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Resident Remediation and Program Director Attitudes Toward Categorical Surgical Resident Attrition at High- and Low-Attrition Programs
Vol. 223, No. 4S1, October 2016
Scientific Forum Abstracts
nonphysician educators said they were “unlikely” to “neutral/unsure” whether they would incorporate a nonphysician educator within the next 2 years (mean 2.4, 95% 2.1-2.8). These opinions were significantly different (p<0.0001). CONCLUSIONS: Few programs assess incoming interns to establish baseline competencies. Programs who use a nonphysician educator are more likely to perform baseline testing. More investigation is needed to evaluate the difference in perceptions of PDs who do and do not use nonphysician educators. Resident Remediation and Program Director Attitudes Toward Categorical Surgical Resident Attrition at High- and Low-Attrition Programs Alexander C Schwed, MD, Steven L Lee, MD, Edgardo S Salcedo, MD, Mark E Reeves, MD, PhD, FACS, Kenji Inaba, MD, FACS, FRCSC, Richard A Sidwell, MD, FACS, Farin Amersi, MD, FACS, Chandrakanth Are, MBBS, MBA, FRCS FACS, Amy H Kaji, MD, PhD, Christian de Vir Harbor-University of California Los Angeles Medical Center, Torrance, CA INTRODUCTION: Though surgery resident attrition remains a concern, previous studies may have overestimated the rate of categorical resident attrition because preliminary residents were included. METHODS: To obtain a better measure of the categorical resident attrition rate, and determine whether program director (PD) attitudes about attrition and remediation affect attrition, we surveyed 21 general surgery PDs’ attitudes toward resident attrition and calculated 5-year attrition rates (2010-2011 to 2014-2015). Firsttime pass rates on the Qualifying (QE) and Certifying (CE) Examinations of the American Board of Surgery (ABS) were collected. High- and low-attrition programs were compared. RESULTS: Overall, 85 of 1,183 residents (7.2%) left training during the study period (15 PGY-1 [17.6%], 34 PGY-2 [40%], 36 PGY3 or higher [42.4%]). The calculated annual attrition rate ranged from 0.73% to 6% (median 2.5%). Comparing high- (>3.4%) and low- (<1.5%) attrition programs, resident remediation was more frequent at low-attrition programs (21% vs 6.8%, p<0.001) (Table). QE and CE pass rates were similar (QE 92.5% vs 93%, p¼0.92; CE 81.5% vs 83%, p¼0.47). PDs at high-attrition programs were more likely to agree with the statement, “I feel it is my responsibility as PD to redirect residents who should not be surgeons.”
Variable Number of residents who left residency during the study period
High-attrition programs (n¼5 programs) (n¼323 residents), n (%)
9 (2.7)
36 (11.1)
TableContinued
Variable Year of residency when residents left PGY-1 PGY-2 PGY-3 or higher Destination of residents who left Left surgery for another discipline Left for a different surgery residency Left graduate medical education Residents undergoing remediation during study period
Low-attrition programs (n¼6 programs) (n¼328 residents), n (%)
High-attrition programs (n¼5 programs) (n¼323 residents), n (%)
p Value
1 (11) 2 (22) 6 (67)
8 (22) 13 (36) 12 (33)
0.78 0.58 0.22
4 (44)
18 (50)
0.77
1 (11)
9 (25)
0.65
4 (44)
9 (25)
0.46
69 (21)
22 (6.8)
<0.001
CONCLUSIONS: The median annual attrition rate was 2.5% and the 5-year attrition rate was 7.2%, both significantly lower than previously reported. Low-attrition programs were more likely to use resident remediation, yet maintained similar ABS pass rates. There were significant variations in attrition rate by program, some of which may be explained by PD attitudes toward remediation and attrition.
Resource Utilization in Implementing the Resident Prep Curriculum Christopher JO Neylan, Kristoffel R Dumon, MD, FACS, Rachel R Kelz, MD, FACS, Steven R Allen, MD, Noel N Williams, MD, FRCSI, Daniel T Dempsey, MD, FACS, Carla S Fisher, MD Hospital of the University of Pennsylvania, Philadelphia, PA INTRODUCTION: The American College of Surgeons, the Association of Program Directors in Surgery, and the Association for Surgical Education developed the Resident Prep Curriculum (published Spring 2015) to improve the quality of medical student preparation for surgical residency. We aim to assess the feasibility and resource use needed for implementation of this curriculum. METHODS: As 1 of 47 pilot institutions in 2015, our large, academic medical center expanded on a pre-existing 2-week surgical preparatory course, adding modules designed to meet the goals and objectives of the curriculum. We performed a formative evaluation of the resources required for these additions.
