Surgical Resident Attrition and the Menninger Morale Curve
Open accessAbstract
BACKGROUND: Attrition in surgical residency programs continues to be a significant challenge. Ap-proximately 20% of residents who begin a categorical surgery residency fail to complete it. A number of studies speculated reasons for this including work hours, life style, family pressures, and resident feelings of inadequacy including fear of termination. To date no research has been conducted investigating the relation-ship between resident morale and attrition. This study sought to determine if this linkage exists in surgery residents. METHODS: The Morale Assessment in General Practice Index (MAGPI) was administered to 21 PGY 1, 2, 3, and 5 surgical residents to assess level of morale. Non-parametric methods were carried out to assess if there were differences in morale among the four PGY groups. Additionally, analyses of the four factors comprising the MAGPI were also conducted. RESULTS: Although differences did not reach statis-tical significance, analysis of the data reveals that residents demonstrate different trends in their levels of morale based on the amount of time they spend in a residency and in a way that approximates the morale curve described by W. Walter Menninger, M.D. Additionally, two of the four factors comprising the MAGPI also indicate trends similar to that described by the Menninger morale curve. CONCLUSIONS: Although no statistically significant results were achieved, the data reveal trends that approximate shifts in morale similar to those described by the Menninger morale curve, with residents at the PGY 2 and 3 levels present-ing lower morale levels than at the PGY 1 and 5 levels. This may be due in part to the size of the population studied. Future research should be continued in this area with a larger sample size.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Almost half of general surgery residents consider quitting their surgery residency and an equal number would not select general surgery for a career again.
“Almost half of general surgery residents consider quitting their surgery residency and an equal number would not select general surgery for a career again [35].”
From How Can We Reduce Attrition in General Surgery Residents? (2018) · cites this paper as [35]
The Introduction reports that the highest proportion who had considered leaving training was 19.2% (among PGY 2 residents), far below 'almost half.' Our copy does not address how many residents would choose general surgery again. (LLM, conf=0.85)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredStrong systems of social support increase the odds that a resident will complete their training.
“Strong systems of social support increase the odds that a resident will complete their training [35].”
From How Can We Reduce Attrition in General Surgery Residents? (2018) · cites this paper as [35]
The Discussion links periods of low morale with higher risk of leaving surgical residency and recommends that programs attend to the support residents receive from colleagues, faculty, and staff. It does not establish that strong social support increases the odds of completing training; the study assessed morale, not completion outcomes. (LLM, conf=0.85)
Experimental — accuracy not yet measuredSupport from family, spouses, partners, and peers in the program all contribute to resident success by helping them to cope with the stresses of the residency.
“Support from family, spouses, partners, and peers in the program all contribute to resident success by helping them to cope with the stresses of the residency [35].”
From How Can We Reduce Attrition in General Surgery Residents? (2018) · cites this paper as [35]
The Discussion recommends attention to support residents receive from colleagues, faculty, and staff, and says residents who have faced similar experiences can help others cope. The Conclusions discuss support from friends and worries about family, but the paper does not establish that support from family, spouses, and partners all contributes to resident success by helping residents cope. No page numbers are available in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSome 69% of surgery residents meet the criteria for burnout.
“Some 69% of surgery residents meet the criteria for burnout, and female residents are more likely to be affected by and report burnout than their peers [17, 35].”
From How Can We Reduce Attrition in General Surgery Residents? (2018) · cites this paper as [35]
The Introduction reports surgical-resident attrition rates, while the Methods describe measuring morale in 21 residents. Neither section reports the proportion meeting burnout criteria. A search for the claimed 69% burnout figure found no supporting passage in our copy; page numbers were unavailable. (LLM, conf=0.76)
Experimental — accuracy not yet measuredFemale residents are more likely to be affected by and report burnout than their peers.
“Some 69% of surgery residents meet the criteria for burnout, and female residents are more likely to be affected by and report burnout than their peers [17, 35].”
From How Can We Reduce Attrition in General Surgery Residents? (2018) · cites this paper as [35]
The Abstract and Discussion examine surgical residents’ morale by training year, not burnout by gender. Searches for female residents, burnout, and the 69% figure found no passage in our copy addressing the attributed claim. (LLM, conf=0.75)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Why do residents leave general surgery? The hidden problem in today's programs
Dodson, T. F., & Webb, A. L. B. (2005) · Current Surgery · doi:10.1016/j.cursur.2004.07.009 · Cited by 137 · cited 2× · see citing works
“In their study of why residents leave general surgery, Dodson and Webb reported that although research in this area is limited, there have been a number of studies that documented a fairly consistent attrition rate between 14% to 23% [3].”
