• Dorothy A Andriole, Donna B Jeffe, Heather L Hageman, Mary E Klingensmith, Rebecca P McAlister, and Alison J Whelan.
• Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8210, St Louis, MO 63110, USA. andrioled@wustl.edu
• Arch Surg. 2008 Dec 1; 143 (12): 1172-7; discussion 1177.

ObjectiveTo identify predictors of attrition during graduate medical education (GME) in a single medical school cohort of contemporary US medical school graduates.DesignRetrospective cohort study.SettingSingle medical institution.ParticipantsRecent US allopathic medical school graduates.Main Outcome MeasureAttrition from initial GME program.ResultsForty-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.ConclusionAcademically 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.

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