Association of Time to Attrition in Surgical Residency With Individual Resident and Programmatic Factors

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Abstract
The rate of attrition from general surgery residency training programs continues to be higher than that of many other medical and surgical specialties, including internal medicine, orthopedics, neurosurgery, and otolaryngology.1-6 Although some attrition early in residency (years 1 and 2) might be expected, late attrition among senior and chief residents who train for years only to leave before graduation is a major concern because this represents loss of time and investment for the resident and the program. During the past 30 years, several reform measures were implemented by the American Board of Surgery (ABS) and the Accreditation Council for Graduate Medical Education to reduce the rate of resident attrition. These reforms included elimination of the pyramidal training system in 1982 and introduction of Accreditation Council for Graduate Medical Education work hour regulations in 2003 and 2011. Nevertheless, attrition from general surgery residencies remains high.1,2,7-10

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