What Drives Attrition amongst Obstetrics and Gynaecology Residents in Singapore
Open accessAbstract
Background: Resident attrition is costly but literature studying the motivations behind it in obstetrics and gynaecology (OBGYN) is lacking.Objectives: We aimed to study the relationship between prior specialty-appropriate work experience and risk of attrition amongst OBGYN residents in Singapore, and identify factors placing residents at greater risk of attrition.Methods: This nationwide mixed methods case control study studied all OBGYN residents in Singapore for the 2011 and 2012 intakes.A pre-piloted questionnaire was used to identify work experience and risk factors related to resident attrition.Structured interviews were conducted with a subgroup of participants chosen for diversity of educational background, work experience, and position towards residency.Results: 28 of 33 (84.8%) eligible residents participated in this study.Female (40.9% vs. 0%), married (50.0% vs. 22.2%) and Singaporean (38.1% vs.14.3%) residents more often considered attrition from training.Those accepted into residency after graduation were 33% less likely to have considered leaving.No statistical difference was observed between residents with prior work experience and those without (38.9% vs. 20.0%,p=0.417).All interviewees believed that prior experience informs expectations and eases initial learning.Low job satisfaction related to mismatched expectations was the most quoted reason for considering attrition.85.7% of interviewed residents were concerned about competing work and family demands.Conclusions: Lack of specialty-appropriate work experience contributes to misinformed training expectations and increased attrition risk.Residents who have considered attrition may still desire career longevity in their specialty.Reduction in mismatched expectations promises to improve job satisfaction and translate to career longevity.
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Across clinical specialties, cited reasons for leaving training include disturbed work-life balance, job discontent, excessive workload, switching career or specialty, unappealing work culture, and mismatch expectation.
“Numerous and diverse reasons for leaving training have been cited across clinical specialties. These are disturbed work-life balance, job discontent, excessive workload, switching career or specialty, unappealing work culture, and mismatch expectation.2,5-7,16,24,25”
From Attrition in the Training Programs of the University of the Philippines-Philippine General Hospital (UP-PGH): A 5-year Review of Trends and Reasons from 2018-2022 (2025) · cites this paper as [2]
The results section on mismatched expectations links considering attrition to low job satisfaction, and the section on balancing work and family describes concerns about work-life balance and increasing work demands. The career-aspirations section also discusses the importance of a positive work culture. This study concerns obstetrics and gynaecology residents in Singapore; it does not establish the full list across clinical specialties or identify switching career or specialty as a reason for leaving. Page numbers were not provided in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredA significant amount of time and resources are invested in recruiting and training every physician.
“A significant amount of time and resources are invested in recruiting and training every physician2-4”
From Attrition in the Training Programs of the University of the Philippines-Philippine General Hospital (UP-PGH): A 5-year Review of Trends and Reasons from 2018-2022 (2025) · cites this paper as [2]
The Introduction reports an estimated training cost of US$100,000 per year for an obstetrics and gynaecology resident, supporting the claim that training requires substantial resources. It does not establish the time or resources spent recruiting physicians, or extend the cost finding to every physician. (LLM, conf=0.85)
Experimental — accuracy not yet measuredEven before the pandemic, burnout and lack of adequate social support were major contributors to trainees' mental health challenges.
“It should be noted, however, that even before the pandemic, burnout and lack of adequate social support remained major contributors in trainees' mental health challenges.”
From Attrition in the Training Programs of the University of the Philippines-Philippine General Hospital (UP-PGH): A 5-year Review of Trends and Reasons from 2018-2022 (2025) · cites this paper as [2]
In C. Interpretation (page unavailable), the paper discusses burnout in connection with work–family stress and suggests supportive mentoring for residents considering leaving training. It does not establish burnout or inadequate social support as major contributors to trainees’ mental health challenges; its findings concern attrition and job satisfaction. (LLM, conf=0.77)
Experimental — accuracy not yet measuredThe loss of a trainee is logistically burdensome and costly to the hospital.
“the loss is not only logistically burdensome but costly to the hospital.”
From Attrition in the Training Programs of the University of the Philippines-Philippine General Hospital (UP-PGH): A 5-year Review of Trends and Reasons from 2018-2022 (2025) · cites this paper as [2]
The Introduction states that training an OBGYN resident costs an estimated US$100,000 per year and calls attrition “an exceedingly costly affair.” It does not describe the loss as logistically burdensome or specify that the hospital bears the cost. (LLM, conf=0.88)
Experimental — accuracy not yet measuredBurnout is associated with poor work-life balance, unhealthy working hours, heavy workload, and unrealized academic expectations, often coupled with external demands of family and private life.
“Burnout is known to be associated with poor work-life balance, unhealthy working hours, heavy workload, and unrealized academic expectation which are oftentimes coupled with the external demands of family and private life.2,25,26”
From Attrition in the Training Programs of the University of the Philippines-Philippine General Hospital (UP-PGH): A 5-year Review of Trends and Reasons from 2018-2022 (2025) · cites this paper as [2]
The Interpretation section (page not provided) reports that work–family conflict is associated with burnout, and the discussion of residents’ experiences describes increasing work demands threatening work–life balance. The paper links mismatched training expectations to dissatisfaction and attrition, not burnout; it does not establish the claimed burnout associations with unhealthy working hours or unrealized academic expectations. (LLM, conf=0.87)
Experimental — accuracy not yet measured
A 2019 study by Lee et al. on Obstetrics and Gynecology resident attrition in Singapore showed that female and married residents were more likely to consider leaving specialty training, possibly due to expectations in the traditional setting of a nuclear family in their country.
