GENDER-RELATED ATTRITION IN A GENERAL-SURGERY TRAINING-PROGRAM

Background. Attracting and retaining highly qualified applicants to ca reers in surgery is a goal of residency training programs. Few studies of attrition in residency exist. This study examines the hypothesis t hat reasons for attrition during general surgery training are differen t for male and female trainees. Materials and methods. NRMP matching i nformation was used to evaluate attrition rates in a categorical gener al surgery (CGS) residency program from 1984 through 1996. The records of all matched residents were examined to determine the association b etween gender and attrition outcomes. Outcome variables included: volu ntary vs involuntary withdrawal and the reasons for withdrawal. Result s. During the study period 132 candidates matched (103 men and 29 wome n) into CGS positions. Of that group, 18 residents, 11 (10.7%) from th e male and 7 (24.1%) from the female cohorts withdrew. Only three invo luntary withdrawals occurred. Women were 2.26 times more likely to wit hdraw than men, a finding that is not statistically significant (P = 0 .073). Women rarely left for preference of other specialty (relative r isk 0.25), whereas men were 4 times more likely to leave for this reas on. Conclusion. These numbers suggest that women are at higher risk of leaving general surgery training than men. When women do leave, it is more likely for family reasons such as lifestyle considerations or to join a spouse in another geographic location. Such findings support t he conclusion that fundamental differences exist in decisions regardin g attrition between genders. National studies of attrition and the rea sons for leaving are needed to develop specific strategies promoting r etention for both genders. (C) 1998 Academic Press.