The Impact of Fellowship Training in Academic Plastic Surgery

Egro, Francesco M.; Smith, Brandon T.; Murphy, Carolyn P.; Stavros, Alexander G.; Nguyen, Vu T.

doi:10.1097/sap.0000000000002932

Cited by 12 publications

(9 citation statements)

References 14 publications

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“…Although not all residents pursue fellowship, it is understood that fellowship training is advantageous when pursuing academic plastic surgery careers. 6 This study aims to identify the current racial/ethnic and gender landscape of plastic surgery fellows in microsurgery fellowships and craniofacial surgery fellowships in the last decade and how it compares with that of medical students, plastic surgery residents, and faculty.…”

Section: Introductionmentioning

confidence: 99%

“…Although gender and racial representations have been studied at the resident level and faculty level, it remains elusive how representation is in the step that frequently runs between—fellowship training. Although not all residents pursue fellowship, it is understood that fellowship training is advantageous when pursuing academic plastic surgery careers 6 . This study aims to identify the current racial/ethnic and gender landscape of plastic surgery fellows in microsurgery fellowships and craniofacial surgery fellowships in the last decade and how it compares with that of medical students, plastic surgery residents, and faculty.…”

Section: Introductionmentioning

confidence: 99%

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Racial/Ethnic and Gender Disparities Over the Last Decade Within Microsurgery and Craniofacial Fellowship Training

Oberoi

Reghunathan

Aref³

et al. 2023

Ann Plast Surg

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BackgroundRacial/ethnic and gender disparities persist in plastic surgery at nearly all levels of training, becoming more pronounced at each stage. Recent studies have demonstrated that the proportion of female plastic surgery residents has increased to nearly 40%, yet only 11% of full professors of plastic surgery are female. Other studies have identified severe declines in underrepresented minority plastic surgery representation between plastic surgery residents and academicians with only 1.6% of Black/African American and 4.9% of Hispanic/Latinx full professors of plastic surgery. Often, residents seek fellowship for advanced training before seeking an academic professorship. This study aims to describe the racial/ethnic and gender representation of microsurgery and craniofacial fellows.MethodsNames and photos of graduated fellows for the past 10 years (2012–2021) were extracted from microsurgery and craniofacial fellowship Web sites. Using a 2-person evaluation method, race/ethnicity and gender were primarily determined by photographic and surname and verified, when possible, through online confirmation methods (articles, social media). Distributions were analyzed with descriptive statistics and compared with the US population.ResultsAmong 30 microsurgery fellowships, 180 graduated fellows (52.7%) were identified, resulting in 66 female fellows (36.7%) and the following racial/ethnic distribution: 113 (62.8%) White, 49 (27.2%) Asian, 12 (6.7%) Hispanic/Latinx, and 6 (3.3%) Black/African American. Among 31 craniofacial fellowships, 136 graduated fellows (45.0%) were identified, resulting in 38 female fellows (27.9%) and the following racial/ethnic distribution: 75 (55.1%) White, 45 (33.1%) Asian, 8 (5.9%) Hispanic/Latinx, and 8 (5.9%) Black/African American. The intersection between race/ethnicity and gender revealed the most disproportionately low representation among Black women. Relative to the US population, Hispanic/Latinx (0.31-fold) and Black/African American (0.48-fold) fellows were underrepresented, White (0.90-fold) fellows were nearly equally represented, and Asian (5.42-fold) fellows are overrepresented relative to the US population. Furthermore, despite pursuing fellowships at a greater rate, Asian and Black fellows are not reaching adequate representation among academic plastic surgeons.ConclusionThis study demonstrates that female racial/ethnic minorities are disproportionately underrepresented among microsurgery and craniofacial fellowships. Efforts should be made to improve the recruitment of fellows of underrepresented backgrounds and thus improve the pipeline into academic careers.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Racial/Ethnic and Gender Disparities Over the Last Decade Within Microsurgery and Craniofacial Fellowship Training

Oberoi

Reghunathan

Aref³

et al. 2023

Ann Plast Surg

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“…For trainees considering an academic career, high-quality surgical training and research productivity are often pursued to be considered against the competitive pool of applicants for highly coveted faculty positions. 7–10 Despite the substantial increase in the number of faculty positions in plastic and reconstructive surgery (PRS) programs over the past decade, the annual number of open faculty positions remains limited partly due to high retention rates. 6,11 Compared with other specialties, plastic surgery has one of the highest 5-year retention rates, with 81% of faculty retained per year.…”

