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Reddy NK, Gutowski KS, Yau A, Lentskevich MA, Aronson S, Bajaj A, Weissman JP, Crawford S, Gosain AK. Effect of Training Backgrounds on Plastic Surgery Leadership: A Logistic Regression Analysis. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5776. [PMID: 38784834 PMCID: PMC11115985 DOI: 10.1097/gox.0000000000005776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/11/2024] [Indexed: 05/25/2024]
Abstract
Background Although career choices are often shaped by training and mentors, it is not clear how training backgrounds have influenced whether plastic surgeons pursue leadership positions. Analysis of these training pathways can serve as a key component of career planning for future leaders. Methods The American Board of Plastic Surgery's annual Newsletter to Diplomates was used to collate surgeons receiving board certification between 2002 and 2013. Online public profiles were used to collect training background data about each surgeon, including fellowship training, board certification year, MBA degree, otolaryngology or maxillofacial surgery training before commencing plastic surgery training, and leadership positions in surgery. A logistic multinomial regression was used to test the effect of training backgrounds on different types of leadership positions. Results In total, 2190 plastic surgeons were included in the analysis. Factors increasing the probability of holding any type of position included fellowships in microsurgery, craniofacial, and hand; an international fellowship; multiple fellowships; a fellowship not otherwise specified; and MBA degree. Training background factors affected probabilities differently for each of the studied positions including chair/chief, vice chair/vice chief, program director, plastic surgery medical director, other institutional positions, and national society positions. Conclusions Training backgrounds of plastic surgeons in leadership positions are multifaceted, involving a mix of intrinsic and extrinsic factors such as additional educational pursuits, subspecialty training, duration of practice, and practice setting. This analysis can help direct current trainees who aspire to future leadership in plastic surgery.
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Affiliation(s)
- Narainsai K. Reddy
- From the Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Kristof S. Gutowski
- From the Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Alice Yau
- From the Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Marina A. Lentskevich
- From the Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Sofia Aronson
- From the Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Anitesh Bajaj
- From the Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Joshua P. Weissman
- From the Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Scott Crawford
- Department of Statistics, Texas A&M University, College Station, Tex
| | - Arun K. Gosain
- From the Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ill
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Aref Y, Engel PV, Miao X, Givant M, Seify H. An Analysis of the Characteristics and Trends in Practicing Plastic Surgeons in California. Ann Plast Surg 2024; 92:S336-S339. [PMID: 38689415 DOI: 10.1097/sap.0000000000003846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
BACKGROUND Studies suggest an increasing trend of plastic surgeons choosing private practice after training, with up to 90% pursuing private practice without future fellowships.1 Previous data showed that 66.7% of graduates from plastic surgery residency programs chose to pursue private practice without future fellowship, while more recent studies estimate this statistic has risen close to 90%.1,2 The literature has yet to characterize the current plastic surgery workforce and changes in its composition over time. This study aims to analyze the characteristics and training of plastic surgeons in California through a comparative study with general surgeons. METHODS Surgeon demographics were extracted from the Centers for Medicare and Medicaid Services open database. Urban/rural classification and academic affiliation were crosslinked from the Inpatient Prospective System database and sole proprietorship status was cross-linked from the NPI Registry. Summary statistics and logistic regressions with chi-squared analysis were analyzed using STATA/MP17. RESULTS Our analysis consisted of 3871 plastic and general surgeons in California. Compared to general surgeons, plastic surgeons were less likely to be females (P < 0.000), and more likely to be sole proprietors (P < 0.000), and affiliated with a teaching hospital (P < 0.005). There was no statistically significant difference in the percentage of rural-practicing plastic and general surgeons (P = 0.590). More recent plastic surgery graduates were more likely to be affiliated with an academic hospital (P < 0.0000). The composition of females significantly increased from the older graduated cohort to the most recent one. There was no significant difference in sole proprietorship and rural practice status between the oldest and youngest graduating cohorts. CONCLUSIONS Although the California plastic surgery workforce is gaining female plastic surgeons and shifting to academic institutions, significant progress in serving rural communities is yet to be made. Our study suggests that there may be a shift in the trend of plastic surgeons opting for private practice, possibly driven by a desire for more stable positions in academia. Continued improvement in diversity and training of future plastic surgeons is needed to alleviate the rural care gap.
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Affiliation(s)
- Youssef Aref
- From the California University of Science and Medicine School of Medicine, Colton
| | - Priya Vedula Engel
- From the California University of Science and Medicine School of Medicine, Colton
| | - Xinfei Miao
- From the California University of Science and Medicine School of Medicine, Colton
| | - Madeleine Givant
- From the California University of Science and Medicine School of Medicine, Colton
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Mullen SA, Akhter HM, Weis LE, Samson KK, Hon HH. Independent Plastic Surgery Match Regional Trends Comparing In-person and Virtual Interview Cycles. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5691. [PMID: 38528845 PMCID: PMC10962897 DOI: 10.1097/gox.0000000000005691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/02/2024] [Indexed: 03/27/2024]
Abstract
Background There is a trend toward matching in a different region than previous training for the independent plastic surgery match cycles from 2019 to 2021, which differs from the trend to match within the same region for integrated plastic surgery programs. Notably, residency interviews transitioned from in-person to virtual in 2020 due to the coronavirus pandemic. Therefore, we compared in-person versus virtual interview match trends from 2019 to 2023. Methods Zip codes and regions of each successfully matched plastic surgery applicant's medical school, residency, and plastic surgery program were gathered from publicly available data for the 2019 and 2020 in-person interview cycles and 2021, 2022, and 2023 virtual interview cycles. Results Although regions did not differ significantly in the proportions of positions each year (P = 0.85), there was a trend toward fewer positions in each region from 2019 to 2022. Overall, applicants were more likely to match in a different region as their medical school or residency during virtual compared with in-person interviews (P = 0.002 and P = 0.04). Applicants matched to programs further from their medical school zip code in virtual interview years (P = 0.02). There was no significant difference in distance between surgical residencies and plastic surgery residencies between the two time periods (P = 0.51). Conclusions Trends toward matching into a different region than prior training after the switch to virtual interviews could be attributed to applicant accessibility to interview broadly. However, this could also be due to the decreased number of independent residency positions over the years, requiring applicants to move regions and travel further from where they began their training.
