AVAS Best Clinical Resident Award (Tied): Fate of non-designated preliminary general surgery residents seeking a categorical residency position

Abstract

Background As pyramidal programs in general surgery were eliminated in recent decades, nondesignated preliminary surgery (NDPS) positions were introduced to fill vacant positions. Graduating medical students can pursue NDPS positions with the goal of obtaining categorical positions in either general surgery residencies or other fields altogether. The fate of residents who complete 2 years as NDPS residents remains ill defined. Methods From 1997 to 2007, data concerning NDPS residents were prospectively collected from 2 general surgery training programs. Trainees were followed by prospectively gathered data, Internet identification, and internal records of hospital privileging. Results One hundred ten graduating medical students initiated postgraduate training as NDPS residents. Seventy-four (67%) were men, and 98 (89%) were international medical graduates. Among all 110 subjects, 95 (86%) were hired as postgraduate year 1 NDPS residents, and 15 (14%) were hired as postgraduate year 2 NDPS residents. Fifteen (14%) left postgraduate medical education. Fifty-two NDPS residents (47%) pursued nonsurgical specialties after their internships. Forty-three (39%) eventually matriculated as categorical general surgical residents. Of these, 20 (47%) became categorical residents in their initial training programs. Nearly all NDPS residents who proceed to categorical positions obtained board certification. Conclusions More than one third of NDPS residents successfully obtained categorical general surgery positions. Only a small fraction (14%) failed to continue in postgraduate medical education. NDPS positions allow most candidates successful career paths. The persistent rate of attrition among categorical surgical residents allows NDPS residents to join categorical training programs and become eligible for board certification in general surgery.