of 18%, with many would-be surgeons relocating to another program or switching to another specialty, according to a study in JAMA Surgery. Female residents were more likely to leave their training program than male residents, and residents were most likely to leave after the first postgraduate year owing to lifestyle-related issues.

In an accompanying editorial, a doctor and researcher suggested mentorship and support could help reduce the dropout rate.

"Surgical residency is notoriously arduous and the longer hours compared with other specialties can take a toll on some residents. That's why it's important for mentors to keep a watchful eye on resident mentees. Those who are thinking about leaving may be too overwhelmed to see how their talents have great value,” wrote Julie A. Freischlag, M.D., and Michelle M. Silva, of the University of California, Davis.

However, one surgeon suggested to MedPage Today that many of the residents may have left involuntarily because they knew their contract would not be renewed.

"Being a surgeon is hard work, and no one should be a surgeon who doesn't really want to, nor should anyone be a surgeon who isn't really good at it,” said Michael E. Shapiro, M.D., surgical program director at Rutgers New Jersey Medical School.

Residents may in fact soon be working longer hours. The Accreditation Council for Graduate Medical Education has proposed changes to its rules governing residents that would allow them to work 24-hour shifts—a third longer than they are currently allowed to work—plus up to four more hours to manage transitions in care. Yet a study published this year by the New England Journal of Medicine concluded that longer hours for surgical residents did not necessarily pose any safety risks.