To compare training experiences of postgraduate year (PGY)-1 and PGY-2 categorical and nondesignated preliminary (NDP) residents and examine NDP educational outcomes.
There is a paucity of research describing the professional attitudes of NDP surgical trainees.
Analysis of the 2009 National Study of Expectations and Attitudes of Residents in Surgery survey and American Board of Surgery 2009 to 2011 Resident Rosters. Chi-square and hierarchical logistic regression modeling were employed.
A total of 1428 PGY-1s (528 NDPs) and 1234 PGY-2s (189 NDPs) were included. Among PGY-1s, NDPs reported lower program satisfaction than categorical residents (84.2% vs 89.2%, P = .007), and less collegiality with coresidents (P = 0.001). NDPs were less satisfied with their operative experience (P = 0.002) and less frequently enjoyed operating (P < 0.001). NDPs more frequently reported that “the personal cost of surgical training is not worth it” (11.2% vs 3.7%, P < 0.001) and were less frequently committed to completing their surgical training (P < 0.001). Among PGY-2s, NDPs expressed a lower program fit (P = 0.008) and commitment to program completion (P = 0.037). Of 1102 NDP PGY-1s and PGY-2s on the 2009 American Board of Surgery Resident Roster, 347 achieved categorical status by 2011 (31.5%), including 237 National Study of Expectations and Attitudes of Residents in Surgery respondents (34.3%). Marked response differences were found between NDPs who ultimately did and did not achieve categorical status. In hierarchical logistic regression modeling, older age [30–34 years, odds ratio (OR): 0.54; ≥35 years, OR: 0.28), and race/ethnicity (black, OR: 0.28; Hispanic, OR: 0.50) were negatively associated with an NDP attaining categorical status.
The residency experience for NDPs appears less rewarding than for categorical residents. NDPs report less robust operative experience and overall support. Ultimately, only one third of NDPs become categorical surgery residents.