On Resident attrition...

[SouthernSurgeon]

This study has been getting a lot of legs lately:

Who Makes It to the End?: A Novel Predictive Model for... : Annals of Surgery


The topic of attrition comes up a lot in this forum. I would say most of us (myself included) tend to be if anything somewhat dismissive of it. Reading this study and some of the commentary on it on social media has made me change my tune a bit.

I've said in the past from my personal experiences, that the people I know who quit did so because they were unhappy, and quitting was a "good" outcome for them as it enabled them to find a field that was a better fit. I still think, knowing those individuals, that that was true. But I guess the question is what could we do differently (either at the selection level or the mentorship/retention level)?

The authors of this study challenge that notion that some attrition is expected/healthy - namely because our peers in fields like ENT and ortho don't seem to have the same problem. You can't blame it on "inadequate exposure" as a student when it seems these other surgical fields do just fine with selection and recruitment.

I do worry a little bit about the possibility of "profiling" applicants based on this data - were I the PD of a large academic program I would certainly be worried about my minority women residents (40% attrition rate!!).

Another (counter-intuitive) finding was that having family nearby was not a protective factor but rather a risk factor for attrition.

Overall an interesting study. But I think the real challenge for the authors (and other educators) is how to put that information to good use.

Anyway, an interesting study, or at least so I thought. Anyone have any brilliant insights/critiques/solutions?

@Winged Scapula @SLUser11 @ThoracicGuy @dpmd @MediCane2006 @LucidSplash @thedrjojo @balaguru @vhawk

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[thedrjojo]

This study has been getting a lot of legs lately:

Who Makes It to the End?: A Novel Predictive Model for... : Annals of Surgery


The topic of attrition comes up a lot in this forum. I would say most of us (myself included) tend to be if anything somewhat dismissive of it. Reading this study and some of the commentary on it on social media has made me change my tune a bit.

I've said in the past from my personal experiences, that the people I know who quit did so because they were unhappy, and quitting was a "good" outcome for them as it enabled them to find a field that was a better fit. I still think, knowing those individuals, that that was true. But I guess the question is what could we do differently (either at the selection level or the mentorship/retention level)?

The authors of this study challenge that notion that some attrition is expected/healthy - namely because our peers in fields like ENT and ortho don't seem to have the same problem. You can't blame it on "inadequate exposure" as a student when it seems these other surgical fields do just fine with selection and recruitment.

I do worry a little bit about the possibility of "profiling" applicants based on this data - were I the PD of a large academic program I would certainly be worried about my minority women residents (40% attrition rate!!).

Another (counter-intuitive) finding was that having family nearby was not a protective factor but rather a risk factor for attrition.

Overall an interesting study. But I think the real challenge for the authors (and other educators) is how to put that information to good use.

Anyway, an interesting study, or at least so I thought. Anyone have any brilliant insights/critiques/solutions?

@Winged Scapula @SLUser11 @ThoracicGuy @dpmd @MediCane2006 @LucidSplash @thedrjojo @balaguru @vhawk

Abstract seems interesting. Will look at further after QE

 

[dpmd]

Seems they could have asked the people leaving why they left. Would help answer some of the questions findings like this bring up.

 

[MediCane2006]

This study has been getting a lot of legs lately:

Who Makes It to the End?: A Novel Predictive Model for... : Annals of Surgery


The topic of attrition comes up a lot in this forum. I would say most of us (myself included) tend to be if anything somewhat dismissive of it. Reading this study and some of the commentary on it on social media has made me change my tune a bit.

I've said in the past from my personal experiences, that the people I know who quit did so because they were unhappy, and quitting was a "good" outcome for them as it enabled them to find a field that was a better fit. I still think, knowing those individuals, that that was true. But I guess the question is what could we do differently (either at the selection level or the mentorship/retention level)?

The authors of this study challenge that notion that some attrition is expected/healthy - namely because our peers in fields like ENT and ortho don't seem to have the same problem. You can't blame it on "inadequate exposure" as a student when it seems these other surgical fields do just fine with selection and recruitment.

