(198) Factors Associated with Attrition Among ENT Residents: A 10-year Analysis

Monday, October 2, 2023

2:45 PM – 3:45 PM East Coast USA Time

Has Audio

Presenting Author(s)

Uche C. Ezeh, MS

Medical Student
University of Miami Miller School of Medicine
Coral Gables, Florida, United States

Co-Author(s)

KC

Kenechukwu Charles-Obi, BS

Drexel University College of Medicine, USA
Carlos L. Green, MD

Resident
University of Miami Miller School of Medicine
Miami, Florida, USA
EN

Elizabeth A. Nicolli, MD

Assistant Professor
University of Miami
Miami, FL, United States
AG

Amanda Gosman, MD

University of California San Diego School of Medicine, USA

Senior Author(s)

ZS

Zoukaa Sargi, MD MPH

Professor Of Otolaryngology and Neurosurgery
University of Miami Miller School of Medicine
Miami, Florida, United States

Disclosure(s):

Uche C. Ezeh, MS: No relevant relationships to disclose.

Zoukaa Sargi, MD MPH: No relevant relationships to disclose.

Introduction: Attrition within a surgical residency program creates significant burdens for faculty and fellow trainees. Factors predicting attrition in ENT are poorly characterized in the literature, as such, our study aimed to investigate the rate of attrition in ENT and identify risk factors for quitting.

Methods: We performed a retrospective analysis on matriculants to U.S ENT residency programs between 2006 to 2015. Data was obtained from Accreditation Council of Graduate Medical Education (ACGME). Variables analyzed included sex, race/ ethnicity, US medical school type (U.S MD, U.S DO, or International Medical Graduate (IMG)), program location, citizenship, and attrition status. Underrepresented minorities (URM) consisted of Blacks/African Americans (AA), Hispanic, Latino, or of Spanish origin, American Indian or Alaska Native, and Native Hawaiian or Other Pacific Islander. A logistic regression model was conducted to determine factors predictive of attrition. Analysis was conducted using SPSS v28 and p< 0.05 was considered significant.

Results: A total of 3,098 ENT residents were analyzed. Residents starting ENT residency from 2006 to 2015 had an overall attrition rate of 3.8%. On multivariable analysis, URM trainees had a 2.3 times higher risk of attrition compared to Whites (odds ratio (OR)=2.3; 95% confidence interval (CI) [1.30-3.91], p=0.004). Matriculants attending a residency in the southern US had 2.7 times higher odds of attrition compared to those in the Northeast (OR 2.7; 95% CI [1.59-4.60], p< 0.001). ENT residents entering training at age 30-39 years had 2.1 times higher odds of attrition compared to those who entered at age 26-29 years (OR=2.1, 95% CI [1.36-3.27], p< 0.001). There was no significant difference in attrition based on sex, medical school type, and citizenship.

Conclusions: URM trainees, matriculants between ages 30-39 years and residents training in the southern US were at the greatest risk for leaving ENT residency prior to completion. Further work is needed to understand the reasons for attrition and novel strategies need to be adopted to promote inclusion and diversity within ENT.