SynthesisWorld journal of surgery2021
Factors Associated with Attrition and Performance Throughout Surgical Training: A Systematic Review and Meta-Analysis.
Synthesis in World journal of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Experiences of Identity-Related Vigilance in Surgical Trainees: A Qualitative Study.JAMA network open · 2026Article
- Factors influencing surgical residents attrition: a mixed-methods study from a low-middle-income country.BMC surgery · 2026Observational
- Mind the Gap: A Nationwide Analysis of Case Distribution, Resident Exposure and Institutional Variation in German Pediatric Surgery Training.Children (Basel, Switzerland) · 2026Article
- Supporting doctors' professional identity development through specialist training.Anatomical sciences education · 2026Article
- Fair access to higher surgical training in the UK: an equity, diversity and inclusion analysis of national selection in 2024.BMJ open · 2025Article
- The 'leaky pipeline' in orthopaedic surgery: why female trainees drop out?Journal of orthopaedic surgery and research · 2025Article
- How do programme directors perceive trainee attrition? A qualitative focus group study in three Dutch teaching hospitals.BMJ open · 2025Article
- Sculpting the good surgeon or excising the bad one: How clinical teachers could perpetuate attrition in surgical residency programmes.Medical education · 2025Article
- Challenges and opportunities in pediatric surgery training in Germany: a view from the trenches.BMC medical education · 2025Article
- Attrition in the Training Programs of the University of the Philippines-Philippine General Hospital (UP-PGH): A 5-year Review of Trends and Reasons from 2018-2022.Acta medica Philippina · 2025Article
- Comparing Different Pathways in Medical Education and Surgical Training: A Global Survey of Surgeons.Plastic and reconstructive surgery. Global open · 2024Article
- The Role of Inclusion in Increasing Diversity and Retention Across Surgical Residencies: a Literature Review.Current reviews in musculoskeletal medicine · 2023Review
- Twelve-step Approach for Academic Development Planning in Academic Surgery: Climbing the Academic Uphill With Strong and Steady Steps.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2022Article
- Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAttrition within surgical training is a challenge. In the USA, attrition rates are as high as 20-26%. The factors predicting attrition are not well known. The aim of this systematic review is to identify factors that influence attrition or performance during surgical training.
methodThe review was performed in line with PRISMA guidelines and registered with the Open Science Framework (OSF). Medline, EMBASE, PubMed and the Cochrane Central Register of Controlled Trials were searched for articles. Risk of bias was assessed using the Newcastle-Ottawa scale. Pooled estimates were calculated using random effects meta-analyses in STATA version 15 (Stata Corp Ltd). A sensitivity analysis was performed including only multi-institutional studies.
resultsThe searches identified 3486 articles, of which 31 were included, comprising 17,407 residents. Fifteen studies were based on multi-institutional data and 16 on single-institutional data. Twenty-nine of the studies are based on US residents. The pooled estimate for overall attrition was 17% (95% CI 14-20%). Women had a significantly higher pooled attrition than men (24% vs 16%, p < 0.001). Some studies reported Hispanic residents had a higher attrition rate than non-Hispanic residents. There was no increased risk of attrition with age, marital or parental status. Factors reported to affect performance were non-white ethnicity and faculty assessment of clinical performance. Childrearing was not associated with performance.
conclusionFemale gender is associated with higher attrition in general surgical residency. Longitudinal studies of contemporary surgical cohorts are needed to investigate the complex multi-factorial reasons for failing to complete surgical residency.
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