Faculty, Staff and Student Publications
Language
English
Publication Date
1-1-2025
Journal
Journal of Educational Evaluation for Health Professions
DOI
10.3352/jeehp.2025.22.24
PMID
40999588
PMCID
PMC12676133
PubMedCentral® Posted Date
9-5-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Purpose: Declining fill rates in US pediatric residency and subspecialty programs requires trainee retention. Attrition, defined as transfers, withdrawals, dismissals, unsuccessful completions, or deaths, disrupts program function and impacts the pediatric workforce pipeline. It aims to evaluate attrition trends among pediatric residents and fellows in Accreditation Council for Graduate Medical Education (ACGME)-accredited programs from 2007 to 2020.
Methods: This repeated cross-sectional study analyzed publicly available ACGME Data Resource Book records. Attrition rates and 95% confidence intervals (CIs) were calculated overall and by subspecialty. Logistic regression assessed temporal changes; odds ratios (ORs) compared 2020 to 2007.
Results: From 2007-2020, pediatric residents increased from 8,145 to 9,419 and fellows from 2,875 to 4,279. Aggregate annual resident attrition averaged 1.71% (range, 0.93%-2.64%), and fellow attrition ranged from 12.39%-30.87%. Transfer rates declined from 18.05 to 5.20 per 1,000 trainees (P< 0.0001), withdrawals from 5.65 to 2.76 (P=0.030), and dismissals from 3.14 in 2010 to 1.27 in 2020 (P=0.0068). Odds of unsuccessful completion significantly decreased in categorical pediatrics (OR, 0.41; 95% CI, 0.29-0.58), pediatric cardiology (OR, 0.08; 95% CI, 0.01-0.64), pediatric critical care (OR, 0.14; 95% CI, 0.06-0.35), and neonatal-perinatal medicine (OR, 0.46; 95% CI, 0.20-1.08).
Conclusion: Although attrition has improved, premature trainee loss can still disrupt program operations and threaten workforce development. Attrition may reflect educational environment quality, support structures, or selection processes. Greater data transparency is needed to understand demographic trends and inform equitable retention strategies, ultimately strengthening training programs and sustaining the United States pediatric workforce.
Keywords
Humans, Cross-Sectional Studies, Internship and Residency, United States, Pediatrics, Fellowships and Scholarships, Education, Medical, Graduate, Accreditation, compensation, diversity, equity, faculty, inclusion, salary, Accreditation, Graduate medical education, Program evaluation, Workforce, United States
Published Open-Access
yes
Recommended Citation
Emma Omoruyi, Greg Russell, and Kimberly Montez, "Decline in Attrition Rates in United States Pediatric Residency and Fellowship Programs, 2007–2020: A Repeated Cross-Sectional Study" (2025). Faculty, Staff and Student Publications. 4234.
https://digitalcommons.library.tmc.edu/uthmed_docs/4234
Graphical Abstract