Attrition rates in neurosurgery residency: analysis of 1361 consecutive residents matched from 1990 to 1999

Gabrielle Lynch Department of Neurosurgery, New York University School of Medicine, New York, New York;

Search for other papers by Gabrielle Lynch in
Current site
Google Scholar
PubMed
Close
,
Karina Nieto Department of Neurosurgery, Northwestern University School of Medicine, Chicago, Illinois;

Search for other papers by Karina Nieto in
Current site
Google Scholar
PubMed
Close
 BA
,
Saumya Puthenveettil Department of Neurosurgery, New York University School of Medicine, New York, New York;

Search for other papers by Saumya Puthenveettil in
Current site
Google Scholar
PubMed
Close
 MS
,
Marleen Reyes Department of Neurosurgery, New York University School of Medicine, New York, New York;

Search for other papers by Marleen Reyes in
Current site
Google Scholar
PubMed
Close
 BA
,
Michael Jureller Department of Neurosurgery, New York University School of Medicine, New York, New York;

Search for other papers by Michael Jureller in
Current site
Google Scholar
PubMed
Close
 BS
,
Jason H. Huang Department of Neurosurgery, University of Rochester School of Medicine, Rochester, New York;

Search for other papers by Jason H. Huang in
Current site
Google Scholar
PubMed
Close
 MD
,
M. Sean Grady Department of Neurosurgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania;

Search for other papers by M. Sean Grady in
Current site
Google Scholar
PubMed
Close
 MD
,
Odette A. Harris Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California;

Search for other papers by Odette A. Harris in
Current site
Google Scholar
PubMed
Close
 MD, MPH
,
Aruna Ganju Department of Neurosurgery, Northwestern University School of Medicine, Chicago, Illinois;

Search for other papers by Aruna Ganju in
Current site
Google Scholar
PubMed
Close
 MD
,
Isabelle M. Germano Department of Neurosurgery, Mount Sinai School of Medicine, New York, New York;

Search for other papers by Isabelle M. Germano in
Current site
Google Scholar
PubMed
Close
 MD
,
Julie G. Pilitsis Department of Neurosurgery, Albany Medical College, Albany, New York;

Search for other papers by Julie G. Pilitsis in
Current site
Google Scholar
PubMed
Close
 MD, PhD
,
Susan C. Pannullo Department of Neurosurgery, Weill Cornell Medical College, New York, New York;

Search for other papers by Susan C. Pannullo in
Current site
Google Scholar
PubMed
Close
 MD
,
Deborah L. Benzil Department of Neurosurgery, Columbia University, New York, New York;

Search for other papers by Deborah L. Benzil in
Current site
Google Scholar
PubMed
Close
 MD
,
Aviva Abosch Department of Neurosurgery, University of Colorado, Denver, Colorado; and

Search for other papers by Aviva Abosch in
Current site
Google Scholar
PubMed
Close
 MD, PhD
,
Sarah J. Fouke Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington

Search for other papers by Sarah J. Fouke in
Current site
Google Scholar
PubMed
Close
 MD
, and
Uzma Samadani Department of Neurosurgery, New York University School of Medicine, New York, New York;

Search for other papers by Uzma Samadani in
Current site
Google Scholar
PubMed
Close
 MD, PhD
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $536.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $636.00
USD  $45.00
USD  $536.00
USD  $636.00
Print or Print + Online Sign in

OBJECT

The objective of this study is to determine neurosurgery residency attrition rates by sex of matched applicant and by type and rank of medical school attended.

METHODS

The study follows a cohort of 1361 individuals who matched into a neurosurgery residency program through the SF Match Fellowship and Residency Matching Service from 1990 to 1999. The main outcome measure was achievement of board certification as documented in the American Board of Neurological Surgery Directory of Diplomats. A secondary outcome measure was documentation of practicing medicine as verified by the American Medical Association DoctorFinder and National Provider Identifier websites. Overall, 10.7% (n = 146) of these individuals were women. Twenty percent (n = 266) graduated from a top 10 medical school (24% of women [35/146] and 19% of men [232/1215], p = 0.19). Forty-five percent (n = 618) were graduates of a public medical school, 50% (n = 680) of a private medical school, and 5% (n = 63) of an international medical school. At the end of the study, 0.2% of subjects (n = 3) were deceased and 0.3% (n = 4) were lost to follow-up.

RESULTS

The total residency completion rate was 86.0% (n = 1171) overall, with 76.0% (n = 111/146) of women and 87.2% (n = 1059/1215) of men completing residency. Board certification was obtained by 79.4% (n = 1081) of all individuals matching into residency between 1990 and 1999. Overall, 63.0% (92/146) of women and 81.3% (989/1215) of men were board certified. Women were found to be significantly more at risk (p < 0.005) of not completing residency or becoming board certified than men. Public medical school alumni had significantly higher board certification rates than private and international alumni (82.2% for public [508/618]; 77.1% for private [524/680]; 77.8% for international [49/63]; p < 0.05). There was no significant difference in attrition for graduates of top 10–ranked institutions versus other institutions. There was no difference in number of years to achieve neurosurgical board certification for men versus women.

CONCLUSIONS

Overall, neurosurgery training attrition rates are low. Women have had greater attrition than men during and after neurosurgery residency training. International and private medical school alumni had higher attrition than public medical school alumni.