Table. Low-attrition programs (n¼6 programs) (n¼328 residents), n (%)
S131
p Value
<0.001 (Continued )
RESULTS: Our course offering satisfied each of the 6 domains outlined in the curriculum. It took place over a consecutive 4-week period in the spring of 2015, with 9 full and 9 half days with educational sessions. The course enrolled 22 students. To meet the needs of the curriculum, approximately 34 hours (41%) were spent in the classroom, 34 hours (41%) in a simulation center, and 15 hours
Scientific Forum Abstracts
nonphysician educators said they were “unlikely” to “neutral/unsure” whether they would incorporate a nonphysician educator within the next 2 years (mean 2.4, 95% 2.1-2.8). These opinions were significantly different (p<0.0001). CONCLUSIONS: Few programs assess incoming interns to establish baseline competencies. Programs who use a nonphysician educator are more likely to perform baseline testing. More investigation is needed to evaluate the difference in perceptions of PDs who do and do not use nonphysician educators. Resident Remediation and Program Director Attitudes Toward Categorical Surgical Resident Attrition at High- and Low-Attrition Programs Alexander C Schwed, MD, Steven L Lee, MD, Edgardo S Salcedo, MD, Mark E Reeves, MD, PhD, FACS, Kenji Inaba, MD, FACS, FRCSC, Richard A Sidwell, MD, FACS, Farin Amersi, MD, FACS, Chandrakanth Are, MBBS, MBA, FRCS FACS, Amy H Kaji, MD, PhD, Christian de Vir Harbor-University of California Los Angeles Medical Center, Torrance, CA INTRODUCTION: Though surgery resident attrition remains a concern, previous studies may have overestimated the rate of categorical resident attrition because preliminary residents were included. METHODS: To obtain a better measure of the categorical resident attrition rate, and determine whether program director (PD) attitudes about attrition and remediation affect attrition, we surveyed 21 general surgery PDs’ attitudes toward resident attrition and calculated 5-year attrition rates (2010-2011 to 2014-2015). Firsttime pass rates on the Qualifying (QE) and Certifying (CE) Examinations of the American Board of Surgery (ABS) were collected. High- and low-attrition programs were compared. RESULTS: Overall, 85 of 1,183 residents (7.2%) left training during the study period (15 PGY-1 [17.6%], 34 PGY-2 [40%], 36 PGY3 or higher [42.4%]). The calculated annual attrition rate ranged from 0.73% to 6% (median 2.5%). Comparing high- (>3.4%) and low- (<1.5%) attrition programs, resident remediation was more frequent at low-attrition programs (21% vs 6.8%, p<0.001) (Table). QE and CE pass rates were similar (QE 92.5% vs 93%, p¼0.92; CE 81.5% vs 83%, p¼0.47). PDs at high-attrition programs were more likely to agree with the statement, “I feel it is my responsibility as PD to redirect residents who should not be surgeons.”
Variable Number of residents who left residency during the study period
High-attrition programs (n¼5 programs) (n¼323 residents), n (%)
9 (2.7)
36 (11.1)
TableContinued
Variable Year of residency when residents left PGY-1 PGY-2 PGY-3 or higher Destination of residents who left Left surgery for another discipline Left for a different surgery residency Left graduate medical education Residents undergoing remediation during study period
Low-attrition programs (n¼6 programs) (n¼328 residents), n (%)
High-attrition programs (n¼5 programs) (n¼323 residents), n (%)
p Value
1 (11) 2 (22) 6 (67)
8 (22) 13 (36) 12 (33)
0.78 0.58 0.22
4 (44)
18 (50)
0.77
1 (11)
9 (25)
0.65
4 (44)
9 (25)
0.46
69 (21)
22 (6.8)
<0.001
CONCLUSIONS: The median annual attrition rate was 2.5% and the 5-year attrition rate was 7.2%, both significantly lower than previously reported. Low-attrition programs were more likely to use resident remediation, yet maintained similar ABS pass rates. There were significant variations in attrition rate by program, some of which may be explained by PD attitudes toward remediation and attrition.
Resource Utilization in Implementing the Resident Prep Curriculum Christopher JO Neylan, Kristoffel R Dumon, MD, FACS, Rachel R Kelz, MD, FACS, Steven R Allen, MD, Noel N Williams, MD, FRCSI, Daniel T Dempsey, MD, FACS, Carla S Fisher, MD Hospital of the University of Pennsylvania, Philadelphia, PA INTRODUCTION: The American College of Surgeons, the Association of Program Directors in Surgery, and the Association for Surgical Education developed the Resident Prep Curriculum (published Spring 2015) to improve the quality of medical student preparation for surgical residency. We aim to assess the feasibility and resource use needed for implementation of this curriculum. METHODS: As 1 of 47 pilot institutions in 2015, our large, academic medical center expanded on a pre-existing 2-week surgical preparatory course, adding modules designed to meet the goals and objectives of the curriculum. We performed a formative evaluation of the resources required for these additions.
Table. Low-attrition programs (n¼6 programs) (n¼328 residents), n (%)
S131
p Value
<0.001 (Continued )
RESULTS: Our course offering satisfied each of the 6 domains outlined in the curriculum. It took place over a consecutive 4-week period in the spring of 2015, with 9 full and 9 half days with educational sessions. The course enrolled 22 students. To meet the needs of the curriculum, approximately 34 hours (41%) were spent in the classroom, 34 hours (41%) in a simulation center, and 15 hours