Background: Despite previous study demonstrating the negative impact of resident attrition on trainees, residency leadership and potentially patient care, the rate of resident attrition in emergency medicine (EM) is unknown. We aimed to quantify the incidence of resident attrition in Accreditation Council for Graduate Medical Education (ACGME) accredited EM residencies between 2007-2016 academic years.
Methods: We performed a retrospective analysis of resident attrition in EM using de-identified resident census data from 2007 to 2016 provided by the AMA National Graduate Medical Education Census. Attrition was defined as any postgraduate who left their original residency program for any reason prior to training completion (ex. transferred to another EM program, transitioned to another specialty, withdrew, dismissed, took a leave of absence, or passed away). We measured the incidence of resident attrition and percentage of programs affected by attrition. A Cochran Armitage Trend test was used to see if there is any overall association between the attrition rate and progression of academic years.
Results: The incidence of EM resident attrition across all ACGME-accredited EM programs was an average of 0.85% per year from 2007-2016. The trend test demonstrated that there has been a very small but overall statistically significant decrease in resident attrition. An average of 22.84% of all programs were affected by attrition over the study period.
Conclusions: In the period between 2007-2016 academic year, the incidence of resident attrition is low ( < 1%) within the specialty of EM, especially compared to research from other specialties. However, almost a quarter of EM programs experienced at least one resident leave their program prior to the completion of their training per year.