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Trends in sub-specialty fellowship training to pursue a non-academic plastic surgery career

Egro FM, Daji AV, Gilbert NL, Smith BT, Nguyen VT
University of Pittsburgh Medical Center
2019-01-31

Presenter: Akshay Daji

Affidavit:
This work is the original work of Dr. Francesco Egro, Akshay Daji, Nicholas Gilbert, Brandon Smith, and Dr. Vu Nguyen.

Director Name: Vu Nguyen

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction

Introduction:
Most plastic surgery residents choose to pursue private practice immediately upon graduating, but many decide to pursue fellowship training because of a perceived benefit in career selection. The aim of this study was to assess the trends of sub-specialty fellowship training in pursuing a career in non-academic plastic surgery.

Methods:
Three-hundred ASPS board-certified private practice plastic surgeons were randomly selected via the ASPS website and matched to 300 academic surgeons based on year of residency graduation. Demographics, residency and fellowship background, practice interests/type were collected from institutional and practice websites, Doximity, LinkedIn, and Google. Between-group analyses were made via odds ratios and within-group analyses were completed via Chi-squared testing.

Results:
Non-academic plastic surgeons are less likely to have undergone sub-specialty fellowship training (41% private, 67% academic, p<0.0001) with microsurgery (12%) and aesthetic surgery (10%) being the most common fellowship choices. Graduates within the last 10 years (2008-2018) who went into private practice were more likely to have foregone fellowship training (χ2=0.0042). Integrated plastic surgeon residents are more likely to have completed fellowship training compared to independent plastic surgery residents (53.9% vs. 37.6%; p=0.019). Age, race, and gender did not significantly correlate with fellowship attainment (p=NS).

Conclusions:
This study provides plastic surgery residents with objective evidence regarding the need for sub-specialty fellowship training to pursue a non-academic career. Less than half of non-academic surgeons have undergone fellowship training for all sub-specialty focuses and practice types. This trend does not appear to be changing, as recent graduates are more likely to forego fellowship training before entering non-academic practice.

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