Attrition in new obstetrics and gynaecology residency: can we identify risk factors at selection?

Background: Resident attrition is costly and stressful to both residents and healthcare systems. Singapore remodelled its specialty training system 10 years ago, adopting the Accreditation Council for Graduate Medical Education International (ACGME-I) framework. A greater understanding of risk factors and trends of attrition could better inform the resident selection process. We aimed to determine if risk factors for resident attrition can be identified through demographic data available at the time of resident selection, and secondly, if differences exist between attrition rates of OBGYN residents under the SingHealth ACGME-I programme and the earlier British-based specialty training (BST-AST) programme. Methods: Anonymised demographic data of all SingHealth ACGME-I obstetrics and gynaecology residents between 2011 and 2018 were retrospectively obtained and compared according to “stay” and “attrition” groups. Attrition rates from the BST-AST programme were obtained from the hospital’s departmental database. Results: From 2011 to 2018, 77 residents were enrolled. There were 5 premature departures, all voluntary. No significant differences were found in demographic parameters between “stay” and “attrition” groups. The annual attrition rate for this programme was 2.07%, versus 3.45% for BST-AST trainees between 2002 and 2011 (OR 0.556, 95% CI 0.140–2.207). Conclusions: Demographic data alone cannot predict risk of resident attrition as decisions to leave specialty training are complex. Introduction of the ACGME-I accredited residency programme appears to reduce resident attrition rates.