Section: Introductionmentioning

confidence: 99%

Trends in Fellowship Training across United States Plastic and Reconstructive Surgery Academic Faculty

Bovill

Haffner

Huffman

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Plastic and reconstructive surgery (PRS) academic positions are more coveted each year. We aim to determine the requirement of fellowship training before PRS academic appointments. Methods: PRS faculty at U.S. academic institutions associated with the American Society of Plastic Surgeons were identified. Outcomes studied included integrated versus independent training, fellowships, gender, academic title, years on faculty, and publications before current hire. Results: Of the 1052 PRS faculty identified, 646 were included across 41 states and the District of Columbia. Seventy-four percent were identified as men (n = 477), and 26.2% (n = 169) identified as women. Academic faculty were significantly more likely to have completed fellowship before hire than not (p<0.0001). An integrated route of training was associated with higher odds of fellowship completion before appointment (OR = 2.19, 95% CI: 1.49-3.22). Odds of fellowship completion was significantly greater among faculty who graduated 5-10 years ago (OR = 2.55, 95% CI: 1.48-4.41) and within the last 5 years (OR = 1.93, 95% CI: 1.18-3.17). Professors were less likely to have completed fellowship training before appointment compared with assistant professors (OR = 0.51, 95% CI: 0.33-0.80). Regarding gender, number of prior publications, or completion of another degree, no significant difference was found between fellowship-and non-fellowship-trained faculty. Conclusions: Although more plastic surgeons enter the field through a shortened integrated residency, the increasing demand for further subspecialization may cause significant challenges for upcoming graduates pursuing an academic appointment. Undergoing additional training considerably impacts social and financial decision-making early in surgical careers for newly graduated residents.

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“…2 While plastic surgeons may practice in a variety of settings, subspecialties that are most strongly associated with a career in academia are craniofacial surgery, microsurgery, and hand surgery. 3,4 In the experience of the senior author (A.K.G. ), applicants frequently express interest in academia and in academic subspecialties at the time of their interviews and early in training.…”

mentioning

confidence: 99%

“…The Accreditation Council for Graduate Medical Education (ACGME) only offers accreditation for 2 plastic surgery subspecialties: craniofacial and hand surgery 2. While plastic surgeons may practice in a variety of settings, subspecialties that are most strongly associated with a career in academia are craniofacial surgery, microsurgery, and hand surgery 3,4…”

mentioning

confidence: 99%

Changes in Subspecialty Interest of Plastic Surgery Residents With Progression of Training: Impact on Academic Attrition

Stoehr

Vaca

Bacos

et al. 2023

Journal of Craniofacial Surgery

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Background: Plastic surgery residency applicants often express interest in academic subspecialties, but only a small percentage of graduating residents pursue academic careers. Identifying reasons for academic attrition may help training programs address this discrepancy. Methods: A survey was sent to plastic surgery residents through the American Society of Plastic Surgeons Resident Council to assess interest in 6 plastic surgery subspecialties during junior and senior years of training. If a resident changed their subspecialty interest, the reasons for change were recorded. The importance of different career incentives over time were analyzed with paired t tests. Results: Two hundred seventy-six plastic surgery residents of 593 potential respondents (46.5% response rate) completed the survey. Of 150 senior residents, 60 residents reported changing interests from their junior to senior years. Craniofacial and microsurgery were identified as the specialties with the highest attrition of interest, while interest in esthetic, gender-affirmation, and hand surgery increased. For residents who left craniofacial and microsurgery, the desire for higher compensation, to work in private practice, and the desire for improved job opportunities significantly increased. The desire for improved work/life balance was a prominent reason for subspecialty change among senior residents who changed to esthetic surgery. Conclusions: Plastic surgery subspecialties associated with academia, such as craniofacial surgery, suffer from resident attrition due to a variety of factors. Increased retention of trainees in craniofacial surgery, microsurgery, and academia could be improved through dedicated mentorship, improved job opportunities, and advocacy for fair reimbursement.

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The Impact of Fellowship Training in Academic Plastic Surgery

Cited by 12 publications

References 14 publications

Racial/Ethnic and Gender Disparities Over the Last Decade Within Microsurgery and Craniofacial Fellowship Training

Racial/Ethnic and Gender Disparities Over the Last Decade Within Microsurgery and Craniofacial Fellowship Training

Trends in Fellowship Training across United States Plastic and Reconstructive Surgery Academic Faculty

Changes in Subspecialty Interest of Plastic Surgery Residents With Progression of Training: Impact on Academic Attrition

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