title: Attrition rates in neurosurgery residency: analysis of 1361 consecutive residents matched from 1990 to 1999.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Neurosurgery, New York University School of Medicine, New York, New York;
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Lynch
authors.forename: Karina
authors.initials: K
authors.lastname: Nieto
authors.forename: Saumya
authors.initials: S
authors.lastname: Puthenveettil
authors.forename: Marleen
authors.initials: M
authors.lastname: Reyes
authors.forename: Michael
authors.initials: M
authors.lastname: Jureller
authors.forename: Jason H
authors.initials: JH
authors.lastname: Huang
authors.forename: M Sean
authors.initials: MS
authors.lastname: Grady
authors.forename: Odette A
authors.initials: OA
authors.lastname: Harris
authors.forename: Aruna
authors.initials: A
authors.lastname: Ganju
authors.forename: Isabelle M
authors.initials: IM
authors.lastname: Germano
authors.forename: Julie G
authors.initials: JG
authors.lastname: Pilitsis
authors.forename: Susan C
authors.initials: SC
authors.lastname: Pannullo
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Benzil
authors.forename: Aviva
authors.initials: A
authors.lastname: Abosch
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Fouke
authors.forename: Uzma
authors.initials: U
authors.lastname: Samadani
mesh_terms: D000465:Algorithms; D002568:Certification / Q000706:statistics & numerical data / Q000639:trends; D004503:Education, Medical, Graduate / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data* / Q000639:trends*; D008297:Male; D009493:Neurosurgery / Q000193:education*; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012577:Schools, Medical / Q000145:classification; D012737:Sex Factors; D013337:Students, Medical / Q000706:statistics & numerical data; D014481:United States
keywords: AAMC = American Association of Medical Colleges; AANS = American Association of Neurological Surgeons; ABNS = American Board of Neurological Surgery; NPI = National Provider Identifier; attrition; board certification; neurosurgery residency; sex