I do worry a little bit about the possibility of "profiling" applicants based on this data - were I the PD of a large academic program I would certainly be worried about my minority women residents (40% attrition rate!!).

Another (counter-intuitive) finding was that having family nearby was not a protective factor but rather a risk factor for attrition.

Overall an interesting study. But I think the real challenge for the authors (and other educators) is how to put that information to good use.

Anyway, an interesting study, or at least so I thought. Anyone have any brilliant insights/critiques/solutions?

@Winged Scapula @SLUser11 @ThoracicGuy @dpmd @MediCane2006 @LucidSplash @thedrjojo @balaguru @vhawk

Interesting. Having a family weekend now but will revisit this week.

 

[deleted480308]

I'm interested in folks thoughts as well, some stuff there I wouldn't have expected

 

[LucidSplash]

As above. After QE. Haven't read but wonder if bigger hurdle to get in correlates to less attrition? (Re: ortho, ENT comparison).

 

[SLUser11]

I know the lead author and she is outstanding. I think it's an important paper, but would be more meaningful if the residents were followed in a longitudinal manner. I would be interested to see how personal factors such as health and childbirth play a role, and how professional factors such as evaluations/performance, case volume/diversity, mentorship, faculty diversity, etc impact attrition.

It's meant to be a predictive model, but I also fear that it may bias PDs during the selection process.

I looked around, but couldn't find any supplemental tables regarding the breakdown of other factors within the CART. It would be nice to see.

 

[SouthernSurgeon]

I know the lead author and she is outstanding. I think it's an important paper, but would be more meaningful if the residents were followed in a longitudinal manner. I would be interested to see how personal factors such as health and childbirth play a role, and how professional factors such as evaluations/performance, case volume/diversity, mentorship, faculty diversity, etc impact attrition.

It's meant to be a predictive model, but I also fear that it may bias PDs during the selection process.

I looked around, but couldn't find any supplemental tables regarding the breakdown of other factors within the CART. It would be nice to see.

While it would probably have involved exponentially more work, I agree with you that more longitudinal data would have been very interesting to see. At the very least try to readminister the same or similar survey to these residents during their chief year.

Given that this project had some support (at least in the form of sharing data) from the ABS, I wonder if it would be possible to conduct a similar survey on the day of the ABSITE (like they did for the FIRST trial). Would take a long time, but you could collect longitudinal data that way on the same residents from intern year on to graduation.

 

[vhawk]

I know the lead author and she is outstanding. I think it's an important paper, but would be more meaningful if the residents were followed in a longitudinal manner. I would be interested to see how personal factors such as health and childbirth play a role, and how professional factors such as evaluations/performance, case volume/diversity, mentorship, faculty diversity, etc impact attrition.

It's meant to be a predictive model, but I also fear that it may bias PDs during the selection process.

I looked around, but couldn't find any supplemental tables regarding the breakdown of other factors within the CART. It would be nice to see.

I know the final author and I can't wait to ask her how she feels about not taking anymore protected group women in residency programs

 

[mikeGR]

I personally know of 5 cases: 2 gen surg left during pgy 2 once they found an out of match spot for the sub-specialty field they really wanted (ent/ortho, gen surg was backup), one ortho left during pgy 3 because the program was too malignant, one gen surg left during pgy 3/4 because gen surg was too bad of a lifestyle for her, and one was basically fired because she violated terms of the employment contract.

I actually do think part of it is due to "inadequate exposure" and unrealistic expectations. We say it all the time, gen surg shouldn't be something you do unless you're really passionate about it. That's what keeps you going and tolerating the variable levels of "abuse" (by the system, patients, nurses, residents, attendings etc). When you don't have that passion/drive, it's more likely to give up.

I agree that the article brings up some great data regarding risk factors for attrition. Female gender, minority, large program to name a few. Another study had indicated that female residents with family were much more likely to burnout than those without one, and the opposite effect of family on males (having a spouse/family was a risk factor for females, but protective factor for males). Looking at the bigger picture, attrition has to do with support systems, and we need to have support systems both outside and inside the hospital. Having a supportive family and friends must be a protective factor. The challenge is to create such protective systems inside the hospital/residency. At our program we are currently trying to create such a system. I'll keep y'all posted.