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Affiliation(s)
- Sarah A. Mullen
- From University of Nebraska Medical Center, College of Medicine, Omaha, Neb
| | - Haris M. Akhter
- From University of Nebraska Medical Center, College of Medicine, Omaha, Neb
| | - Lauren E. Weis
- From University of Nebraska Medical Center, College of Medicine, Omaha, Neb
| | - Kaeli K. Samson
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, Neb
| | - Heidi H. Hon
- Division of Plastic and Reconstructive Surgery, University of Nebraska Medical Center, Omaha, Neb
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James I, Kochuba A, Grow JN, Ho I, Calobrace MB, Movassaghi K, Zins JE. Trends in Aesthetic Surgery Fellowship Training: An Analysis of Supply and Demand. Aesthet Surg J 2023; 44:95-101. [PMID: 37431878 DOI: 10.1093/asj/sjad208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/13/2023] [Accepted: 07/09/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Aesthetic surgery fellowship applications were consolidated under the San Francisco Match in 2018. The impact of these changes on aesthetic program and applicant numbers had not yet been investigated. OBJECTIVES In this study we sought to evaluate changes in programs, positions, applications, match rates, and fill rates since aesthetic surgery joined the San Francisco Match. We also aimed to compare these trends to craniofacial surgery, microsurgery, and hand surgery fellowships over this same time period. METHODS San Francisco and National Resident Matching Program (NRMP) match data for aesthetic, craniofacial, microsurgery, and hand fellowships were obtained from 2018 to 2022, and the number of applications, positions, programs, and successful matches were evaluated. RESULTS The number of aesthetic fellowship positions increased from 17 to 41 (141%) over the period studied. This resulted in increased match rates and more unfilled positions. Over the same period, fellowship positions for craniofacial, hand, and microsurgery increased by 3.4%, 6%, and 2.5% respectively. There was no increase in applications to any postgraduate subspecialty, nor was there any change in the number of residents pursuing fellowship. Similarly, there was no change in the percentage of fellowship-bound residents applying to any given discipline. CONCLUSIONS The increase in aesthetic fellowship programs and positions did not generate an increase in applications. Applications to other plastic surgery subspecialties also failed to increase. Unlike aesthetic fellowships, their program numbers have remained stable. Given the limited fellowship applicant pool, our focus should be on enhancing the quality of existing aesthetic programs rather than continuing to increase the number of aesthetic positions. LEVEL OF EVIDENCE: 3
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Sendek G, Blum JD, Reghunathan M, Chen S, Luong TT, Gosman AA, Butler PD. Deconstructing the Excellent Plastic Surgeon: A Survey of Key Attributes. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5460. [PMID: 38098952 PMCID: PMC10721122 DOI: 10.1097/gox.0000000000005460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/17/2023] [Indexed: 12/17/2023]
Abstract
Background Most plastic surgeons practice in nonacademic settings, leaving a small subset of academic plastic surgeons with the responsibility of selecting the future generation of plastic surgeons without representation from a majority of our field. This raises questions as to whether the academic attributes valued during residency selection are valid predictive markers of who will become an excellent plastic surgeon. A survey was conducted of both academic and nonacademic plastic surgeons, as well as trainees, to determine what traits are considered most essential to being an excellent plastic surgeon. Methods An electronic survey was distributed before the American Council of Academic Plastic Surgeons 10th Annual Winter Meeting. Demographics and information regarding the respondents' training and academic status were collected. Respondents were asked to select five traits that they considered most important to be an excellent plastic surgeon from a list of 20 preselected traits. Chi-square and Fisher exact tests were used to perform subgroup analyses. Results A total of 187 responses were received from meeting attendees, representing an 89.0% response rate. Overall, the five values endorsed as most important for a plastic surgeon were being technically sound (53%), collaborative (48%), ethical (44%), compassionate (37%), and emotionally intelligent (33%). However, the emphasis placed on these different attributes differed significantly amongst different demographic groups. Conclusion It is important that we use methods such as holistic review when evaluating plastic surgery applicants to ensure our selection process is congruent with the traits we value.
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Affiliation(s)
- Gabriela Sendek
- From the Division of Plastic Surgery, Department of Surgery, University of California, San Diego, San Diego, Calif
| | - Jessica D Blum
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin, Madison, Wis
| | - Meera Reghunathan
- From the Division of Plastic Surgery, Department of Surgery, University of California, San Diego, San Diego, Calif
| | - Shirley Chen
- Department of Plastic Surgery, Vanderbilt University, Nashville, Tenn
| | - Thanh T Luong
- From the Division of Plastic Surgery, Department of Surgery, University of California, San Diego, San Diego, Calif
| | - Amanda A Gosman
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin, Madison, Wis
| | - Paris D Butler
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn
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Reghunathan M, Camacho JM, Blum J, Sendek G, Luong TT, Chen S, Bradford P, Llaneras J, Butler PD, Gosman AA. A SWOT Analysis of Hot Topics in Plastic Surgery Resident Education: Consensus From the ACAPS 10th Annual Winter Meeting. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5461. [PMID: 38098955 PMCID: PMC10721128 DOI: 10.1097/gox.0000000000005461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/17/2023] [Indexed: 12/17/2023]
Abstract
Background With the aim of facilitating a critical self-reflection on how to align plastic surgery education with making excellent plastic surgeons, a rotating small-group session followed by live interactive audience polling was used to perform a SWOT (strengths, weaknesses, opportunities, and threats) analysis at the 10th Annual American Council of Academic Plastic Surgeons Winter Meeting. Methods The final day of the conference included a 3-hour session of rotating small groups followed by live interactive audience polls discussing the following six relevant educational topics: the Plastic Surgery Common Application and resident selection, aesthetic surgery education, leadership development and business education, embedded fellowships and focused training, mentorship, and faculty retention. Results A total of 60 individuals participated in the activity. A SWOT analysis was successfully performed for each educational topic, and a minimum of four opportunities were identified per topic to help guide future endeavors. Examples of opportunities include releasing recommendations for the implementation of holistic review; developing formal guidelines for aesthetic surgery education in residency via collaboration between ACAPS, American Society of Plastic Surgeons, and The Aesthetic Society; creating extended focused elective rotations; integrating business education into formal curricula for all training levels; enforcing transparency regarding position expectations and offerings including salary, call schedule, and current challenges; and more. Conclusion The results of this study will help guide future initiatives by the ACAPS to improve resident education and academic retention.
