Factors Associated with Attrition among Residents in Pediatrics: A Mixed-method Study in a Single Center in the Philippines

Background. Attrition in residency training can lead to lower workplace morale and increased costs. Finding associated factors can help revise admissions criteria or identify at-risk residents.

Objective. We aimed to determine factors associated with attrition among residents in pediatrics.

Methods. We applied a mixed cross-sectional (survey) and retrospective cohort (records review) study design. Residents who began training in the Philippine General Hospital in 2012–2018 were included. Our primary outcomes were non-completion of training within three years (attrition), completion beyond three years or ongoing training at a delayed year level (off-cycle), and the composite of attrition or off-cycle. Fisher’s exact probability test and t-test were used to compare the non-attrition group versus the attrition group, and the non-attrition group versus the attrition or off-cycle group.

Results. The overall attrition rate and off-cycle rate among 162 residents were 7.41% and 4.32%, respectively. The survey response rate was 73.00%. Four factors were significantly associated with attrition: higher age at entry into the program (p = 0.030), advanced degree (p = 0.009), longer interval from internship completion to start of residency training (p = 0.017), and a lower case presentation score (p = 0.048). The proportion of respondents older than 29 years was significantly higher in the attrition group than the non-attrition group (40.00% vs 0.94%, p = 0.031). Higher age at entry was also significantly associated with the composite outcome (attrition or off-cycle).

Conclusion. Older age at entry, advanced degree, a longer interval from internship, and lower-case presentation scores were associated with attrition among residents in pediatrics from a single center.