And sadly I am pretty sure this study will lead to further profiling of applicants...

 

[Jolie South]

The authors of this study challenge that notion that some attrition is expected/healthy - namely because our peers in fields like ENT and ortho don't seem to have the same problem. You can't blame it on "inadequate exposure" as a student when it seems these other surgical fields do just fine with selection and recruitment.

While residency in these other specialties may be as hard as general surgery hours or malignancy wise, so much of what we do in general surgery has a life or death consequence. I don't think that holds true for orthopedics, urology, ENT, etc. For some people, I think that stress in combination with the hard work is too much. I know people who haven't quit residency but are now trying to get fellowships in breast or plastics because of this. I personally like that and find satisfaction in knowing that I did my best to prolong life. But when a patient dies after we have done all the right things, I also am able to see that and don't place personal blame. Some people don't have that ability, I think.

The resident that I know that quit general surgery residency was in a difficult personal situation in her intern year(i.e. living in a different state away from her husband) and couldn't handle it.

 

[XCdude]

as someone who recently left general surgery for another surgical specialty, I find this article particularly interesting.

I was at a medium mid tire academic program, with many protective factors in terms of finishing the program. But, my program was malignant, poorly ran and inequitable in regards to treatment of house staff.

In short, I left because I had a horrible boss and my program and training was a reflection of him and not what I needed to be successful in practice. Thus, when the opportunity came to leave and do what I ultimately wanted to do I took it without a second thought, despite the hassle involved of moving cross country and selling my home

I think ultimately general surgery has a horrible culture. few fields eat their young like general surgery. If one wants to improve retention, we need to look internally. Our colleagues in neurosurgery don't have near the amount of retention issues. I don't think stress and the ability to handle stress are reasons people quit. I think many quit because it simply sucks and the amount of pay relative to work sucks. Every surgical subspecialty pays more, works less and is better treated than general surgery. Furthmore, most programs aren't creating competent graduates who can operate, safely without a fellowship so why wouldn't more people quit?

 

[AcademicNeurosurgery]

as someone who recently left general surgery for another surgical specialty, I find this article particularly interesting.

I was at a medium mid tire academic program, with many protective factors in terms of finishing the program. But, my program was malignant, poorly ran and inequitable in regards to treatment of house staff.

In short, I left because I had a horrible boss and my program and training was a reflection of him and not what I needed to be successful in practice. Thus, when the opportunity came to leave and do what I ultimately wanted to do I took it without a second thought, despite the hassle involved of moving cross country and selling my home

I think ultimately general surgery has a horrible culture. few fields eat their young like general surgery. If one wants to improve retention, we need to look internally. Our colleagues in neurosurgery don't have near the amount of retention issues. I don't think stress and the ability to handle stress are reasons people quit. I think many quit because it simply sucks and the amount of pay relative to work sucks. Every surgical subspecialty pays more, works less and is better treated than general surgery. Furthmore, most programs aren't creating competent graduates who can operate, safely without a fellowship so why wouldn't more people quit?

A few thoughts...first, congrats on your move and I hope you are finding more satisfaction in your new program. If you don't mind me asking, why did you switch to another surgical specialty rather than another general surgery residency program? And what surgical specialty did you switch to? The reason I ask is because you said your specific program was malignant but then you go on to say general surgery as a whole is malignant. No field is without problems, and general surgery certainly has it's fair share of issues. Based on the factors you listed for general surgery (long hours, less pay, etc), however, it seems like the bigger issue is that GS may not have been the right field for you.

