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Attrition is a disruptive problem in residency training programs. Resident attrition has been more thoroughly investigated and reported in other medical fields with limited data specific to otolaryngology. Using a Web-based survey of otolaryngology residency program directors, information regarding a 5-year cohort of residents was collected. The survey response rate was 61% (59 of 97 programs), representing 779 of 1239 training positions (63%). Forty-two percent of responding programs (25 of 59) lost a total of 47 residents (range, 1-7; mode 1). The overall attrition rate was 6% for the 5-year cohort (47 of 779) or 1.2% annually. Involuntary attrition affected 6 residents. Eighteen residents voluntarily left for other medical programs. Four left medicine entirely. The remaining 19 residents' career paths were not described. Attrition within otolaryngology occurs with less frequency than general surgery and is likely comparable to other surgical subspecialties.

Objectives: Applying the concept of the ACGME general competencies, it is possible to define the essential job objectives and competencies of a junior otolaryngology resident. The objective of this study is to incorporate commercially available tools of business in the identification of competencies specific to the junior otolaryngology resident and develop behavioral-based interview questions and techniques designed to identify these qualities in candidates for residency., Study Design: Institution of a pilot program involving a focus group within an otolaryngology department, a professional development consultant, commercial business software for occupational analysis and personnel selection, and an interview technique training seminar for faculty and residents., Methods: In coordination with a university-based professional development consultant, a formal job analysis was conducted to define the job objectives and competencies of a junior otolaryngology resident. These results were used to generate behavioral-based interview questions for use in the resident selection process. All interviewing faculty and residents were trained in behavioral-based interviewing., Results: Occupational objectives for the junior resident position specific to a particular university department of otolaryngology were identified. Additionally, the essential skills, areas of knowledge, and competencies were identified. Behavioral-based questions specific to the competencies were created and incorporated into the current resident selection interview., Conclusions: Using tools of occupational analysis and personnel selection, a list of job objectives and competencies for the junior otolaryngology resident can be created. Using these results, behavioral-based interviews may be implemented to complement traditional interviews with the ultimate goal of improving candidate selection.