Attrition in the Training Programs of the University of the Philippines-Philippine General Hospital (UP-PGH): A 5-year Review of Trends and Reasons from 2018-2022.

Background and objective: Attrition in the medical training programs not only affects the specialty but also the hospital, the trainee's career path, and the provision of care to patients. This study aims to determine the trends, annual rates, and reasons of attrition at the University of the Philippines-Philippine General Hospital (UP-PGH) from 2018-2022.

Methods: The study was carried out in two stages. A retrospective review of trainees' records from the Office of the Deputy Director of Health Operations (ODDHO) and Human Resource Department (HRD) was initially done followed by a survey of the resident training officers (RTOs). Associations between physician and program attributes to attrition were analyzed using t-test and Chi-square at p <0.05 level of significance.

Results: There were 141 resignations recorded during the 5-year review (residents=113, fellows=28). The mean age for residents was 28.76 years ± 3.05, 55.75% were females, 59.29% graduated from non-UP College of Medicine (UPCM) schools, and 92.92% were single. Most left during their first year (53.98%); Ob-Gyne (n=20) and Anesthesiology (n=18) had the most number of drop-outs. For fellows, the mean age was 32.73 years ± 2.70, most were female (60.71%), single (71.43%), from non-UPCM schools (71.43%), left during their 1^st year (78.57%) and not from PGH residency (78.57%). Pediatrics (n=13) and Internal Medicine (n=9) had the highest numbers of fellow resignations. The reasons cited were mental health, unmet expectation, change in specialty, and sickness. The mean resident attrition rate was 3.51% while for fellows it was 1.36%, an evident rise was seen during the COVID-19 years.

Conclusion: The decision to take postgraduate training is a personal journey for medical graduates. It is important to focus on strategies in identifying modifiable stressors during demanding times and be more receptive in addressing anxiety and mental health issues. Adjustments in the selection process must give applicants the real-world feel of the training environment, so a more realistic expectation will be met.