quitters

[HighPriest]

I partially agree. But grit is not everything, a person is not a mountain.

The most important predictor in my opinion, excluding glaring cases or poor fit, is lack of attending support or role figures.

People often forget that residency is a learning period. Hiding in the midst of all bs, the most important thing is learning.

If you are a resident that lands a spot with unsupportive staff , no one throws you a rope, soon and very easily you can become the bad resident, little defects spiral into something everybody talks about.

It is as simple as an attending being or not being invested in your training.

Agree with that. Of the N of 2 residents I’ve seen fail, both had no support. Once it looked like they were starting to sink, people just threw them anchors. Maybe one conversation like “Hey, bucko. Chin up.” Probably more demeaning than helpful. After that, it was typically “why aren’t you doing better?”
The problem is that most surgical residents do extremely well, especially considering the pressure and circumstances they’re put into. So, when someone flounders, the pack eats the pup. But we have a major physician shortage, so that might not be the best approach. I think there’s a point at which you need to sit a resident down and say “you know, maybe surgery isn’t for you.” I also think that needs to be sooner rather than later, for the resident’s benefit. You don’t want to be 4 years in before someone says that to you. But there’s time in between to help them work through issues that might not have anything to do with work.
I know I had some personal issues during the peak stress period of my residency (my wife’s health), and I got very little support. It was a struggle but once it was over I was just fine. It would have helped quite a bit to have just had someone back me up during that period of time.

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