How do general surgery replacement residents match up with those recruited through the National Resident Matching Program?

Background: Although the scope and patterns of attrition of general surgery residents have been reported, no study has examined the residents who replaced them. The purpose of this study was to assess the quality of replacement residents (RRs).

Methods: A questionnaire asked program directors (PDs) about the prevalence, characteristics, and disposition of RRs in general surgery residency programs from 2001 to 2002.

Results: PDs from 169 programs (67%) responded, and 109 (64%) of these programs had RRs. Of 244 RRs (7%), 18 (7%) were postgraduate year (PGY)-1 residents; 64 (26%) were PGY-2 residents; 77 (32%) were PGY-3 residents; 52 (21%) were PGY-4 residents; and 33 (14%) were PGY-5 residents. RRs averaged 1.9 years in their programs. One hundred seventy-five (72%) came from outside the current institution, and 142 had (58%) graduated from U.S. medical schools. PDs judged RRs to be superior (20%), comparable (55%), or inferior (25%) to their peers. Neither internal recruitment nor United States medical school graduation predicted performance. Disposition included promotion and graduation (88%), leaving the program voluntarily (5%), repeating the year (4%), and dismissal (3%). Successful RR performance occurred in 71% of RRs.

Conclusions: Typically, RRs were U.S. medical school graduates, were recruited from outside the institution, and have performed satisfactorily.