title: Career outcomes of nondesignated preliminary general surgery residents at an academic surgical program.
abstract: OBJECTIVE
  There remains a debate as to whether nondesignated preliminary (NDP) positions in surgery ultimately translate into successful surgical careers for those who pursue them. We sought to identify the success with which our NDP residents were able to transition to their desired career and what, if any, factors contributed to their success.
  
  
  METHODS
  The records of all NDP residents accepted into the Massachusetts General Hospital General Surgery Residency Program from 1995 to 2010 were examined and long-term follow-up was completed.
  
  
  RESULTS
  Thirty-four NDP residents were identified, including 26.5% US graduates and 73.5% international medical graduates. At the end of the initial preliminary year, 30 (88%) got placed in a postgraduate residency program, whereas 4 (12%) pursued other career paths. Of those who got placed, 25 (83%) attained surgical residency positions, including 17 (57%) who continued as preliminary residents at our institution and 8 (27%) who got placed in categorical surgical positions at other programs. After multiple preliminary years, 15 of 17 achieved a categorical position, of which, 93% were in surgical fields. Overall, 64.7% of all entering NDP residents eventually went on to have careers in general surgery (50%) or surgical subspecialties (14.7%), and 24 of 34 (71%) fulfilled their desired career goals. No factor predicted success. From 1995 to 2012 there have been 15 midlevel (11 postgraduate year 4) vacancies in our program, 4 of which were filled by preliminary residents, 2 from our program and 2 from elsewhere. All have gone on to board certifications and careers in surgery.
  
  
  CONCLUSIONS
  More than 70% of NDP residents in our program successfully transitioned to their desired career paths, many achieving categorical surgical positions and academic surgical careers, thus demonstrating the benefit of this track to both residency programs and trainees.
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Rima
authors.initials: R
authors.lastname: Ahmad
authors.forename: John T
authors.initials: JT
authors.lastname: Mullen
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D001900:Boston; D002321:Career Choice; D002983:Clinical Competence; D003162:Competency-Based Education; D016208:Databases, Factual; D004503:Education, Medical, Graduate / Q000458:organization & administration; D005260:Female; D013502:General Surgery / Q000193:education* / Q000639:trends; D006784:Hospitals, Teaching; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D007588:Job Satisfaction; D008297:Male; D015397:Program Evaluation; D012189:Retrospective Studies
keywords: Interpersonal and Communication Skills; Professionalism; Systems-Based Practice; career; general surgery; nondesignated preliminary residents; professional goals; surgical education