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The Impact of Fellowship Training in Academic Plastic Surgery
Francesco M. Egro, MD; Brandon T. Smith, MD; Carolyn P. Murphy, MD; Alexander G. Stavros, MD; Vu T. Nguyen, MD
University of Pittsburgh Medical Center, Pittsburgh, PA

Background: The competitive nature of an academic plastic surgery career has led to an increase in sub-specialization. Residents interested in a career in academia are therefore left with the dilemma of the value of pursuing further fellowship training. The aim of this study is to assess the benefits of sub-specialty fellowship training to pursue a career in academic plastic surgery.

Methods: A comprehensive database characterizing all current academic plastic surgeons (APS) participating in certified residency programs was created by cross-referencing 2018 ACGME program reports with online faculty website listings.

Results: A total of 931 APS met inclusion criteria, of which 67.2% had undergone fellowship training. Hand and upper extremity training was the most common fellowship (35.5%), followed by craniofacial surgery (32.8%), and microsurgery (28%). Although rates of fellowship attainment were significantly lower among APS who graduated from residency within the last 2 years [OR: 0.68, (95% CI: 0.51-0.90)], the overall trend demonstrates an increasing proportion of fellowship-trained APS over the past 15 years. Non-white APS were more likely to have had fellowship training [OR: 1.6, (95% CI: 1.15-2.25)], as were integrated residency trainees [OR: 2.34, (95%CI: 1.54-3.56)]. Those who completed fellowship training were more likely to be assistant professors [OR: 1.44, (95% CI: 1.09-1.92)], more likely to be fellowship directors [OR: 3.23, (95% CI: 1.58-6.63)], and less likely to be full professors [OR: 0.66, (95% CI: 0.49-0.90)]. After controlling for individual variation in years of post-residency experience, differences in fellowship attainment were no longer significant at the assistant professor [OR: 1.32, (95% CI: 0.87-1.99)] or full professor [OR: 0.89, (95% CI: 0.56-1.43)] positions. Additionally, fellowship attainment did not correlate with the size of the employing academic program, population of the city of practice, being a residency director or chair.

Conclusion: Although the majority of APS hold a fellowship, the evidence suggests that a fellowship doesn’t always lead to greater entry or advancement towards an academic career.

Previously Presented: 35th Annual Meeting of the Northeastern Society of Plastic Surgeons

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