In the ACGME data book, attrition from residency program is recorded as deceased, dismissal, transfer, or withdrawal. In most cases, is withdrawal essentially an euphemism for dismissal in a sense that the program lets the resident withdrawal instead of being dismissed? It would be interesting to hear the perspectives of program directors on this question. I have a hard time believing that a resident would withdraw from a program when there is not already another place lined up (ie. transfer).