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Affiliation(s)
- Meera Reghunathan
- From the Division of Plastic Surgery, Department of Surgery, University of California San Diego, San Diego, Ca
| | | | - Jessica Blum
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin, Madison, Wis
| | - Gabriela Sendek
- From the Division of Plastic Surgery, Department of Surgery, University of California San Diego, San Diego, Ca
| | - Thanh T. Luong
- From the Division of Plastic Surgery, Department of Surgery, University of California San Diego, San Diego, Ca
| | - Shirley Chen
- Vanderbilt University School of Medicine, Nashville, Tenn
| | - Perry Bradford
- Department of Plastic Surgery, University of Virginia Health, Charlottesville, Va
| | - Jason Llaneras
- From the Division of Plastic Surgery, Department of Surgery, University of California San Diego, San Diego, Ca
| | - Paris D. Butler
- Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn
| | - Amanda A. Gosman
- From the Division of Plastic Surgery, Department of Surgery, University of California San Diego, San Diego, Ca
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7
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Mukit M, Sumner L, O’Brien RC, Bhanat EL, Walker ME. The Influence of Training Pathway, Institution Type, Gender, and a Global Pandemic on Post Graduation Career Plans in Plastic Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5292. [PMID: 37753328 PMCID: PMC10519548 DOI: 10.1097/gox.0000000000005292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/20/2023] [Indexed: 09/28/2023]
Abstract
Background Anecdotal statements are often made about what percentage of residents go into fellowship versus private practice versus academia after graduation. However, few objective studies have been completed on this topic. This project is designed to shed light on the career choices of plastic surgery residents immediately after graduation from 2018 to 2022. A secondary objective was to determine whether the COVID-19 pandemic had any measurable impact on postgraduation plans. Methods After obtaining institutional review board approval, publicly available data were obtained from institution websites or via program queries. Comparison between pre-COVID-19 and post-COVID-19 (2018-2019 versus 2020-2022), integrated versus independent, and private versus public cohorts were analyzed using Fisher exact test. A two-sided P value less than 0.01 was considered statistically significant. Results Data were collected for 690 graduates across 64 plastic surgery training programs. Responses were obtained from 60 of 88 (68%) integrated and 30 of 47 (64%) independent programs. Most graduates pursued fellowship training (61%), followed by private practice (28%), academic practice (5%), or military post (1%). Independent residents were more likely to pursue private practice (40% versus 26%, P = 0.001), whereas integrated residents were more likely to pursue fellowship (49% versus 70%, P < 0.0001). Public institution graduates were more likely to go into private practice (37% versus 23%, P = 0.0002), whereas private institution residents were more likely to pursue fellowship (55% versus 72%, P < 0.0001). Public institutions were more likely to graduate women (45% versus 35%, P = 0.009). The COVID-19 pandemic (P = 0.31) had no impact on postgraduation plans. Conclusions This study demonstrates that training pathway and institution type have a significant impact on postgraduation plans, whereas a global pandemic does not. This information can be used by educators, residents, and medical students as they plan for the future.
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Affiliation(s)
- Muntazim Mukit
- From Division of Plastic and Reconstructive Surgery, University of Mississippi Medical Center, Jackson, Miss
| | - Leigh Sumner
- From Division of Plastic and Reconstructive Surgery, University of Mississippi Medical Center, Jackson, Miss
| | - Robert C. O’Brien
- Department of Data Science, University of Mississippi Medical Center, Jackson, Miss
| | - Eldrin L. Bhanat
- Department of General Surgery, University of Mississippi Medical Center, Jackson, Miss
| | - Marc E. Walker
- From Division of Plastic and Reconstructive Surgery, University of Mississippi Medical Center, Jackson, Miss
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8
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Lentskevich MA, Reddy NK, Yau A, Gosain AK. Residency Training Pathways of Program Directors and Chiefs/Chairs in Plastic Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5253. [PMID: 38152717 PMCID: PMC10752447 DOI: 10.1097/gox.0000000000005253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/20/2023] [Indexed: 12/29/2023]
Abstract
Background Medical students interested in plastic surgery may become discouraged by barriers to career development during residency training. This study surveyed plastic surgery program directors (PDs) and chiefs/chairs to highlight the pathway followed by academic leaders in these positions. Methods A self-administered anonymous survey was sent to a list of 189 PDs and chiefs/chairs identified via plastic surgery residency programs' websites. Chi-squared tests assessed answer distributions. Results Of the 189 recipients (25.9%), 49 completed the survey. Respondents' medical school graduation range was 1973-2009. Seventeen respondents entered a plastic surgery residency directly after medical school, and 32 began in another specialty. Comparison between these two groups showed no significant differences in preference rank of their program (P = 0.671). A total of 18 respondents conducted an academic enrichment year, but timing of this year differed significantly based on the initial specialty match (P = 0.012). There was no significant perceived difficulty in gaining recognition by gender (P = 0.107) or race (P = 0.125). Six respondents did not match into the specialty of first choice; five did not complete their initial residency programs; three did not match into plastic surgery at first attempt. Conclusions Information on residency training pathways and barriers to career development of current academic leaders will improve transparency as to potential stumbling blocks that current PDs and chief/chairs of plastic surgery residency programs have faced during their initial training. This will help current trainees anticipate these stumbling blocks and place these in perspective based on the experience of senior plastic surgeons.
