Daniel M Avery Jr*, Joseph C Wallace, John Burkhardt, John Bell VII, Charles E Geno, Andrew G Harrell, Garrett Taylor and Melanie Tucker
Department of Obstetrics and Gynecology, College of Community Health Sciences, University of Alabama, USAFulltext PDF
Background: General Surgery has the highest rate of attrition of all medical and surgical residencies. Uncontrollable lifestyle remains the number one reason residents quit general surgery residencies. Uncontrollable lifestyle means long hours, unpredictable schedules, long operative procedures and limited personal time. One out of every 6 general surgery residents quits residency training. More than half of general surgery residents contemplate leaving their surgery residency. Attrition is a major concern because of the existing shortage of general and rural surgeons in this country and even greater projected shortage in the near future.Design, Setting and
Participants: A list of 6,271 graduates of the University of Alabama School of Medicine (UASOM) from the Birmingham, Tuscaloosa and Huntsville campuses from 1974 to 2015 was obtained from the published records of the main campus in Birmingham. The list included residents who changed from general surgery to another specialty, were dismissed, quit medicine altogether, specialized early into an integrated program, or completed and practiced a surgical subspecialty. Graduates from the Tuscaloosa campus between 1974 and 2015 and graduates from the Birmingham and Huntsville campuses between 2001 and 2011 were interviewed by telephone or sent surveys by mail.Results: Ninety residents were identified from the study that changed from general surgery (1 had expired). Fifty-eight graduates (65.2%) responded. Eighteen graduates matched into non5 year categorical positions before other surgical specialties like urology, ENT, etc., and were excluded from the calculations. Nineteen (47.5%) graduates changed to another specialty. Fourteen (35%) graduates completed general surgery, then subspecialty fellowships and practiced surgical subspecialties.Discussion: The most common reason residents quit general surgery residencies is uncontrollable lifestyle; the second is the physical demands of the presidency itself. Both are amenable to improvement. The attrition rate of general surgery residents in this study is 44%. Most residents who quit changed to another specialty or completed general surgery and pursued a subspecialty fellowship.
Avery DM Jr, Wallace JC, Burkhardt J, Bell J VII, Geno CE, Harrell AG, et al. Why Do Residents Quit General Surgery Residencies? A Study of 789 Graduates from 3 Campuses Who Matched into General Surgery over 40 Years: 1974 to 2015. Clin Surg. 2017; 2: 1720.