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Many, many people start out in categorical surgery positions and then after a few months realize how hard surgery sucks. These people switch in to other specialties.Sebastian. said:
In other words, the attrition for residents at many surgery programs is tremenedous.
Before I get flamed, let me say that surgery is pretty cool but you have to love it, I mean absolutely love it to the exclusion of wife, family, God, and country or you will be miserable.
Case in point: I have a friend that did a surgery prelim year at a program that is coming under investigation. He worked 120+ hours/week and realized surgery was not for him. He liked it, but did not eat, breathe, and $#!t it. So now he is doing OB/GYN (go figure 
) and loving only having to work 80 hours/week.
) and loving only having to work 80 hours/week.There is a whole netherworld of people bouncing from prelim to prelim. At some point they either:
- land a gig in a rural ED (essentially as a GP)
- work at a 'doc in the box'
- earn a living on subsistence farming (aka insurance physicals)
- enter a family practice residency
- do another prelim in the hopes to become a surgeon
While there are some RRC limits on the number of non-designated prelims, there seem to be a good number of surgery residencies (ab)using them to maintain their pyramid scheme. Abolishing them alltogether would probably not be a big loss to medical education (it would however be a financial loss to the institutions participating in this game).
- land a gig in a rural ED (essentially as a GP)
- work at a 'doc in the box'
- earn a living on subsistence farming (aka insurance physicals)
- enter a family practice residency
- do another prelim in the hopes to become a surgeon
While there are some RRC limits on the number of non-designated prelims, there seem to be a good number of surgery residencies (ab)using them to maintain their pyramid scheme. Abolishing them alltogether would probably not be a big loss to medical education (it would however be a financial loss to the institutions participating in this game).