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

Abstract

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.