BackgroundResult
Flagged first, then by citations
Research works printed but not linked: 10
- R. Bell, M. Banker, R. Rhodes, T. Biester and F. Lewis, "Graduate Medical Education in Surgery in the United States," Surgical Clinics of North America, Vol. 87, No. 4, 2007, pp. 811-823. doi:10.1016/j.suc.2007.06.005 · DOI
- D. A. Andriole, et al., "Attrition during Graduate Medical Education," Archives of Surgery, Vol. 143, No. 12, 2008, pp. 1172-1177. doi:10.1001/archsurg.143.12.1172 · DOI · Paper page
- R. P. McAlister, D. A. Andriole, S. E. Brotherton and D. B. Jeffe, "Attrition in Residents Entering U.S. Obstetrics and Gynecology Residencies: Analysis of GME Census Data," American Journal of Obstetrics and Gynecology, Vol. 199, No. 5, 2008, pp. 574e1-574e6.
- W. Longo, J. Seashore, A. Duffy and R. Udelsman, "At- trition of Categoric General Surgery Residents: Results of a 20-Year Audit," The American Journal of Surgery, Vol. 197, No. 6, 2009, pp. 774-778. doi:10.1016/j.amjsurg.2008.06.038 · DOI
- D. C. Lynge, E. H. Larson, M. J. Thompson, R. A. Rosenblatt and L. G. Hart, "A Longitudinal Analysis of the General Surgery Workforce in the United States 1981-2005," Archives of Surgery, Vol. 143, No. 4, 2008, pp. 345-350. doi:10.1001/archsurg.143.4.345 · DOI
- C. B. Everett, S. D. Helmer, J. S. Osland and R. S. Smith, "General Surgery Resident Attrition and the 80-Hour Workweek," The American Journal of Surgery, Vol. 194, No. 6, 2007, pp. 751-757. doi:10.1016/j.amjsurg.2007.08.033 · DOI
- T. J. Leibrandt, C. M. Pezzi, S. A. Fassler, E. F. Reilly and J. B. Morris, "Has the 80-Hour Work Week Had an Impact on Voluntary Attrition in General Surgery Resi- dency Programs?" Journal of The American College of Surgeons, Vol. 202, No. 2, 2006, pp. 340-344. doi:10.1016/j.jamcollsurg.2005.09.018 · DOI · Paper page
- H. Yeo, et al., "Attitudes, Training Experiences, and Professional Expectations of US General Surgery Resi- dents," Journal of the American Medical Association, Vol. 302, No. 12, 2009, pp. 1301-1308. doi:10.1001/jama.2009.1386 · DOI
- W. W. Menninger, "Adaptation and Morale, Predictable Responses to Life Changes," Bulletin of the Menninger Clinic, Vol. 52, No. 3, 1988, pp. 198-210.
- B. McKinstry, M. Porter, R. Wrate, R. Elton and J. Shaw, "The MAGPI (Morale Assessment in General Practice Index): A New Way for Doctors to Self-Assess Their Morale," Education for Primary Care, Vol. 15, No. 2, 2004, pp. 231-241.
Cited by
Sorted by citations
How Can We Reduce Attrition in General Surgery Residents?
DM, A. (2018) · Austin Journal of Surgery · doi:10.26420/austinjsurg.2018.1129 · Cited by 2 · see citing works
Department of Surgery, T. U. O. A., M Avery, D., G Harrell, A., Department of Surgery, T. U. O. A., C Wallace, J., Department of Surgery, T. U. O. A., E Geno, C., Department of Family, I. &. R. M., Taylor, G., University of Alabama School of Medicine, U., et al. (2018) · International Journal of Innovative Surgery · doi:10.33582/2639-9229/1003 · Cited by 1 · see citing works
- Authors
- Contessa, J., & Kyriakides, T.
- Affiliations
- Yale University (US)
- ORCID
- Kyriakides, Tassos
- Venue
- Surgical Science
- Publisher
- Scientific Research Publishing, Inc.
- Published
- 2011
- Volume
- 02
- Issue
- 07
- Pages
- 397-401
- ISSN
- 2157-9407 (ISSN-L)
- 2157-9415
- OpenAlex
- W2030827589
- Cited by
- 6
- References
- 1
- Citations by year
- 2024: 2 · 2018: 4
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Surgical Science (publishedVersion, cc-by)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Gender Studies › Diversity and Career in Medicine
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Keywords
- postgraduate year level, resident retention, surgical residents
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
