Factors Associated With Attrition Among Otolaryngology-Head and Neck Surgery Residents: A 10-Year Analysis.

Objective: To identify the risk factors for Otolaryngology-Head and Neck Surgery (OHNS) resident attrition.

Study design: Retrospective cohort study.

Setting: Annual Graduate Medical Education track survey.

Methods: We conducted a retrospective analysis of OHNS residents who matriculated between 2006 and 2015. Variables analyzed included age at matriculation, sex, race/ethnicity, medical degree type, program location, attrition status, and matriculation year period (2006-2010, 2011-2015). A logistic regression model was used to determine factors predictive of attrition, with a significance level set at P < .05.

Results: A total of 3073 residents were analyzed. The overall attrition rate was 3.7%. Multivariable regression showed older residents (≥30 years) had a 2.1 times higher risk of attrition compared to younger residents (≤29 years) (adjusted odds ratio [aOR]: 2.1; 95% confidence interval, CI [1.383-3.316], P < .001). Underrepresented minorities in medicine (URiM) residents had a 3.5 times higher risk of attrition compared to whites (aOR: 3.5; 95% CI [1.823-6.806], P < .001). Southern US programs had a 2.5 times higher risk of attrition compared to northeastern programs (aOR: 2.5; 95% CI [1.480-4.315], P < .001). There was no statistically significant difference in attrition based on sex, medical degree type, or matriculation year period.

Conclusion: A higher risk of attrition was found among OHNS trainees who were older, self-identified as URiM, and in the southern US programs. There was no significant difference in attrition risk based on gender, medical degree type, or matriculation period. Further research is needed to understand the reasons for attrition and to develop strategies to promote inclusion and diversity in OHNS.