RS14 - The causes and incidence of trainee attrition amongst integrated vascular surgery programs.

Thursday, June 11, 2026

11:45 AM - 11:52 AM ET

Location: Hynes CC, Third Level, Ballroom B

Submitting & Presenting Author(s)

Sarah V. Lauve, MD

New Orleans, Louisiana

Co-Author(s)

TZ

Tara J. Zielke

Vascular Surgery Resident Physician
Division of Vascular Surgery, Department of Surgery, Indiana University, Indianapolis, IN
Indianapolis, Indiana
EC

Esteban Calle

Postdoctoral Research Fellow
Louisiana State University Health Sciences Center
New Orleans, Louisiana
DD

Denise Danos
YS

Yash Singh
Claudie M. Sheahan, MD

New Orleans, LA, Louisiana

Senior Author(s)

Dawn M. Coleman, MD

Chief, Division of Vascular and Endovascular Surgery and Professor of Surgery
Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University, Durham, NC
Durham, North Carolina

Senior Author Discussant(s)

Malachi G. Sheahan, III, MD

Department Head and Professor
Division of Vascular and Endovascular Surgery, Department of Surgery, Louisiana State University School of Medicine, New Orleans, LA
New Orleans, Louisiana

Objectives: The integrated training paradigm for vascular surgery was approved in 2007 and has surged in popularity over the past 18 years. While outcomes in terms of board passage rates and self-assessed “readiness for practice” meet or exceed those seen with the traditional fellowship pathway, little is known about the causes or incidence of trainee attrition. The purpose of this study was to address this knowledge gap by assessing trainee attrition in integrated vascular programs and compare this with the levels seen among the integrated pathways in interventional radiology, thoracic surgery, and plastic surgery.

Methods: Through an agreement with the Association of American Medical Colleges, data was extracted from the GME Track Resident dataset from 2014-2025. The primary outcome was attrition in an integrated residency program, defined as a binary event and time to event variable. Time to attrition was measured in years from year entered to year of attrition. Cumulative incidence of attrition was calculated using the Kaplan Meier method. Attrition was modeled with Cox proportional hazard models, executed separately for each type of program.

Results: During the 10-year study period, 4,232 residents entered an integrated residency program: 1,827 in plastic surgery (43.2%), 1,207 in interventional radiology (28.5%), 766 in vascular surgery (18.1%), and 432 in thoracic surgery (10.2%). Rates of attrition at the end of the program were comparable amongst plastic surgery, interventional radiology, and vascular surgery, 4.2% (CI:3.3-5.3), 4.6% (3.5-6.1), and 4.1% (CI: 2.8-5.8), respectively. Attrition was highest in thoracic surgery (8.7% (CI: 6.2-12.2) with a steep rate of attrition seen within the first year that was not seen in the other programs; however, no significant associated factors were identified. Within Vascular Surgery specifically, age is the only factor statistically associated with attrition with increased age upon entry associated with higher attrition rates (P <.05). US region was associated with attrition only in interventional radiology programs, with greatest rates of attrition in the west and south (P <.05). Gender, sex, citizenship, and medical school type were not associated with attrition (P>.05) in any specialty.

Conclusions: Attrition is rare among integrated vascular surgery training programs. While there is an increased risk with advanced age at matriculation, no gender disparities were seen. Attrition rates for integrated vascular programs are similar to those seen in comparable interventional radiology and plastic surgery paradigms, while thoracic surgery is an outlier, with a prevalence that is nearly double what is seen in the other integrated specialties.