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Affiliation(s)
- Marina A. Lentskevich
- From the Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Narainsai K. Reddy
- From the Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Alice Yau
- From the Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Arun K. Gosain
- From the Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ill
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Gao Q, Li R, Xia Z, Qu X, Jiang L. Factors associated with graduation examination results from standardised residency training in Zhejiang Province, China: a cross-sectional analysis of medical examination results data from 2020. BMJ Open 2023; 13:e066167. [PMID: 37438063 PMCID: PMC10347489 DOI: 10.1136/bmjopen-2022-066167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 06/22/2023] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVE Standardised residency training is an important part of postgraduation medical education in China. The graduation examination tests the effect of residency training and is an important measure to guarantee the quality of residency training. This study aimed to analyse the results and associated factors of the graduation examination of standardised residency training in Zhejiang Province in 2020. DESIGN Cross-sectional analysis of examination results data. SETTING Medical and health institutions and universities in Zhejiang Province. PARTICIPANTS A total of 5555 examinees took the graduation examination of standardised residency training in Zhejiang Province in 2020. PRIMARY OUTCOMES Pass rates of the practical skill examination and written examination. RESULTS The pass rates for the practical skill examination and written examination were 91.8% and 96.5%, respectively. Examinees aged 30 and above (adjusted OR (AOR)=0.48, 95% CI 0.26 to 0.89), those with 3 years (AOR=0.19, 95% CI 0.09 to 0.43) and 2 years (AOR=0.61, 95% CI 0.40 to 0.96) of training, those who retook the examination (AOR=0.28, 95% CI 0.20 to 0.391) and those from primary healthcare institutions (AOR=0.56, 95% CI 0.40 to 0.77) were less likely to pass the practical skill examination. Examinees with a postgraduate degree and those from colleges and universities had higher pass rates in the written examination (AOR=6.37, 95% CI 1.95 to 23.34; AOR=2.87, 95% CI 1.40 to 6.65, respectively). Examinees aged 30 and above (AOR=0.08, 95% CI 0.01 to 0.30), those aged between 25 and 30 (AOR=0.22, 95% CI 0.03 to 0.80), those who retook the examination (AOR=0.04, 95% CI 0.03 to 0.07), those from second-level hospitals (AOR=0.58, 95% CI 0.39 to 0.87) and those who failed the practical skill examination (AOR=0.17, 95% CI 0.12 to 0.25) were less likely to pass the written examination. CONCLUSIONS The pass rate of the graduation examination of standardised residency training was associated with the individual characteristics of the examinees. The results of practical skill examination were related to the results of the written examination.
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Affiliation(s)
- QiSheng Gao
- School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Ruoqi Li
- The Fourth Clinical Medical College (Hangzhou First People's Hospital), Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhijun Xia
- Office of Academic Research, Hangzhou Medical College, Hangzhou, China
| | - Xianguo Qu
- The Fourth Clinical Medical College (Hangzhou First People's Hospital), Zhejiang Chinese Medical University, Hangzhou, China
| | - Ling Jiang
- Department of Education and Training, Zhejiang Evaluation Center for Medical Service and Administration, Hangzhou, China
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10
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Lee CJ, Azimi R, Willey B, Gosman A, Reid CM. Recent Training Trends in Independent Plastic Surgery Graduates: American Board of Surgery Certification and Academic Priorities. Ann Plast Surg 2023; 90:611-615. [PMID: 37311317 DOI: 10.1097/sap.0000000000003568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Among independent plastic surgery graduates, most have general surgery training, but the utility of American Board of Surgery (ABS) certification in plastic surgery practice is unclear. We elucidated attitudes and trends of ABS certification in American Board of Plastic Surgery diplomates. METHODS American Board of Plastic Surgery diplomates from 2018 to 2020 were reviewed to identify independent plastic surgery graduates. These graduates were anonymously surveyed regarding demographics, employment, fellowships, practices, and attitudes toward ABS certification. RESULTS Of 568 American Board of Plastic Surgery diplomates, 223 independent graduates (39%) were identified. Sixty-eight percent of these graduates were ABS certified, 80% of whom achieved certification during the beginning of plastic and reconstructive surgery training; 41% were fellowship trained. About half are in private practice, 25% are part of a hospital group, and 17% work in universities. Of 223 independent graduates, 54 (24.4%) completed the survey; 85.2% reported ABS certification, and 21.7% perform general surgery procedures. Most stated that general surgery training was valuable to their career, regardless of certification. Most agreed that ABS certification benefited their career; 63% plan to recertify. Of those surveyed, 59.3% had completed a plastic surgery fellowship. Non-fellowship-trained surgeons felt more strongly that ABS certification was beneficial (P = 0.014) and valued by patients (P = 0.026) compared with fellowship-trained surgeons. CONCLUSIONS American Board of Surgery certification is a priority to independent plastic surgery trainees, despite potential disruption to training, personal costs, and unclear utility to their practice. Although few perform general surgery procedures, most plan to recertify. Future studies should investigate recertification among surgeons later in their careers and the impacts of dual board certification on plastic surgery practice.
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Affiliation(s)
- Clara J Lee
- From the Division of Plastic Surgery, University of California San Diego, La Jolla, CA
| | - Roxana Azimi
- Department of Plastic and Reconstructive Surgery, MedStar Health-Georgetown University Hospital, Washington, DC
| | - Brea Willey
- Miller School of Medicine, University of Miami, Miami, FL
| | - Amanda Gosman
- From the Division of Plastic Surgery, University of California San Diego, La Jolla, CA
| | - Chris M Reid
- From the Division of Plastic Surgery, University of California San Diego, La Jolla, CA
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11
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Comparison of Long-term Surgical Outcomes and Microsurgical Skills between Independent and Integrated Plastic Surgery Trainees. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4709. [PMID: 36910735 PMCID: PMC9995086 DOI: 10.1097/gox.0000000000004709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/20/2022] [Indexed: 03/11/2023]
Abstract
We compared the surgical skills and outcomes of microsurgical fellows who completed an independent versus integrated plastic surgery residency. Methods We reviewed outcomes of abdominal wall reconstructions performed autonomously by microsurgical fellows at our institution from March 2005 to June 2019; outcome measures included hernia recurrence, surgical site occurrence, surgical site infection, length of hospital stay, unplanned return to the operating room, and 30-day readmission. The microsurgical skills were prospectively evaluated using the validated Structured Assessment of Microsurgical Skills at the start and end of the fellowship, in an animal laboratory model and clinical microsurgical cases. Multivariable hierarchical models were constructed to evaluate study outcomes. Results We identified 44 fellows and 118 consecutive patients (52% women) who met our inclusion criteria. Independent fellows performed 55% (n = 65) of cases, and 45% were performed by integrated fellows. We found no significant difference in hernia recurrence, surgical site occurrences, surgical site infections, 30-day readmission, unplanned return to the operating room, or length of stay between the two groups in adjusted models. Although laboratory scores were similar between the groups, integrated fellows demonstrated higher initial clinical scores (42.0 ± 4.9 versus 37.7 ± 5.0, P = 0.04); however, the final clinical scores were similar (50.8 ± 6.0 versus 48.9 ± 5.2, P = 0.45). Conclusions Independent and integrated fellows demonstrated similar long-term patient outcomes. Although integrated fellows had better initial microsurgical skills, evaluation at the conclusion of fellowship revealed similar performance, indicating that fellowship training allows for further development of competent surgeons.