ABBREVIATIONS

AAMC = American Association of Medical Colleges; AANS = American Association of Neurological Surgeons; ABNS = American Board of Neurological Surgery; NPI = National Provider Identifier.
  • Collapse
  • Expand
  • 1

    Although a male-dominated field, more women are pursuing an orthopedic career. Orthopedics Today October 2103, (http://www.healio.com/orthopedics/business-of-orthopedics/news/print/orthopedics-today/%7B8e78161e-f87a-484fb61a-eb71d43ef2a6%7D/although-a-male-dominated-fieldmore-women-are-pursuing-an-orthopedic-career) [Accessed October 13, 2014]

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Ash AS, , Carr PL, , Goldstein R, & Friedman RH: Compensation and advancement of women in academic medicine: is there equity?. Ann Intern Med 141:205212, 2004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Association of American Medical Colleges: Table 1: Medical students, selected years. 1965. 2012. AAMC (https://www.aamc.org/download/305282/data/2012_table1.pdf) [Accessed October 11, 2014]

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Association of American Medical Colleges: Table 3: Distribution of full-time faculty by department, rank, and gender. 2012. AAMC (https://www.aamc.org/download/305522/data/2012_table3.pdf) [Accessed October 11, 2014]

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Benzil DL, , Abosch A, , Germano I, , Gilmer H, , Maraire JN, & Muraszko K, et al.: The future of neurosurgery: a white paper on the recruitment and retention of women in neurosurgery. J Neurosurg 109:378386, 2008

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Bergen PC, , Turnage RH, & Carrico CJ: Gender-related attrition in a general surgery training program. J Surg Res 77:5962, 1998

  • 7

    Blakemore LC, , Hall JM, & Biermann JS: Women in surgical residency training programs. J Bone Joint Surg Am 85-A:24772480, 2003

  • 8

    Borman KR: Gender issues in surgical training: from minority to mainstream. Am Surg 73:161165, 2007

  • 9

    Cropsey KL, , Masho SW, , Shiang R, , Sikka V, , Kornstein SG, & Hampton CL: Why do faculty leave? Reasons for attrition of women and minority faculty from a medical school: four-year results. J Womens Health (Larchmt) 17:11111118, 2008

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Dodson TF, & Webb AL: Why do residents leave general surgery? The hidden problem in today's programs. Curr Surg 62:128131, 2005

  • 11

    Dyrbye LN, , Freischlag J, , Kaups KL, , Oreskovich MR, , Satele DV, & Hanks JB, et al.: Work-home conflicts have a substantial impact on career decisions that affect the adequacy of the surgical workforce. Arch Surg 147:933939, 2012

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Hatton MP, & Loewenstein J: Attrition from ophthalmology residency programs. Am J Ophthalmol 138:863864, 2004

  • 13

    Janus K, , Amelung VE, , Baker LC, , Gaitanides M, , Schwartz FW, & Rundall TG: Job satisfaction and motivation among physicians in academic medical centers: insights from a cross-national study. J Health Polit Policy Law 33:11331167, 2008

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Longo WE, , Seashore J, , Duffy A, & Udelsman R: Attrition of categoric general surgery residents: results of a 20-year audit. Am J Surg 197:774780, 2009

  • 15

    Meyer FB: ABNS Newsletter, Number 30. 2012. 4, ABNS (http://www.abns.org/pdfs/newsletter_info_30.pdf) [Accessed October 11, 2014]

  • 16

    Najjar DM: Attrition from ophthalmology residency programs. Am J Ophthalmol 139:948, 2005. (Letter)

  • 17

    Seltzer VL, , Messer RH, & Nehra RD: Resident attrition in obstetrics and gynecology. Am J Obstet Gynecol 166:13151317, 1992

  • 18

    Sullivan MC, , Bucholz EM, , Yeo H, , Roman SA, , Bell RH, & Sosa JA: “Join the club”: effect of resident and attending social interactions on overall satisfaction among 4390 general surgery residents. Arch Surg 147:408414, 2012

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Sullivan MC, , Yeo H, , Roman SA, , Bell RH Jr, & Sosa JA: Striving for work-life balance: effect of marriage and children on the experience of 4402 US general surgery residents. Ann Surg 257:571576, 2013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    van Zanten M, , Boulet JR, , McKinley D, & Whelan GP: Attrition rates of residents in postgraduate training programs. Teach Learn Med 14:175177, 2002

  • 21

    Wingard DL, , Garman KA, & Reznik V: Facilitating faculty success: outcomes and cost benefit of the UCSD National Center of Leadership in Academic Medicine. Acad Med 79:10 Suppl S9S11, 2004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Woodrow SI, , Gilmer-Hill H, & Rutka JT: The neurosurgical workforce in North America: a critical review of gender issues. Neurosurgery 59:749758, 2006

  • 23

    Yeo H, , Bucholz E, , Sosa JA, , Curry L, , Lewis FR Jr, & Jones AT, et al.: A national study of attrition in general surgery training: which residents leave and where do they go?. Ann Surg 252:529536, 2010

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Zhuge Y, , Kaufman J, , Simeone DM, , Chen H, & Velazquez OC: Is there still a glass ceiling for women in academic surgery?. Ann Surg 253:637643, 2011

Metrics

All Time Past Year Past 30 Days
Abstract Views 128 128 44
Full Text Views 2614 277 7
PDF Downloads 1537 178 8
EPUB Downloads 0 0 0