I also wonder how much of the attrition in general surgery has to do with people who wanted to do a surgical specialty but didn't match/weren't competitive. N=1 but I know a peer who wanted to do ortho and didn't match. Ended up matching the next year in GS and is pretty miserable. I am certain he will finish training but he often talks about how he sees medicine as more of a job now than had he gotten into ortho. Should he ever be involved in teaching medical students/residents, it is possible his resentment for not matching ortho could manifest as him being a 'malignant' attending. Not saying it will as he may grow out of this phase, but I wouldn't be surprised given how much he loved ortho. And I am sure these kind of examples are a dime a dozen.

 

[TypeADissection]

A few thoughts...first, congrats on your move and I hope you are finding more satisfaction in your new program. If you don't mind me asking, why did you switch to another surgical specialty rather than another general surgery residency program? And what surgical specialty did you switch to? The reason I ask is because you said your specific program was malignant but then you go on to say general surgery as a whole is malignant. No field is without problems, and general surgery certainly has it's fair share of issues. Based on the factors you listed for general surgery (long hours, less pay, etc), however, it seems like the bigger issue is that GS may not have been the right field for you.

I also wonder how much of the attrition in general surgery has to do with people who wanted to do a surgical specialty but didn't match/weren't competitive. N=1 but I know a peer who wanted to do ortho and didn't match. Ended up matching the next year in GS and is pretty miserable. I am certain he will finish training but he often talks about how he sees medicine as more of a job now than had he gotten into ortho. Should he ever be involved in teaching medical students/residents, it is possible his resentment for not matching ortho could manifest as him being a 'malignant' attending. Not saying it will as he may grow out of this phase, but I wouldn't be surprised given how much he loved ortho. And I am sure these kind of examples are a dime a dozen.

I agree with above. General surgery is often used as a backup for many of the other more competitive surgical subspecialties. The problem is, general surgery is so uniquely painful that if you're not all in, it can be the most miserable thing anyone could ever do. I couldn't even imagine wanting to do let say ENT or Ortho and ending up in a general surgery program working on butt stuff, SBOs, and mountains upon mountains of BS trauma. It's just too painful unless you love this. I have had similar experiences with senior residents (N =2) who wanted ortho or uro and although had strong scores, just didn't match after two application cycles. Their general viewpoint and attitude towards general surgery patients at times became somewhat toxic (although being a junior resident and workhorse for a program has a way of bringing out the worst and trying your patience). Eventually, as they continued to advance and reality set in that this was going to be their lives, they got much better. On a side note, good luck to everyone preparing to sit for the QE in 4 days. The end is almost in sight. Cheers.

 

[XCdude]

A few thoughts...first, congrats on your move and I hope you are finding more satisfaction in your new program. If you don't mind me asking, why did you switch to another surgical specialty rather than another general surgery residency program? And what surgical specialty did you switch to? The reason I ask is because you said your specific program was malignant but then you go on to say general surgery as a whole is malignant. No field is without problems, and general surgery certainly has it's fair share of issues. Based on the factors you listed for general surgery (long hours, less pay, etc), however, it seems like the bigger issue is that GS may not have been the right field for you.

I also wonder how much of the attrition in general surgery has to do with people who wanted to do a surgical specialty but didn't match/weren't competitive. N=1 but I know a peer who wanted to do ortho and didn't match. Ended up matching the next year in GS and is pretty miserable. I am certain he will finish training but he often talks about how he sees medicine as more of a job now than had he gotten into ortho. Should he ever be involved in teaching medical students/residents, it is possible his resentment for not matching ortho could manifest as him being a 'malignant' attending. Not saying it will as he may grow out of this phase, but I wouldn't be surprised given how much he loved ortho. And I am sure these kind of examples are a dime a dozen.

I thought about transferring into another general surgery program but wasn't able to get support to do that...I was in a malignant program and in a specialty I hated and tried to make the best of. Like a lot of GS residents any port in a storm will do when you're going through the match.

Given that I had developed a network of connected people in my chosen field that was/is a fellowship and an integrated residency I jumped ship when I could.

I'm much happier and far more interested in my day to day stuff and excited for the future.

I think general surgery just was a terrible fit for me and made me miserable because it is a miserable job. Just look around at a lot of senior general surgeons and you'll find some of the most maladjusted, overweight, overworked and unhappy people you will ever meet. Then, compare them with their counterparts in ENT/GU/ortho/plastics and see who's happier. General surgery in my opinion just never gets better, only worse which is why it has an abusive culture.