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Practice Management in Plastic Surgery: A Survey Comparing Skills Acquired During Residency and Those Applied in Independent Practice. Aesthetic Plast Surg 2023; 47:1225-1231. [PMID: 36820861 DOI: 10.1007/s00266-023-03277-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/20/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Understanding the extent of practice management education within plastic surgery residency may serve to enhance elements of current curricular training. METHODS A survey was sent to private practice plastic surgeons who completed training between 2008 and 2020. The survey elicited opinions about their practice management training during residency and experiences as attendings. RESULTS Forty-nine private practice plastic surgeons completed the survey with a mean of 5 years in practice. 96% of respondents entered private practice immediately following their final training program. 48% of respondents cited "autonomy" as the primary reason for pursuing private practice. Surgeon's narrative responses regarding practice management skills learned outside of residency revealed the most grouped into the following themes: "Finance, Marketing, Accounting, Human Resources (HR), Operations" (n = 19), "Hiring, Firing, Employee Management" (n = 17), "Insurance Coverage, Billing, Coding" (n = 13), "General Skills" (n = 12), and "Starting & Running a Practice" (n = 11). 71.4% of respondents reported that they learned practice management skills from on-the-job training. Almost all respondents felt that there should be formal training in practice management (n = 35), with "Finance & Accounting" and "Management" cited as the most important skills to learn as a plastic surgeon. 51% of current surgeons felt allowing senior residents additional opportunities to rotate in private practices was the best way to enhance residency curricula. CONCLUSION Incorporating practice management skills into training curricula will address the demonstrated knowledge gap and accelerate plastic surgeons' career growth. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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The Impact of Dedicated Research Years During Residency Upon Continued Academic Productivity of Plastic Surgeons. J Craniofac Surg 2023; 34:103-108. [PMID: 35968949 DOI: 10.1097/scs.0000000000008916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/29/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND This study explored the impact of dedicated research year(s) on long-term research productivity and career choices of plastic surgeons as academicians. METHODS Scopus and Web of Science were accessed in September 2020 to collate publications and H indexes of alumni who graduated from integrated plastic surgery residency programs from 2011 to 2020. Public profiles were utilized to determine academic status. Corresponding data were grouped by residency program type (traditional programs without required research, programs with one required research year, and a single program with variable research years). Unpaired t tests and 1-way analysis of variance were conducted to compare average H indexes and publication counts of alumni from each group. χ 2 tests analyzed differences in academic statuses. RESULTS Alumni who completed one required research year published significantly more with a higher H index compared with those from traditional programs. Similar results were found among alumni who completed 2 research years compared with 0 or 1 year within a single program. Residents who completed one required research year were more likely to hold dual academic and nonacademic positions after graduation compared with their traditional counterparts. However, there was no statistical difference in academic status observed for surgeons who graduated from the program with variable research years. CONCLUSIONS Participating in research year(s) during residency is predictive of ongoing academic productivity of surgeons within the first 10 years of completion of residency. This becomes important for training craniofacial surgeons, the majority of whom practice in academic settings.
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Trends in Fellowship Training across United States Plastic and Reconstructive Surgery Academic Faculty. Plast Reconstr Surg Glob Open 2022; 10:e4611. [PMID: 36262681 PMCID: PMC9575958 DOI: 10.1097/gox.0000000000004611] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/26/2022] [Indexed: 12/05/2022]
Abstract
UNLABELLED 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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Chun M, Girard A, Zhang Y, Meyers A, Roohani I, Cook T, Song P, Chaffin A. What Attributes Make United States Plastic Surgery Programs Desirable? Perspectives from Medical Students and Residents. EPLASTY 2022; 22:e3. [PMID: 35958739 PMCID: PMC9350546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Plastic surgery is a competitive specialty that attracts many qualified applicants. This study provides results of a survey conducted to identify the attributes that make integrated and independent plastic surgery residency programs in the United States most desirable. Medical students' preferences for virtual events during the 2020 to 2021 Match cycle were also investigated. METHODS An anonymous 7-question survey was deployed to plastic surgery residency program directors to forward to medical students and current residents during the 2021 to 2022 National Resident Matching Program cycle. Demographics and ranking of program attributes were collected in the survey, and data analysis consisted of both qualitative and quantitative results. RESULTS A total of 50 survey respondents from 28% of plastic surgery residency programs was received. The happiness and well-being of residents and training at their preferred geographical location were identified as the most desirable qualities of a program (P < 0.05). However, 82% of respondents opposed mandatory research (P = 0.002). There was a statistically significant larger proportion of students that highly valued faculty responsiveness to feedback over perceived program ranking (P < 0.05). In the context of COVID-19, virtual meet and greets, as well as resident happy hours, were rated most desirable (n = 35, 70%), followed by social media outreach (n = 23, 46%). CONCLUSIONS Resident happiness and well-being, followed by preferred geographical location, were the most favorable program attributes. Plastic surgery residency programs may seek to better integrate these preferences within their curricula, as well as showcase them on social media, to attract high-quality applicants and optimize the training experience for matched residents.
