This book is an analysis of the factors in the dropout of surgical residents from their training programs. It was originally initiated by a neurosurgical society to address a 25% dropout rate in their house staff. The study was begun in 1990; after collecting information from surveys of 556 residencies in anesthesiology, general surgery, orthopedic surgery, and plastic surgery, 75 interviews were carried out in 5 neurosurgical programs. The last years of the survey group were 1993-1994.
The author is a social scientist, and she analyzed the data in a relatively careful statistical manner. Data on such issues as sex, minority race/ethnicity, perceived satisfactory surgical traits, fatigue of the workday, and family issues were studied as they applied to resignations. Those who resigned most commonly cited stress as the cause. Family pressures were the second most common reason, especially in women. Faculty advice of incompetence was the third reason.
The problems of the terminated house staff were recognized by the faculty in the first year. Inappropriate behavior was the most common problem cited by the faculty.
There are some real problems, however, with the author's basic approach. Why not include information on residencies in head and neck surgery, urology, and gynecology? Do the different specialties have the same problems? Why include anesthesiology? There is no mention of the Residency Review Committees for the Accreditation Committee for Graduate Medicine Education, which accredits each program and has extensive information on each and every dropout. The author also did not make use of the data available for each resident on each year's cognitive written In-Training Examination.
This information is now more than a decade old, and much has changed in surgical training programs. The mandated 80-hour work week currently in force contrasts with the 125-hour work week typical for the study group a decade ago. The sex and minority race/ethnicity problems still exist, despite efforts at seeking diversity. Accordingly, this book should be reviewed by program chiefs as a criticism of the old methods and a stimulus for continued change.
Financial Disclosures: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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