The only gratifying part of general surgery is operating and that made it awful for me. I have zero interest in non-op mgmt.

 

[Dr.LeoSpaceman]

I was in a malignant program and in a specialty I hated and tried to make the best of.

I still don't get this whole "general surgeons are the most miserable people". This has not been my experience at all. And while I'm at a fairly benign program, my friends at other programs don't seem to have this feeling either.

One might consider that if you're miserable, it's hard to hide and that is sure to color others attitude towards you.

 

[AdmiralChz]

I still don't get this whole "general surgeons are the most miserable people". This has not been my experience at all. And while I'm at a fairly benign program, my friends at other programs don't seem to have this feeling either.

One might consider that if you're miserable, it's hard to hide and that is sure to color others attitude towards you.

While I didn't train as a general surgeon, the GS program at my institution was notably pretty rough and "malignant." I had many friends in the GS program, many were absolutely miserable and just going through the motions trying to get through as the training was solid and the name was excellent overall with a track record of good fellowship placements.

Rather than just assume all general surgeons are d*cks, it's important to try to understand why some have such short fuses and come across so aggressively. At my institution, physicians were notoriously underpaid and, coupled with faculty retiring/leaving for other jobs without quick replacements, quite overworked. The Trauma team in particular was so short the newer general surgeons of colorectal/pancreatic/minimally invasive variety took regular in-house overnight call which was a new phenomenon in this past year. Then you throw in an OR that has great difficulty with rentention with tons of new hires and locums rotating through... it makes for a difficult work environment, particularly in urgent/emergent circumstances. The surgeons get frustrated with the above, the anger (unfortunately) gets passed down the ranks to the chiefs, to the juniors, to the interns etc... They've had above-average attrition to other specialities (anesthesia, ortho, IM off the top of my head) for some time and I've witnessed more than one complete breakdown of general surgery residents in the hospital. I didn't see this in medical school or at my new institution.

Anyway, things are a lot more positive at my fellowship institution with the general surgery folks. Overall work environment makes a big difference and if it's nasty, can impact even the most positive of people.

 

[dpmd]

I thought about transferring into another general surgery program but wasn't able to get support to do that...I was in a malignant program and in a specialty I hated and tried to make the best of. Like a lot of GS residents any port in a storm will do when you're going through the match.

Given that I had developed a network of connected people in my chosen field that was/is a fellowship and an integrated residency I jumped ship when I could.

I'm much happier and far more interested in my day to day stuff and excited for the future.

I think general surgery just was a terrible fit for me and made me miserable because it is a miserable job. Just look around at a lot of senior general surgeons and you'll find some of the most maladjusted, overweight, overworked and unhappy people you will ever meet. Then, compare them with their counterparts in ENT/GU/ortho/plastics and see who's happier. General surgery in my opinion just never gets better, only worse which is why it has an abusive culture.

The only gratifying part of general surgery is operating and that made it awful for me. I have zero interest in non-op mgmt.

Don't know where you have been working, but that isn't the experience I have seen at all. My med school had a fairly malignant GS residency but where I am at now and at many of the places I rotated at in residency things were not malignant and the senior surgeons were pretty happy and good to work with. And this is coming from someone who had to do surgery because of not matching in the preferred specialty. I purposefully sought out a better training environment because I knew that I wanted to make the best of a second choice situation. There was plenty of malignancy present in the preferred specialty during training and there were plenty of miserable maladjusted senior surgeons in that field that I encountered as a student. But I would have been willing to suck it up for 5 yrs in order to get the training. You weren't because it wasn't a specialty you had enough interest in. As for it not getting better, just a few years out of residency my part time workweek that earns me good money and involves lots of operating that I enjoy argues against that. The people in miserable jobs are there because of their priorities, not because there is no other option.

