Invited Critique |

Remediation and Attrition:  Are They Related?
Comment on “General Surgery Resident Remediation and Attrition”

Karen Deveney, MD
Arch Surg. 2012;147(9):833. doi:10.1001/archsurg.2012.1685.
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The article by Yaghoubian et al1 compiles data from 6 Western US surgical residency programs on the incidence and demographics of attrition and need for remediation of graduates from 1999 to 2010. Although an impressively high 31% required remediation at some time during their training, primarily for deficits of medical knowledge, most of these individuals did finish their residencies. The authors did not have data on whether the residents had difficulty passing their boards. In general, lower scores on standardized tests such as United States Medical Licensing Examination (USMLE) step 1 predicted the need for remediation. However, the mean USMLE step 1 score of the remediated group was a quite respectable 225, and those in that group also had a greater likelihood of having received honors in their surgery clerkship in medical school than those who did not need remediation.

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