The State of General Surgery Residency in the United States

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Abstract
GENERAL SURGERY residency has rapidly evolved from a highly competitive specialty choice to one plagued by recruitment and retention concerns. The effect of "controllable lifestyle" on medical student specialty selection is undeniable.1,2 Recent trends in the National Resident Matching Program match highlight the increased concern for lifestyle considerations by medical students; anesthesiology, pathology, and radiology have increased the number of residency positions offered and the percentage of these positions filled, whereas general surgery and family practice have filled fewer offered positions.3 Furthermore, spousal opinion affects specialty selection, with many spouses being unwilling to accept the lifestyle demands of general surgery residency.4 A complementary concern is the persistence of a substantial attrition rate among general surgery residents in the postpyramidal residency era. Documented attrition rates are 12% to 26% in various studies.5-7 Residents who voluntarily leave surgical training consistently cite time commitment or family demands as the basis for their departure.6,7 The same factors driving the diminishing student interest in surgical careers seem to be at work in the retention of general surgical residents as well.

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