Getting Cut : Failing to Survive Surgical Residency Training

The national withdrawal rate from medical school averages about 1%, but withdrawal from surgical residency programs is much higher, roughly 16%. The drop out risk is greater for white women and minorities than for white males. Getting Cut examines the factors which lead to resignation from these graduate residency programs by observing the dynamic interplay between the institution and individual residents. Professor O'Connell analyzes the current shortcomings in the process of selection, and looks at how the culture, structure, and organization of these educational programs affect the drop out rate once residents have been accepted. An analysis of the "old boy's network" culture of these surgical programs exposes the greater risk of withdrawal among female and minority residents. Further examination of the process of resident evaluation reveals that in addition to being graded on cognitive knowledge and critical judgment, residents are also evaluated on personal characteristics, the most important being "honesty." Professor O'Connell demonstrates how the medical faculty's subjective assessment of these elusive and contestable qualities not only aid in identifying the morally deficient among the technically proficient, but also how these practices promote discrimination as well.

The national withdrawal rate from medical school averages about 1%, but withdrawal from surgical residency programs is much higher, roughly 16%. The drop out risk is greater for white women and minorities than for white males. Getting Cut examines the factors which lead to resignation from these graduate residency programs by observing the dynamic interplay between the institution and individual residents. Professor O''Connell analyzes the current shortcomings in the process of selection, and looks at how the culture, structure, and organization of these educational programs affect the drop out rate once residents have been accepted. An analysis of the "old boy''s network" culture of these surgical programs exposes the greater risk of withdrawal among female and minority residents. Further examination of the process of resident evaluation reveals that in addition to being graded on cognitive knowledge and critical judgment, residents are also evaluated on personal characteristics, the most important being "honesty." Professor O''Connell demonstrates how the medical faculty''s subjective assessment of these elusive and contestable qualities not only aid in identifying the morally deficient among the technically proficient, but also how these practices promote discrimination as well.