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Affiliation(s)
- Magnus Chun
- Tulane University School of Medicine, New Orleans, LA
| | - Alisa Girard
- Tulane University School of Medicine, New Orleans, LA
| | - Yichi Zhang
- Tulane University School of Medicine, New Orleans, LA
| | | | - Idean Roohani
- Tulane University School of Medicine, New Orleans, LA
| | - Tracey Cook
- Tulane University School of Medicine, New Orleans, LA
| | - Ping Song
- Tulane University School of Medicine, New Orleans, LA
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Diversity in Plastic Surgery Authorship: A 14-Year Analysis of 2688 Articles Published in Plastic and Reconstructive Surgery. Plast Reconstr Surg 2022; 149:313e-322e. [PMID: 35077432 DOI: 10.1097/prs.0000000000008789] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Publication in peer-reviewed journals is a duty and privilege. It is essential to the advancement of evidence-based medicine and often used as a proxy for academic achievement, contributing to decisions around promotion in academia. Within plastic surgery, authors have historically been male surgeons affiliated with academic institutions, lacking representation of women, private practice, medical students, and international collaboration. This study analyzes differences in authors' gender, practice affiliation, degree of education, and international collaboration in articles published in Plastic and Reconstructive Surgery, which was chosen as the representative journal given its high impact factor (3.946) and consistent ranking as the number one journal in plastic surgery worldwide. METHODS A list of Breast, Cosmetic, and Hand/Peripheral Nerve articles published between 2006 and 2019 was compiled from the online archive of Plastic and Reconstructive Surgery. Demographic author characteristics were recorded, and statistical analyses were performed to identify trends over time. RESULTS A total of 2688 articles were analyzed. The proportion of articles written by female authors in the Breast category, authors in private practice with academic affiliation in the Cosmetic section, and U.S. collaboration with other countries increased over time (p = 0.038, p = 0.029, p < 0.001, respectively). First authors with bachelor's, master's, and doctorate degrees have also been contributing increasingly. CONCLUSIONS This analysis revealed increasing demographic heterogeneity of authors in Plastic and Reconstructive Surgery over time, with increasing contributions from women, surgeons in private practice with academic affiliation, medical students, and international collaborations. The Journal is capturing contributions from an increasingly diverse authorship, consistent with the changing demographics of plastic surgeons.
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Variability in Hand Surgery Training Among Plastic and Orthopaedic Surgery Residents. J Am Acad Orthop Surg Glob Res Rev 2022; 6:01979360-202201000-00005. [PMID: 34982053 PMCID: PMC8735791 DOI: 10.5435/jaaosglobal-d-21-00138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/30/2021] [Indexed: 11/18/2022]
Abstract
Background: A career in hand surgery in the United States requires a 1-year fellowship after residency training. Different residency specialty programs may vary in case volume. The purpose of this study was to characterize variation in hand surgery training within and between orthopaedic and plastic surgery residents. Methods: Publicly available hand surgery case logs for graduating orthopaedic and plastic surgery residents during the 2010 to 2011 to 2018 to 2019 academic years were obtained through the Accreditation Council of Graduate Medical Education. Student t-tests were used to compare mean case volumes among several categories between plastic surgery (PRS) and orthopaedic surgery (OS) residents. Intraspecialty variation was assessed by comparing the 90th and 10th percentiles in each category. Results: A total of 6,254 orthopaedic and 1,070 plastic surgery graduating residents were included. The mean hand surgery case volume for orthopaedic residents (OS 247.0) was significantly lower than that for plastic surgery residents (PRS 412.0) (P < 0.0001). Orthopaedic residents performed more trauma cases (OS 133.2, PRS 54.5; P < 0.0001) but fewer nerve repairs (OS 3.3, PRS 28.5 P < 0.0001) and amputations (OS 6.4, PRS 15.8; P < 0.0001). Nerve decompression case volumes were similar between the two specialties (OS 50.2, PRS 47.3; P = 0.34). Case volumes among orthopaedic residents varied considerably in amputations and among plastic surgery residents in replantation/revascularization procedures. Conclusions: Orthopaedic surgery residents performed significantly more trauma cases than plastic surgery residents did, but fewer overall cases, nerve repairs, and amputations, while nerve decompression volumes were similar between specialties. This information may help inform residency and fellowship directors regarding areas of potential training deficiency.
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Davis MJ, Luu BC, Cole SH, Abu-Ghname A, Winocour S, Reece EM. Employment as a Plastic Surgeon: A Review of Trends and Demand Across the Field. Ann Plast Surg 2021; 87:377-383. [PMID: 34117135 DOI: 10.1097/sap.0000000000002780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Intrinsic to the field of plastic surgery, constant changes in health care policy, consumer demands, and medical technology necessitate periodic evaluation of trends in employment over time. In this article, we review the existing literature to report the current state of plastic surgery employment in the United States with regards to compensation, practice patterns, subspecialty trends, contract negotiation, representation of women in the field of plastic surgery, burnout and job satisfaction, and retirement. Understanding how the plastic surgery job market is changing not only serves as a valuable tool for the individual plastic surgeon regarding the navigation of his or her own career but also offers insight into the future of the field as a whole.
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Affiliation(s)
| | - Bryan C Luu
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine
| | - Samuel H Cole
- Section of Plastic and Reconstructive Surgery, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA
| | | | - Sebastian Winocour
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine
| | - Edward M Reece
- From the Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine
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Premaratne ID, An A, Spector JA. Plastic and reconstructive surgeons' views of a single payer health care system: Implications for patients and practice. J Plast Reconstr Aesthet Surg 2021; 74:2737-2743. [PMID: 33896742 DOI: 10.1016/j.bjps.2021.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 12/09/2020] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Rising health care costs and the high number of uninsured Americans has led to the increasing popularity of a single payer alternative. While opinions of physicians at large have been studied, we present the first data examining the views of United States (U.S.) board-certified plastic surgeons on a single payer health care system and its implications for patients and practice. METHODS A total of 3,431 US plastic and reconstructive surgeons were sent a 25-item Qualtrics survey and responses collected from September 1 to November 1, 2019. Independent variables included surgeon sociodemographic characteristics. The association between these and a preference for a single payer was evaluated using the logistic regression. RESULTS There was a 11% response rate (n = 383). The majority of respondents were in private practice (64.5%). Forty-four percent believed that it is the government's responsibility to ensure care is provided for all; 34% were willing to give up income in exchange for reduced paperwork and administrative burden. Sixty-three percent would not work the same number of hours under single payer. Private practice plastic surgeons were significantly less likely to favor single payer (95% CI: 0.19 and 0.76). Among academic plastic surgeons, 24% would consider leaving if single payer were enacted and 60% would decrease the reconstructive portion of their practice. CONCLUSIONS Most U.S. plastic and reconstructive surgeons do not support a single payer health care system. Its enactment could have sweeping implications for plastic surgeons nationwide, among the most significant being a shift from academic to private practice with a potential reduction in patient access to complex reconstructive procedures.
