Abstract
BACKGROUND: Currently, there are no data available on dropouts from residency programs and changes of clinic in orthopedics and trauma surgery (O&T). The aim of the study is to identify personal and structural risk factors leading to dropout or switching of postgraduate training in O&T in order to present solution strategies. METHODS: A nationwide anonymous online survey was conducted among residents in O&T in summer 2020. Official mail addresses were identified via the Traumanetzwerk© of the DGU and the German Hospital Federation (n = 2090). A questionnaire (51 questions) was administered using SurveyMonkey (San Mateo, CA, USA). All residents who worked in O&T for at least 1 month in the 6 years prior to the start of the survey (from 07/2014) were eligible to participate. A binary logistic regression was calculated to identify the risk factors. The significance level was p = 0.05. RESULTS: Of the 221 respondents, 37% switched hospital and 5% dropped out altogether. The regression revealed 3 significant risk factors for switching hospitals. Living in a partnership (p = 0.029, RR: 2.823) and less than 2 days of shadowing before the start of residency (p = 0.002, RR: 2.4) increased the risk of switching. Operating room (OR) allocation of residents according to the training plan/status (p = 0.028, RR: 0.48) reduces the risk of switching. Significant risk factors for leaving postgraduate training could not be determined (insufficient number of cases, n = 11). DISCUSSION: Switching the hospital and residency dropouts in O&T are a relevant problem (42%). Gender has no significant influence. Tools such as longer job shadowing, as well as OR allocation according to the training plan/status can minimize the risk of switching.