 

[balaguru]

It took me a while to find institutional access to the paper but I read it and the comments that followed. A few of the findings were interesting but it wasn't particularly shocking to find that women have a harder time in residency. It will be interesting to see what follows from these investigators. They suggested that they are working on several different questions.

My criticism is that that while this paper focuses on resident qualities and broad generalizations of programs (region, type, size) I suspect that attrition may cluster around a certain set of individual programs. This was of course lost with the way they de-identified data. I would love to see a histogram that shows the distribution of noncompletion events. I think about where I trained. It was a large program. At any given time there were around 13 x 5 = 65 residents and yet I can only think of 2 or 3 residents who left of their own volition.

Is noncompletion data available for programs? If not, I am willing to bet that if you required programs to publish this data you might see attrition numbers go down. Applicants would have more informed expectations and programs might institute sensible policies to address the issue.

On the subject of general surgery as a field, I can probably go on and on based on what I've learned in starting my practice but that is probably best left to another thread.

 

[thedrjojo]

This year was one of my programs worst for attrition.

Two of 8 interns left. One matched into our departments integrated plastics program. Another left for anesthesia after realizing surgery wasn't a fit for them. A pgy2 also was lost. A pgy3 took family leave, will sit out this coming year, then return as a pgy3 the following year (That's the plan at least. Not sure if this counts as attrition). We also lost 2 pgy2 prelims mid stream...

We had previously probably did better than the 20% average but in general it was the move of gs to anesthesia or gs to lab to a more prestigious program affiliated with the lab they worked in.

I think our med schools fail students more than ever, but I think major paradigm changes are needed to our training model. I've been told they have no concerns I couldn't be a general surgeon today and the chief at my VA offered me a job if I wanted it, but that isn't the case with all the graduated at my program, nor most programs. The regulatory and political climate is also fairly bleak.

I think this report will be looked at and taken with a grain of salt, but hopefully large amounts of profiling won't happen from it

 

[armybound]

I think there's a big difference between what you think you're getting yourself in to and what you actually are. You don't understand a field until you're really in it living day to day, and gen surg is brutal. My hat really goes off to you guys. That's rigorous training and it seems to me like it's vastly underappreciated throughout all other specialties and, at my training site, within the program itself.

We're on the verge of losing our first resident if something doesn't change, and it's very difficult. We are definitely very patient, forgiving, and supportive without much of a "malignant" attitude. The workload on a new PGY2 can be overwhelming, even for someone who did well in medical school or as an intern. It's the first time in my field that you see what it's really all about, so you might be that far in and finally realize it's not for you, or it's more work than you intended to do, or it's not as easy to grasp as you thought it would be.

We obviously choose people who we feel are smart and capable, but also put a huge weight on personality. I can't think of a way you can judge how a resident applicant deals with day in and day out stress, sleep deprivation, anxiety, etc. I don't think anyone knows how they will react to it until they're living it.

 

[Pir8DeacDoc]

We obviously choose people who we feel are smart and capable, but also put a huge weight on personality. I can't think of a way you can judge how a resident applicant deals with day in and day out stress, sleep deprivation, anxiety, etc. I don't think anyone knows how they will react to it until they're living it.

Reminds me of the Mike Tyson Quote:
"Everyone has a plan until they get punched in the mouth"
Indeed

 

[TypeADissection]

Reminds me of the Mike Tyson Quote:
"Everyone has a plan until they get punched in the mouth"
Indeed

Speaking of Iron Mike, another hidden gem of a quote: "They called me a 'rapist' and a 'recluse.' I'm not a recluse."

 

[Apollyon]

My last year of EM residency at Duke, the PGY-1s for ENT were both female, and, at least one of the 2 PGY-2s (because I don't recall who was the other PGY-2). I mention this, because both ENT 1s did not return for PGY-2, and the PGY-2 woman left in mid year. That meant that, the next year, there was one PGY-3, and zero PGY-2s. I have no idea what Duke did, as to recruiting to fill those holes, or what. As I look now, I can't find anything online about 2 of the 3 women (I don't recall the name of the third) in medicine anywhere. There was no scuttlebutt about malignancy (although, at Duke, that is synonymous, more or less).

