[Residency attrition in orthopaedic surgery; an explanatory model based on qualitative research].

Abstract

Objective: Many factors can lead to residency attrition. The underlying process however and how these factors interact remains unclear. Understanding this process can provide background to put the available evidence into perspective. The aim of the study was to develop an explaining model that describes voluntary residency attrition.

Design: Development of an explanatory model based on qualitative research METHOD: Semi-structured interviews with orthopaedic surgery residents in the Netherlands who dropped out of training, were analysed using the constructivist grounded theory approach.

Results: 17 interviews were analysed. Reasons for attrition were different for each individual and often a result of a cumulative effect of negative experiences. Individual expectations and needs determine residents' experience with the content of the profession, the professional culture and the learning climate. Personal circumstances and personal characteristics influence expectations and needs. Specific aspects of the residency programme contributing to attrition were type of patient care, required skills, work-life balance and interpersonal interaction (between residents among themselves and between residents and supervisors).

Conclusion: This study provides an explaining model of residency attrition that incorporates existing theories and fits well with the results of previous studies.