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Medical School Perspective

Dorothy A. Andriole, MD; Donna B. Jeffe, PhD; Heather L. Hageman, MBA; Mary E. Klingensmith, MD; Rebecca P. McAlister, MD; Alison J. Whelan, MD

Arch Surg. 2008;143(12):1172-1177.

Objective  To identify predictors of attrition during graduate medical education (GME) in a single medical school cohort of contemporary US medical school graduates.

Design  Retrospective cohort study.

Setting  Single medical institution.

Participants  Recent US allopathic medical school graduates.

Main Outcome Measure  Attrition from initial GME program.

Results  Forty-seven of 795 graduates (6%) did not complete the GME in their initial specialty of choice. At bivariate analysis, attrition was associated with election to the Alpha Omega Alpha Honor Medical Society, being an MD-PhD degree holder, and specialty choice (all P < .05). Attrition was not associated with graduation year (P = .91), sex (P = .67), or age (P = .12). In a multivariate logistic regression model, MD-PhD degree holder (odds ratio, 3.43; 95% confidence interval, 1.27-9.26; P = .02), election to Alpha Omega Alpha (2.19; 1.04-4.66; P = .04), choice of general surgery for GME (5.32; 1.98-14.27; P < .001), and choice of 5-year surgical specialty including those surgical specialties with a GME training requirement of 5 years or longer (2.74; 1.16-6.44; P = .02) each independently predicted greater likelihood of attrition.

Conclusion  Academically highly qualified graduates and graduates who chose training in general surgery or in a 5-year surgical specialty were at increased risk of attrition during GME.

Author Affiliations: Departments of Surgery (Drs Andriole and Klingensmith), Medicine (Dr Jeffe), Obstetrics and Gynecology (Dr McAlister), and Medicine and Pediatrics (Dr Whelan), and Office of Medical Student Education (Ms Hageman), Washington University School of Medicine, St Louis, Missouri.

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Arch Surg. 2008;143(12):1177.
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