 

[JamesPotterMS-3]

My last year of EM residency at Duke, the PGY-1s for ENT were both female, and, at least one of the 2 PGY-2s (because I don't recall who was the other PGY-2). I mention this, because both ENT 1s did not return for PGY-2, and the PGY-2 woman left in mid year. That meant that, the next year, there was one PGY-3, and zero PGY-2s. I have no idea what Duke did, as to recruiting to fill those holes, or what. As I look now, I can't find anything online about 2 of the 3 women (I don't recall the name of the third) in medicine anywhere. There was no scuttlebutt about malignancy (although, at Duke, that is synonymous, more or less).

... but but but diversity

 

[Dr.LeoSpaceman]

... but but but diversity

It's unclear what your actual point is here. If it's that this is evidence that efforts to promote gender diversity in surgery are miguided, then you've clearly missed the point of the thread (and the original article).

 

[neoevolution]

My last year of EM residency at Duke, the PGY-1s for ENT were both female, and, at least one of the 2 PGY-2s (because I don't recall who was the other PGY-2). I mention this, because both ENT 1s did not return for PGY-2, and the PGY-2 woman left in mid year. That meant that, the next year, there was one PGY-3, and zero PGY-2s. I have no idea what Duke did, as to recruiting to fill those holes, or what. As I look now, I can't find anything online about 2 of the 3 women (I don't recall the name of the third) in medicine anywhere. There was no scuttlebutt about malignancy (although, at Duke, that is synonymous, more or less).

At an institution known for malignant programs, retention that low of women in a surgical subspecialty makes me wonder about how they were treated. ENT actually has pretty good retention from what I recall on discussions of gen surg v subspecialty retention, so 3 women leaving a small, highly competitive program that's mostly men suggests more about the culture of that residency program than the women IMO.

 

[evilbooyaa]

At an institution known for malignant programs, retention that low of women in a surgical subspecialty makes me wonder about how they were treated. ENT actually has pretty good retention from what I recall on discussions of gen surg v subspecialty retention, so 3 women leaving a small, highly competitive program that's mostly men suggests more about the culture of that residency program than the women IMO.

Maybe they were forced to take birth control to avoid maternity leave like OSU

 

[deleted547339]

Maybe they were forced to take birth control to avoid maternity leave like OSU

Uhhhhhh.....what????

 

[Smurfette]

Uhhhhhh.....what????

IIRC, there were allegations that OSU's urology PD demanded the female residents be on birth control to ensure they didn't take maternity leave. This was part of a larger series of allegations against the PD a few years ago.

 

[Light at end of tunnel]

Uhhhhhh.....what????

Dr. Bahnson - former chairman of ohio state Urology Residency; Bahnson was the Chairman, but he effectively controlled every aspect of the program through his crony and PD Geoffrey Box

He forced his female residents to take birth control to avoid having to deal with things like maternity leave. No joke.

 

[Wordead]

My last year of EM residency at Duke, the PGY-1s for ENT were both female, and, at least one of the 2 PGY-2s (because I don't recall who was the other PGY-2). I mention this, because both ENT 1s did not return for PGY-2, and the PGY-2 woman left in mid year. That meant that, the next year, there was one PGY-3, and zero PGY-2s. I have no idea what Duke did, as to recruiting to fill those holes, or what. As I look now, I can't find anything online about 2 of the 3 women (I don't recall the name of the third) in medicine anywhere. There was no scuttlebutt about malignancy (although, at Duke, that is synonymous, more or less).

At an institution known for malignant programs, retention that low of women in a surgical subspecialty makes me wonder about how they were treated. ENT actually has pretty good retention from what I recall on discussions of gen surg v subspecialty retention, so 3 women leaving a small, highly competitive program that's mostly men suggests more about the culture of that residency program than the women IMO.

Duke had a notoriously malignant ENT program and until last year I think was the only program that went unfilled in the match. People often attributed it to them being a part of the general surgery department rather than separate. Word is that they're better now.