J. S. Abelson1, H. L. Yeo1,4, M. Symer1, N. Wong1, F. Michelassi1, R. Bell5, J. A. Sosa2 1Weill Cornell Medical College,Surgery,New York, NY, USA 2Duke University Medical Center,Surgery,Durham, NC, USA 3American Board Of Surgery, Inc,Philadelphia, PA, USA 4Weill Cornell Medical College,Healthcare Policy And Research,New York, NY, USA 5Temple University,Lewis Katz School Of Medicine,Philadelphia, PA, USA
Introduction: Medical school experience plays a role in the decision to pursue graduate surgical education. However, no studies have examined the effect of medical school experiences on a resident’s likelihood of completing general surgery training.
Methods: This is a national prospective longitudinal cohort study of all categorical general surgery (GS) interns who entered training in the 2007-2008 academic year. Interns were asked a series of questions related to their medical school experience and reasons for pursuing general surgery residency. Responses were linked with American Board of Surgery residency completion data. The primary outcome was completion of residency training. Multivariable Cox proportional hazards modeling was used to evaluate the association between medical school experiences and residency attrition.
Results: 792/1043 (76%) GS interns had complete survey data; 287 (36%) were female, 252 (32%) non-White, and 70 (8.8%) Hispanic. The overall attrition rate was 20%. After multivariable adjustment for survey respondent gender, race/ethnicity and residency program type and size, two factors related to medical experience were found to be associated with completion of training. Residents who had medical school experiences with surgery attendings who were happy with their careers were more likely to complete training than those who did not (Hazard Ratio [HR] = 0.60; p=0.01). In addition, residents who matched at their first choice training program were more likely to complete their residency compared to those who did not match at their top choice (HR = 0.69; p = 0.04). Having completed a sub-internship in surgery or having spent more time (0-8 wks vs. 9-12+ weeks) on surgical clerkships in the 3rd and 4th year were not associated with lower rates of attrition.
Conclusion: This is the first prospective national study to evaluate the potential association between medical school experiences and completion of general surgery residency. These findings offer important insight into how exposure to surgery during medical school may impact a learner’s likelihood of finishing residency training and underlines the importance of positive role models and mentors for the development of trainees.