Early to mid-career attrition and employment outcomes among prosthetists and orthotists in the United States: An observational cross-sectional cohort study

BACKGROUND: For the United States or any county's Prosthetic and Orthotic profession, early to mid-career attrition and employment outcomes have not been published. OBJECTIVES: The primary objective of this study was to present a cross-sectional perspective of employment outcomes for a cohort of graduates from a single P&O graduate level training program 5 to 20 years postgraduation. The secondary objective was to calculate early to mid-career attrition rate. A tertiary objective was to measure time from graduation to certification and, for those who became certified and left clinical practice, measure the time before transitioning to other employment. STUDY DESIGN: This was an observational, cross-sectional cohort study design. METHODS: Graduates' careers were traced 5 to 20 years postgraduation, and on May 1, 2024, the employment status of the cohort was identified. Data on certification type, additional education, time from graduation to certification, and for some, to departure from clinical practice were calculated. Attrition was measured over a 16-year period. RESULTS: Ninety percent of graduates attained national certification. Five to 20 years postgraduation, 69% remained in clinical practice, 11% remained in the P&O profession in nonclinical roles, and 20% percent were not in P&O. Clinical practitioner timespan (CPT), the time from initiation in clinical practice until employment change, was an average 5.5 years. The early to mid-career annual attrition rate for this cohort of P&O graduates was 2.66%. CONCLUSIONS: Attrition within the US P&O profession is real, warrants further exploration and remediation. The metric of clinical practitioner timespan was introduced.