Why do residents leave general surgery? The hidden problem in today’s programs

Dodson, Thomas F.; Webb, Alexandra L.

doi:10.1016/j.cursur.2004.07.009

Cited by 125 publications

(109 citation statements)

References 19 publications

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“…When consulting the literature it seems that the word "lifestyle" is seldom actually defined in studies, and it is left to both the study participants and to those reading the ensuing paper to determine what aspect or aspects of "lifestyle" are being referred to. 1,6,7 Alleviating lifestyle issues cannot be as simple as merely reducing working hours, as the introduction of the 80-hour working week was met with a paradoxical increase in resident attrition from general surgical programs in the United States. 6 Similarly the introduction of a 16-hour maximum workday restriction in Quebec was met with a perceived reduction in quality of life by the affected residents and perceived deteriorations in the quality of care for patients and quality of training for residents by the professors involved.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6] The reasons cited by those considering leaving have been primarily to do with a desire for an improved work-life balance both during and after residency. 1,5,7 Qualitative studies have suggested that prioritization of work provision over education, lack of perceived freedom to express concerns, lack of role models demonstrating an improved work-life balance and negative interactions with senior colleagues were all common themes among former surgical trainees who actually had left their programs. 8 A recently published study by our group has sought to determine whether or not the same phenomenon was occurring among residents in comparable Canadian general surgery programs.…”

mentioning

confidence: 99%

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Attitudes and factors contributing to attrition in Canadian surgical specialty residency programs

Adams¹,

Ginther²,

Neuls³

et al. 2017

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Background:We recently studied attrition in Canadian general surgical programs; however, there are no data on whether residents enrolled in other surgical residencies harbour the same intents as their general surgical peers. We sought to determine how many residents in surgical disciplines in Canada consider leaving their programs and why.Methods: An anonymous survey was administered to all residents in 9 surgical disciplines in Canada. Significance of association was determined using the Pearson χ 2 test. The Canadian Post-MD Education Registry (CAPER) website was used to calculate the response rate. Results:We received 523 responses (27.6% response rate). Of these respondents, 140 (26.8%) were either "somewhat" or "seriously" considering leaving their program. Residents wanting to pursue additional fellowship training and those aspiring to an academic career were significantly less likely to be considering changing specialties (p = 0.003 and p = 0.005, respectively). Poor work-life balance and fear of unemployment/ underemployment were the top reasons why residents would change specialty (55.5% and 40.8%, respectively), although the reasons cited were not significantly different between those considering changing and those who were not (p = 0.64). Residents who were considering changing programs were significantly less likely to enjoy their work and more likely to cite having already invested too much time to change as a reason for continuing (p < 0.001). Conclusion:More than one-quarter of residents in surgical training programs in Canada harbour desires to abandon their surgical careers, primarily because of unsatisfactory work-life balance and limited employment prospects. Efforts to educate prospective residents about the reality of the surgical lifestyle and to optimize employment prospects may improve completion rates.Contexte : Nous avons récemment étudié les taux d'attrition dans les programmes de chirurgie générale canadiens; toutefois, on ne dispose pas de données pour déterminer si les résidents inscrits dans d'autres programmes de chirurgie ont les mêmes intentions que leurs collègues de chirurgie générale. Nous avons voulu savoir combien de résidents des disciplines chirurgicales au Canada envisagent de quitter leur programme et pourquoi.Méthodes : Tous les résidents de 9 disciplines chirurgicales au Canada ont passé un sondage anonyme. La portée de la corrélation a été déterminée à l'aide du test χ 2 de Pearson. Le site Web du Répertoire canadien sur l'éducation post-MD (RCEP) a été utilisé pour calculer le taux de réponse.Résultats : Nous avons reçu 523 réponses (taux de réponse de 27,6 %). Parmi les répon-dants, 140 (26,8 %) envisageaient « peut-être » ou « sérieusement » de quitter leur programme. Les résidents qui souhaitaient suivre une formation de surspécialité et ceux qui aspiraient à une carrière universitaire étaient notablement moins susceptibles d'envisager un changement de programme (p = 0,003 et p = 0,005, respectivement). Les problèmes de conciliation travail-famille et la crainte ...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Attitudes and factors contributing to attrition in Canadian surgical specialty residency programs

Adams¹,

Ginther²,

Neuls³

et al. 2017

cjs

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“…Educating medical students about what general surgery residency and practice are like is crucial [6]. Most medical students decide on a residency and career during the third year clerkships [19].…”

Section: Better Education Of Medical Students About Surgery Residenciesmentioning

confidence: 99%

“…Lifestyle issues remain the number one reason residents quit general surgery residencies [5]. One out of every 6 general surgery residents withdraw from training [1,6]. The national attrition rate for general surgery is 20% which is 4 to 5 times higher than surgical subspecialties and 2 to 3 times higher than internal medicine [1,3,7].…”

Section: Introductionmentioning

confidence: 99%

How Can We Reduce Attrition in General Surgery Residents?

DM¹

2018

Austin J Surg

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General surgery residencies have the highest rate of attrition of all training programs. Lifestyle issues remain the number one reason residents quit general surgery residencies. Almost half of surgery residents consider dropping out of residency. Research should be directed in determining the cause of attrition and trying to reduce it. Residency Programs must be vigilant and proactive about retention of general surgery residents. Many ways to reduce attrition are discussed. Mentoring programs may be a first line defense against burnout.

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“…''Lifestyle'' frequently is cited by residents as a major reason for leaving. [7][8][9] The difficulty of balancing home and work obligations is not merely an individual-level problem; it also represents a challenge for the specialty. A step in the right direction is to establish a family leave policy, as described above, for all residents.…”

mentioning

confidence: 99%