“A 2019 study by Lee et al. on Obstetrics and Gynecology resident attrition in Singapore showed that female and married residents were more likely to consider leaving specialty training, possibly due to expectations in the traditional setting of a nuclear family in their country.2”
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Cites
Measuring Employee Expectations in a Strategic Human Resource Management Research: Job Satisfaction
Oraman, Y., Unakıtan, G., & Selen, U. (2011) · Procedia - Social and Behavioral Sciences · doi:10.1016/j.sbspro.2011.09.022 · Cited by 29 · see citing works
Flagged first, then by citations
Research works printed but not linked: 9
- Aryeel, S. (1993). Dual-earner couples in Singapore: An examination of work and nonwork sources of their experienced burnout. Human Relations, 46(12), 1441-1468. http://doi.org/10.1177/001872679304601205. · DOI
- Bacharach, S. B., Bamberger, P., & Conley, S. (1991). Work-home conflict among nurses and engineers: Mediating the impact of role stress on burnout and satisfaction at work. Journal of Organizational Behaviour, 12(1), 39-53. http://doi.org/10.1002/job.4030120104. · DOI
- Connell, J., Zurn, P., Stilwell, B., Awases, M., & Braichet, J. M. (2007). Sub-Saharan Africa: beyond the health worker migration crisis? Social Science & Medicine, 64(9), 1876-1891. http://doi.org/10.1016/j.socscimed.2006.12.013. · DOI
- Ghaem-Maghami, S., Brockbank, E., & Bridges, J. (2006). Survey of surgical experience during training in obstetrics and gynaecology in the UK. Journal of Obstetrics and Gynaecology, 26(4), 297-301. http://doi.org/10.1080/01443610600594740. · DOI
- McAlister, R. P., Andriole, D. A., Brotherton, S. E., & Jeffe, D. B. (2008). Attrition in residents entering US obstetrics and gynecology residencies: analysis of National GME Census data. American Journal of Obstetrics and Gynecology, 199(5), 574 e571-576. http://doi.org/10.1016/j.ajog.2008.06.081. · DOI
- Ogbonmwan, S. E., & Ogbonmwan, D. E. (2010). Recruitment and retention in obstetrics and gynaecology in the UK. British Journal of Hospital Medicine (Lond), 71(2), 103-105. http://doi.org/10.12968/hmed.2010.71.2.46490. · DOI
- Rozen, W. M., & Rozen, G. (2006). Postgraduate obstetrics and gynaecology experience: The role for early exposure. Australian and New Zealand Journal of Obstetrics and Gynaecology, 46(6), 538-540. http://doi.org/10.1111/j.1479-828X.2006.00656.x. · DOI
- Shields, M. A., & Ward, M. (2001). Improving nurse retention in the National Health Service in England: The impact of job satisfaction on intentions to quit. Journal of Health Economics, 20(5), 677-701.
- Mannan, S. D., Heng, J. M. J., Andrada, J. A., Choon, P. H., Yeo, H. S. H. & Lim, B. L. (2018, March). Improving resident selection through analysis of attrition rate in SingHealth Residency. Poster presented at the Accreditation Council for Graduate Medical Education Annual Education Conference, Orlando, FL.
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Sorted by citations
Tabuñar, S. M. S., & Parreño Sacdalan, M. D. (2025) · PubMed · doi:10.47895/amp.vi0.9376 · Cited by 2 · see citing works
(2025) · Acta Medica Philippina · doi:10.47895/amp.v59i6.9376 · Cited by 1 · see citing works
“1 A significant amount of time and resources are invested in recruiting and training every physician 2-4 and the loss is not only logistically burdensome but costly to the hospital.”
- Authors
- Lee, J. C. S., Kee, X. L. J., Wiener-Ogilvie, S., Chern, B. S. M., & Chin, C. Y.
- Affiliations
- KK Women's and Children's Hospital (SG)
- National University of Singapore (SG)
- NHS Education for Scotland (GB)
- SingHealth (SG)
- National Heart Centre Singapore (SG)
- Venue
- The Asia Pacific Scholar
- Publisher
- Yong Loo Lin School of Medicine
- Published
- 2019-01-02
- Volume
- 4
- Issue
- 1
- Pages
- 34-41
- ISSN
- 2424-9270 (ISSN-L)
- 2424-9335
- OpenAlex
- W2906609866
- Cited by
- 5
- References
- 1
- Citations by year
- 2025: 1 · 2022: 2 · 2021: 1 · 2020: 1
- FWCI
- 0.93
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc
- Locations
- The Asia Pacific Scholar (publishedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- University of Edinburgh
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison
- Topics
- Social Sciences › Gender Studies › Diversity and Career in Medicine
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Keywords
- resident attrition, training expectations, job satisfaction, work-family balance, career longevity, resident retention, Singapore
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