Resident dropouts and fellow resignations are often driven by mental health issues, unmet expectations, specialty changes, and illness

30 Jun 2026

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 to 2022, and to explore physician and program characteristics associated with attrition.

A retrospective review of trainees’ records from the Office of the Deputy Director of Health Operations, and Human Resource Department was initially done, followed by a survey of the resident training officers. Associations between physician and program attributes to attrition were analyzed using t-test and Chi-square at p <0.05 level of significance.

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 largest number of dropouts.

For fellows, the mean age was 32.73 years, most were female (60.71%), single (71.43%), from non-UPCM schools (71.43%), left during their 1st 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 expectations, 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.

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

Premature resignation has ramifications and detrimental consequences for the provision of patient care, aside from the substantial and unquantifiable liability to manpower. Attrition in residency programs has been widely studied in recent decades in Western countries, but no definitive solutions have been identified. The paucity of literature on the local setting, particularly in UP-PGH, makes it worth investigating.

Authors: Scarlett Mia Soleta Tabuñar (Department of Emergency Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila) and Marie Dionne Parreño Sacdalan (Department of Surgery, College of Medicine and Philippine General Hospital, University of the Philippines Manila)

Read the full paper: https://doi.org/10.47895/amp.v59i6.9376

Image by Mix and Match Studio from Pexels

Resident dropouts and fellow resignations are often driven by mental health issues, unmet expectations, specialty changes, and illness

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 to 2022, and to explore physician and program characteristics associated with attrition.

A retrospective review of trainees’ records from the Office of the Deputy Director of Health Operations, and Human Resource Department was initially done, followed by a survey of the resident training officers. Associations between physician and program attributes to attrition were analyzed using t-test and Chi-square at p <0.05 level of significance.

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 largest number of dropouts.

For fellows, the mean age was 32.73 years, most were female (60.71%), single (71.43%), from non-UPCM schools (71.43%), left during their 1st 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 expectations, 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.

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

Premature resignation has ramifications and detrimental consequences for the provision of patient care, aside from the substantial and unquantifiable liability to manpower. Attrition in residency programs has been widely studied in recent decades in Western countries, but no definitive solutions have been identified. The paucity of literature on the local setting, particularly in UP-PGH, makes it worth investigating.

Authors: Scarlett Mia Soleta Tabuñar (Department of Emergency Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila) and Marie Dionne Parreño Sacdalan (Department of Surgery, College of Medicine and Philippine General Hospital, University of the Philippines Manila)

Read the full paper: https://doi.org/10.47895/amp.v59i6.9376

Image by Mix and Match Studio from Pexels