Gender-related attrition in a general surgery training program

Background. Attracting and retaining highly qualified applicants to careers in surgery is a goal of residency training programs. Few studies of attrition in residency exist. This study examines the hypothesis that reasons for attrition during general surgery training are different for male and female trainees. Materials and methods. NRMP matching information was used to evaluate attrition rates in a categorical general surgery (CGS) residency program from 1984 through 1996. The records of all matched residents were examined to determine the association between gender and attrition outcomes. Outcome variables included: voluntary vs involuntary withdrawal and the reasons for withdrawal. Results. During the study period 132 candidates matched (103 men and 29 women) into CGS positions. Of that group, 18 residents, 11 (10.7%) from the male and 7 (24.1%) from the female cohorts withdrew. Only three involuntary withdrawals occurred. Women were 2.26 times more likely to withdraw than men, a finding that is not statistically significant (P = 0.073). Women rarely left for preference of other specialty (relative risk 0.25), whereas men were 4 times more likely to leave for this reason. 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 the conclusion that fundamental differences exist in decisions regarding attrition between genders. National studies of attrition and the reasons for leaving are needed to develop specific strategies promoting retention for both genders. (C) 1998 Academic Press.