Attrition from surgical residency training: perspectives from those who left

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


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.

MeSH terms

  • Adult
  • Career Choice*
  • Female
  • General Surgery / education*
  • Humans
  • Internship and Residency*
  • Interprofessional Relations
  • Job Satisfaction
  • Male
  • Motivation
  • Organizational Culture
  • Qualitative Research
  • Student Dropouts / psychology*