Introduction: Resident attrition creates a profound burden on trainees and residency programs. This study aims to analyze trends in resident attrition within Neurosurgery.

Methods: This study followed a cohort of 1275 residents who started neurosurgery residency from 2005-2010. A list of residents matching during this time was obtained from the American Association of Neurological Surgeons (AANS). Residents who did not finish their residency training at the program in which they started were placed into one of five groups: transferred neurosurgery programs; transferred to a different specialty; left clinical medicine; deceased; or unknown. A thorough internet search was conducted for residents who did not complete their training at their first neurosurgery program. Variables leading to attrition were also analyzed, including: age, gender, presence of advanced degree (Ph.D.), post-graduate year (PGY), and geographical region of program.

Results: Residents starting neurosurgery residency from 2005-2010 had an overall attrition rate of 11.15%. There was no statistically significant difference in attrition rates between the years (p=0.337). The outcomes for residents in the attrition group were found to be: 33.61% transferred neurosurgery programs, 56.30% transferred to a different medical specialty, 8.40% left clinical medicine, and 1.68% were deceased. It was observed that women had a higher attrition rate (18.50%) than men (10.35%) (p<0.01). Most attrition (65.07%) occurred during the PGY 1 or 2 years. The attrition group was also observed to be significantly older at the beginning of residency training, with a mean of 31.69 years of age compared to 29.31 in the non-attrition group (p<0.001). No significant difference was observed in the attrition rates for residents with a Ph.D. (9.86%) compared to those without a Ph.D. (p=0.472).

Conclusions: Resident attrition remains a significant problem within neurosurgical training, and future studies should focus on targeted interventions to identify at risk individuals to help them succeed in their medical careers.

Patient Care: Analyzing trends in resident attrition will enable programs to identify at risk individuals and enact early intervention mechanisms to help them succeed in their medical careers thereby facilitating continued patient care and positive clinical outcomes.

Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of resident attrition, 2) Discuss, in small groups, trends in attrition, 3) Identify an effective methods to identify at risk individuals and enact appropriate interventions.

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