American Council of Academic Plastic Surgeons

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Independent or Integrated Plastic Surgery Residency Pathways: Trends in Representation in Academic Plastic Surgery in the United States
Samyd S. Bustos1, Sarah P. Erpenbeck2, Brandon T. Smith2, Francesco M. Egro1, Vu T. Nguyen1
1Department of Plastic Surgery, University of Pittsburgh Medical Center, 2School of Medicine, University of Pittsburgh

Introduction: The training pathway for plastic surgery has evolved in recent years with the adoption and rise in popularity of the integrated model. Studies have demonstrated that there may be differences between integrated graduates and independent graduates, specifically in career choices and type of practice. This study seeks to understand if there are differences in representation at academic and leadership positions between graduates of the two pathways
Methods: A cross-sectional study was conducted in June of 2018 to assess integrated and independent pathway graduate’s representation in academic plastic surgery in the United States. Factors examined were career qualifications, academic productivity, faculty positions, and influence of pathway on career advancement
Results: A total of 924 academic plastic surgeons were analyzed, 203 (22.0%) of whom were integrated graduates and 721 (78.0%) of whom were independent graduates. Independent graduates had greater NIH funding (integrated=$40,802, independent=$257,428, p=0.0043), higher h-index (integrated=7.0, independent=10.0, p<0.001), and higher publication number (integrated=17, independent=25, p=0.0011). Integrated graduates were more likely to be assistant professors (integrated=70%, independent=40.7%, p<0.001) and required a shorter post-residency time to reach all positions examined compared to independent graduates
Conclusion: Residency training pathway influences academic plastic surgeons in research output, qualifications, and academic positions. This may reflect qualities inherent to the type of individuals each pathway attracts as well as research skills developed during residency and perceptions of graduates from both models.


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