MD I need advice. I don't know what to do.

[Dr.Bruh]

No residency banks on having residents drop out. That’s exactly one of the reasons for the Match in the first place, to weed out those who aren’t interested.

I know that there are anesthesia programs out there that specifically reserve a spot in their program for anticipated Gen surg drop out.

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[Taddy Mason]

According to this, psych is the highest at 6% with general surgery being the second highest at 2.7%.

The reason I asked is anecdotally (and according to a quick google search, e.g. here and here) the overall attrition rate for surgery (across ~5 years) is ~20%; I have a friend whose cohort is losing two residents this year alone. From the perspective of my field (neurology) losing even a single resident would have a pretty significant affect across all the classes for the average/smaller program.

If I'm reading the data you cited correctly, though, an annual attrition rate of 6% for psychiatry blows that out of the water...

Although this is not specifically germane to the current discussion regarding surgery, I would like to point out that that figure for psychiatry is probably not accurate.

Reading through that article, it's pretty ambiguous as to how they're getting the figures for non-EM specialties. They define their study population as residents in an ACGME-accredited EM program. They describe their methods, but it's unclear whether those methods only relate to their study population or whether those are the methods they used to arrive at the data for all specialties. For our purposes here, I'll assume they used the same methods to assess attrition in psychiatry.

The article states the following:

There are two main ways to view resident attrition: There is attrition from the training program the resident initially enrolled in, and there is attrition from the specialty altogether. For several reasons, we chose the most inclusive definition by counting all attrition statuses, including attrition from one EM program to go to another EM program as well as attrition from the specialty altogether.​

This leads me to believe that they assessed the attrition in psychiatry by including any resident who switches programs prior to the completion of their full 4 years of categorical residency in the attrition group. They don't explicitly describe the details of how this was determined for psych residents but my strong suspicion is that residents who fast-tracked into child psychiatry got lumped into the attrition group. That is, these residents were part of a 4-year general psychiatry program but left their program in PGY-4 to start a 2-year child psychiatry fellowship where the first year is counts as their last year of general psychiatry training.

This would inflate the attrition numbers for psychiatry. I don't think that fast-tracking into child is reasonably seen as attrition for many meaningful purposes.

Anecdotally, a 6% attrition rate seems extremely high to me for psychiatry, which is why I strongly suspect that something's off about how they're measuring it.

The artificially high attrition rate in psych pops up in the Allo and Psych forum from time to time. Based on how the data is sorted in the various sources I've seen posted on here over the years it doesn't account for people who fast track into CAP (i.e., they're counted as people who didn't finish residency), thus appears much higher than it actually is. Supporting this is when the attrition rate is broken down by year it's highest after PGY-3 for psych.
Cause for Large Amount of Attrition in Psych Residency?

 

[Phloston]

Match day today... I matched to IM.. my 10th rank. I had 9 categorical gen surg interviews.

I am devastated. What are my options? I know that the NRMP considers your contract "complete" after 45 days. Can I look for spots that open up for categorical PGY1 surgery after July 1st? Or can I use the program that searches for open residency spots and potentially change spots any time during my IM intern year?

I know that I can reapply for the match (and I will), but can I apply for PGY2 after 1 year of IM? If I reapply for the match and don't match, does this mean that I will lose my current residency spot?

I was meant for surgery. This COVID/virtual stuff was just so difficult for me. I applied IM as a backup ONLY because of this year's abnormalities.

Any advice is appreciated.

Try to stay positive about things. Plenty of people don't match. You matched into a program you ranked. That was your call. Are you really "devastated." Not to infuse you with the philosophical, but this is sort of how life works. And for the better. That is, you go to a program you hadn't originally intended on going to, and things work out great. You meet X female, encounter Y opportunity, etc.