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Affiliation(s)
- Ishani D Premaratne
- Weill Cornell Medical College/NewYork-Presbyterian Hospital, 1300 York Avenue, New York, NY 10065 USA
| | - Anjile An
- Weill Cornell Medical College/NewYork-Presbyterian Hospital, 1300 York Avenue, New York, NY 10065 USA
| | - Jason A Spector
- Weill Cornell Medical College/NewYork-Presbyterian Hospital, 1300 York Avenue, New York, NY 10065 USA.
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Hitting the Books: A Nationwide Analysis of Advanced Degrees in Academic Plastic Surgery Faculty. Aesthetic Plast Surg 2021; 45:2473-2482. [PMID: 33660017 DOI: 10.1007/s00266-021-02197-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/14/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Plastic surgery is one of the most competitive and innovative fields in medicine. The role of the academic plastic surgeon continues to grow beyond clinical care, and many surgeons have pursued advanced degrees (AD) to expand their professional skillset. We present an analysis of ADs of academic plastic surgery faculty in the USA, with consideration of timing of AD attainment. METHODS All academic plastic surgery faculty members were identified from plastic surgery program websites, as recognized by the American Council of Academic Plastic Surgeons. ADs were defined as additional degrees beyond the primary medical degree. Outcomes included timing of AD attainment, residency rankings, institutional standings, and research productivity. RESULTS 949 faculty members were identified, and 167 had ADs. The most common ADs were PhD (30%), MS/MSc (18%), and MBA/EMBA (17%). Timing of AD attainment was available for 146 faculty members (84.7%). Having an AD before residency was associated with matching into higher-tiered and integrated residency programs (both p < 0.05). For attending physicians, having an AD was associated with more journal editorial board positions, more publications, higher H-index, receiving NIH funding, and median number of NIH grants (adjusted for years in practice, all p<0.05). Institutional analysis revealed that employing more faculty with an AD was associated with having an integrated residency program, higher residency research ranking, and higher tier integrated residency (all p < 0.05). CONCLUSION ADs are growing in popularity in academic plastic surgery and are temporally associated with specific advantages in terms of residency placement, research productivity, and institutional standing. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Egro FM, Smith BT, Murphy CP, Stavros AG, Nguyen VT. The Impact of Fellowship Training in Academic Plastic Surgery. Ann Plast Surg 2021; 87:461-466. [PMID: 34559715 DOI: 10.1097/sap.0000000000002932] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The competitive nature of an academic plastic surgery career has contributed to an increase in sub-specialization. The aim of this study is to assess the benefits of subspecialty fellowship training to pursue a career in academic plastic surgery. METHODS A cross-sectional study was conducted of all current academic plastic surgeons (APSs) participating in Accreditation Council for Graduate Medical Education-certified residency programs. Online faculty website listings were used to collect their demographics, training and practice characteristics, academic rank and leadership positions, and research productivity. RESULTS A total of 927 APSs met the inclusion criteria, of which 70.2% had undergone fellowship training, with an overall significant increase in fellowship-trained surgeons within the last 10 years (odds ratio [OR], 1.66; P = 0.0005). Hand training was the most common fellowship (35.6%), followed by craniofacial (32.0%) and microsurgery (28.1%). Fellowship training was more prevalent among younger (48.7 vs 53.5 years, P < 0.0001), White (67.8%), and non-White (77.4%, P = 0.0058) APSs who had received either integrated (67.1%) or independent (81.8%, P < 0.0001) plastic surgery training and are currently working in a department (OR, 1.44; P = 0.028). Fellowship training was shown to influence academic rank (associate professor: OR, 1.68 [P = 0.0073]; full professor: OR, 0.58 [P = 0.0008]), leadership position (fellowship director OR, 10.09; P < 0.0001) and research productivity (publications: 26 vs 16.5; P = 0.0009). In addition, fellowship attainment did not correlate with the size of the employing academic program, population of the city of practice, or being a residency director or chair. CONCLUSION The majority of APSs have undergone fellowship training, and there is very strong evidence supporting its impact in current entry and advancement in academic plastic surgery.
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Affiliation(s)
- Francesco M Egro
- From the Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
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22
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Erpenbeck SP, Bustos SS, Smith BT, Egro FM, Nguyen VT. Independent or Integrated Plastic Surgery Residency Pathways: Trends in Representation in Academic Plastic Surgery in the United States. Ann Plast Surg 2021; 87:467-471. [PMID: 34176910 DOI: 10.1097/sap.0000000000002926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
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 2 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 National Institutes of Health 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 postresidency time to reach all positions examined compared with independent graduates. CONCLUSIONS Residency training pathway influences academic plastic surgeons in research output, qualifications, and academic positions. This is likely due to the relatively new nature of the integrated program compared with the independent, as well as the shorter length of training for integrated graduates. However, trends are moving toward integrated graduates showing increased interest and productivity in academic medicine.
