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

Attrition from surgical residency training: perspectives from those who left.

Author information

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.

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

PMID:
26238074
DOI:
10.1016/j.amjsurg.2015.05.014
[Indexed for MEDLINE]
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