A closer look at general surgery resident attrition reveals key reasons for departures—and why they afflict women more often than men.
Resident attrition from general surgery training programs is high, but a meta-analysis of 22 studies published in JAMA Surgery shows why residents leave programs and how to improve retention.
The review found that the overall rate of attrition among general surgery residents was 18%, but that female residents were more likely to leave (25%) than male residents (15%). Leading causes of attrition for both genders included:
- Uncontrollable lifestyle
- Choosing another specialty (13% switched to anesthesia)
- Relocating to another general surgery program due to family issues or geographic preference
Lead author Zeyad Khoushhal, MBBS, MPH, from the Division of Vascular Surgery, St. Michael's Hospital in Toronto, Ontario, Canada, and colleagues noted several factors that may disproportionately drive female residents to leave or change training programs, including lack of appropriate role models for female residents, a lack of sufficient support or mentorship, and a perception of sex discrimination.
Adding credence to the latter notion is a separate study of practicing cardiologists that revealed female physicians experience nearly three times the rate of discrimination of all types than men.
In a commentary about the study, Julie A. Freischlag, MD, of the University of California Davis School of Medicine, stressed the importance of mentorship in boosting surgical residents' success.
"Mentorship and support is especially important for women," she wrote. "As a woman who has built a career in a traditionally male-dominated field, I can understand the unique challenges that female residents face, particularly conscious and unconscious biases that remain pervasive despite recent efforts for equality," the commentary continued, adding that men can make good mentors for women, too.
Moreover, Freischlag and coauthor Michelle M. Silva, BA, also of UC-Davis Med, noted the importance of a "mentorship culture," that can foster a sense of camaraderie that enables residents to listen to one another, collaborate on research, and enjoy outside activities together.
Debra Shute is the Senior Physicians Editor for HealthLeaders Media.