title: Attrition during graduate medical education: medical school perspective.
abstract: OBJECTIVE
  To identify predictors of attrition during graduate medical education (GME) in a single medical school cohort of contemporary US medical school graduates.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Single medical institution.
  
  
  METHODS
  Recent US allopathic medical school graduates.
  
  
  METHODS
  Attrition from initial GME program.
  
  
  RESULTS
  Forty-seven of 795 graduates (6%) did not complete the GME in their initial specialty of choice. At bivariate analysis, attrition was associated with election to the Alpha Omega Alpha Honor Medical Society, being an MD-PhD degree holder, and specialty choice (all P < .05). Attrition was not associated with graduation year (P = .91), sex (P = .67), or age (P = .12). In a multivariate logistic regression model, MD-PhD degree holder (odds ratio, 3.43; 95% confidence interval, 1.27-9.26; P = .02), election to Alpha Omega Alpha (2.19; 1.04-4.66; P = .04), choice of general surgery for GME (5.32; 1.98-14.27; P < .001), and choice of 5-year surgical specialty including those surgical specialties with a GME training requirement of 5 years or longer (2.74; 1.16-6.44; P = .02) each independently predicted greater likelihood of attrition.
  
  
  CONCLUSIONS
  Academically highly qualified graduates and graduates who chose training in general surgery or in a 5-year surgical specialty were at increased risk of attrition during GME.
authors.affiliation: Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8210, St Louis, MO 63110, USA. andrioled@wustl.edu
authors.forename: Dorothy A
authors.initials: DA
authors.lastname: Andriole
authors.forename: Donna B
authors.initials: DB
authors.lastname: Jeffe
authors.forename: Heather L
authors.initials: HL
authors.lastname: Hageman
authors.forename: Mary E
authors.initials: ME
authors.lastname: Klingensmith
authors.forename: Rebecca P
authors.initials: RP
authors.lastname: McAlister
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Whelan
mesh_terms: D002321:Career Choice; D015331:Cohort Studies; D004503:Education, Medical, Graduate / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data; D010563:Personnel Turnover / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012577:Schools, Medical / Q000706:statistics & numerical data*; D013038:Specialization; D013043:Specialties, Surgical / Q000706:statistics & numerical data