Variables impacting the likelihood of successful remediation during residency training

Introduction Factors influencing successful remediation in postgraduate medical education remain largely unexplored. This study aims to investigate the variables associated with remediation outcomes.Methods This was a retrospective cohort study of all residents who underwent remediation from July 1, 2012 – June 30, 2024 at the University of Calgary Cumming School of Medicine Postgraduate Medical Education. Multilevel mixed-effects logistic regression was used to identify outcome variables associated with remediation success.Results The most common CanMEDS roles remediated were Professional (52.7%), Communicator (51.1%), and Medical Expert (45.1%). Reduced odds of successful remediation were seen when the remediation plan included the Medical Expert Role (Odds Ratio (OR) 0.35 [0.14, 0.82], p = 0.016); and an increasing number of successful prior remediations (OR 0.58 [0.35, 0.95], p = 0.029).Discussion Remediation rates in postgraduate medical education are rising. Difficulties in the Medical Expert role are associated with lower remediation success and persistent issues that lead to recurrent remediations predict poor outcomes. Support should target core competencies, provide compassionate exit strategies for recurring struggles, and prioritize early intervention research.