Little is known about the fate of categorical surgical residents who leave a program or if they differ from those who successfully complete a program.Matching into separate categorical and preliminary categories with elimination of the pyramid began in 1982. The files of all categorical residents matched between 1982 and 1995 were reviewed for demographic and scholastic data. Drop-outs were compared with the residents who completed the program and with the current house staff. All residents have been followed up to the present.Between 1982 and 1996, 19 of 88 (22%) categorical residents who matched into the program left voluntarily. Eleven of 63 (17%) were male and 8 of 25 (32%) female (P = 0.12; test of proportions-Z = -1.55). They entered both surgical and nonsurgical fields. The major reasons for leaving were related to life-style issues. Their academic credentials are very similar to those who remained.The drop-out rate of categorical surgical residents is significant, and replacing them is not easy. We have not identified any characteristics that might predict attrition.