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A Qualitative Study of United States Burn Units: Pathways to a Career in Burn Surgery
Francesco M. Egro, MD; Erica Johnson, MD; Elizabeth M. Kenny, MD; Aaron M. Foglio, MD; Vu T. Nguyen, MD; Alain A. Corcos, MD; Jenny A. Ziembicki, MD
University of Pittsburgh Medical Center, Pittsburgh, PA

Background: The leadership and teams involved in the different aspects of burn care varies greatly by hospital and country. With current changes in training requirements, it is important to understand the venues in the United States for a general surgery (GS) and plastic surgery (PS) resident interested in pursuing a burn surgery career. The aim of this study was to evaluate the current state of leadership and care in burn centers across the United States, and the training requirements to secure a burn surgery position.

Methods: A cross-sectional study was conducted between August and September 2017. A 12-question survey was sent to all Burn Unit Directors in the United States. Directors were queried about their background, who manages various aspects of burn care at their respective hospitals, and the hiring requirements.

Results: Responses were received from 55 burn unit directors (47% response rate). Burn units are lead most commonly by physicians who received GS training (69%), but interestingly the majority either did not undergo fellowship training (31%) or completed a burn surgery fellowship (29%). While surgical care (GS=51%, PS=42%) and wound care (GS=51%, PS=42%) were predominantly managed by GS or PS-trained burn teams, management of other aspects of burn care varied depending on the institution, demonstrating that a shift in burn care management is occurring. The desired hiring characteristics included GS (67%) or PS residency (44%), and a burn surgery (55%), trauma surgery (15%), or critical care (44%) fellowship. Directorsí training significantly influenced their preferences for hiring requirements.

Conclusion: While leadership in burn surgery is dominated by GS-trained physicians, the surgical and wound care responsibilities are shared among PS and GS. Although one third of current directors did not undergo fellowship training, aspiring surgeons are advised to obtain a burn surgery and/or critical care fellowship.

Previously Presented: Plastic Surgery The Meeting. Top 6 Poster Presentation invited to be presented at ASPS Center Stage. 61st Annual Meeting of the Ohio Valley Society of Plastic Surgeons.

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