A recent paper in Annals of Surgery depicts the rate of resident remediation over a decade or so at six general surgery programs in California. The authors reviewed the records of 348 categorical general surgery residents and found that 107 (31 percent) required mediation with knowledge deficits the primary reason in 74 percent. Other issues, such as interpersonal and communication skills, patient care and professionalism, were cited far less often.
Need for remediation did not correlate with attrition. Remediated residents left programs at a rate of 20 percent compared to 15 percent of non-remediated residents, p = 0.40.
On multivariate analysis, only two factors were associated with the need for remediation. One was USMLE Step 1 scores which were lower in the remediated group. But the median difference in scores between remediated and non-remediated residents was only 7 points with wide and overlapping interquartile ranges, and both median scores were above the average for all medical students over the years of the study.