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Affiliation(s)
| | - Samyd S Bustos
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | - Francesco M Egro
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Vu T Nguyen
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
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Bhat D, Kollu T, Giutashvili T, Patel A, Ricci JA. Does Surgeon Training Affect Patient Perception of Surgeon Skill in DIEP Flap Breast Reconstruction? J Reconstr Microsurg 2021; 38:361-370. [PMID: 34454406 DOI: 10.1055/s-0041-1733977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The aim of this study is to investigate whether a surgeon's training background and years of experience advertised on a social media platform influences perception of surgeon competence, patient recruitment likelihood, and referral likelihood. METHODS A mockup of an Instagram post was created using a before and after picture of a deep inferior epigastric perforator (DIEP) flap patient. The caption under each post was changed to reflect one of six possible training categories: 1 year of experience, 10 years of experience, 20 years of experience, fellowship, Ivy League training, and a null case (with no training information against which all other cases were compared). Surveys asked female responders to evaluate surgeon competence, likelihood of becoming a patient, and likelihood of making a referral to their friends or family. Amazon MTurk crowdsourcing platform was used to distribute the survey. RESULTS A total of 1,878 responses were recorded, with the majority identifying as Caucasian (59%). The surgeon with 20 years of experience had the highest patient recruitment scores when compared with the null, 1 year, 10 year, and Ivy League training backgrounds (p = 0.0314, p = 0.0065, p = 0.0207, and p = 0.0244, respectively). The majority of responders (67%) preferred a female surgeon. Responders with a history of breast reconstruction assigned lower surgeon competence scores compared with women without a history of breast cancer (p <0.0001). Women who underwent breast reconstruction were also less likely to make referrals to their family and friends (p <0.0001). CONCLUSION Surgeon's experience influences whether a patient is likely to seek care from a plastic surgeon. Personal history of breast cancer has a negative impact on perceived surgeon competence as well as patient recruitment likelihood and referral likelihood. Emphasizing fewer years of training or Ivy League training did not make an appreciable difference in patient perception of competence or likelihood of recruiting a new patient.
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Affiliation(s)
- Deepa Bhat
- Division of Plastic Surgery, Department of Surgery, Albany Medical Center, Albany, New York
| | - Tejas Kollu
- Division of Plastic Surgery, Department of Surgery, Albany Medical Center, Albany, New York
| | | | - Ashit Patel
- Division of Plastic Surgery, Department of Surgery, Albany Medical Center, Albany, New York
| | - Joseph A Ricci
- Division of Plastic Surgery, Department of Surgery, Montefiore Medical Center, Bronx, New York
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Are You Ready to Negotiate Your First Employment Contract? Experience of More Than 700 Plastic Surgeons. Plast Reconstr Surg 2021; 147:761-771. [PMID: 33620950 DOI: 10.1097/prs.0000000000007685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Plastic surgeons have been shown to be unprepared to negotiate their first employment contracts. Previous survey studies have attempted to assess plastic surgeons' first employment contracts to outline common pitfalls in contract negotiation. With this study, the authors aim to expand these previous studies and help plastic surgeons become prepared to negotiate their employment contracts. METHODS A seven-question, cross-sectional survey was sent to attending-level surgeon members of the California Society of Plastic Surgeons, the American Society of Plastic Surgeons, the Texas Society of Plastic Surgeons, and the American Cleft Palate-Craniofacial Association. Questions investigated plastic surgeons' first contracts. Correlations were determined using a two-sample Wilcoxon rank sum test in an attempt to link these questions with overall satisfaction. RESULTS From the 3908 distributed surveys, 782 (20 percent) responses were collected, and 744 were included for analysis. The majority of respondents were found to join a group-centered, private practice following residency. Surprisingly, 69 percent of surgeons did not use attorney assistance when negotiating their contract. Although greater than 70 percent of respondents reported a salary of $200,000 or less, satisfaction with one's contract was most strongly correlated with a salary of greater than $300,000 (p < 0.0001). However, only 12 percent of respondent surgeons were able to secure such a salary. CONCLUSIONS This study examined the largest, most diverse plastic surgeon cohort to date regarding surgeons' first employment contract. Although the authors' findings indicate that certain factors should be prioritized when approaching a first employment contract, they ultimately recommend that all surgeons take into account their personal priorities and attempt to proactively define their terms of employment before signing a contract.
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Chawla S, Ding J, Faheem S, Shelly S, Khosa F. How Comprehensive Are Canadian Plastic Surgery Fellowship Websites? Cureus 2021; 13:e15815. [PMID: 34306881 PMCID: PMC8294012 DOI: 10.7759/cureus.15815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 11/29/2022] Open
Abstract
Background Online fellowship program websites are more commonly becoming the primary information resource used by prospective applicants. This study aimed to analyze the online content of Canadian plastic surgery fellowship program websites. Methods The content of all accredited Canadian Plastic Surgery fellowship program websites was evaluated using a 75-point criterion in the following ten domains: recruitment, faculty, residents/fellows, research and education, surgical program, clinical work, benefits, and career planning, wellness, environment and gender of faculty leadership. Results On average, fellowship program websites obtained a score of 29.9 (SD=12.6). No correlation was detected between program websites and location (P > 0.05) nor by ranking (P > 0.05). Conclusions Most Canadian plastic surgery fellowship program websites lacked content relevant to prospective applicants. More comprehensive fellowship program websites may be of benefit to prospective applicants and the programs.
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Affiliation(s)
- Sahil Chawla
- Medicine, The University of British Columbia, Vancouver, CAN
| | - Jeffrey Ding
- Medicine, The University of British Columbia, Vancouver, CAN
| | - Sarim Faheem
- Faculty of Science, The University of British Columbia Okanagan, Kelowna, CAN
| | - Sandeep Shelly
- Otolaryngology, Head and Neck Surgery, Emory University School of Medicine, Atlanta, USA
| | - Faisal Khosa
- Radiology, Vancouver General Hospital, Vancouver, CAN
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Maisner RS, Babu A, Ayyala HS, Ramanadham S. How Comprehensive Are Aesthetic Surgery Fellowship Websites? Ann Plast Surg 2021; 86:615-617. [PMID: 32756245 DOI: 10.1097/sap.0000000000002518] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Fellowship programs heavily utilize websites in the recruitment of senior residents. Studies in subspecialty areas have demonstrated deficiencies in website content; however, no study has evaluated the websites of esthetic surgery fellowships. The recent establishment of the aesthetic fellowship match in 2018 highlights the need for accessible program information. OBJECTIVE To assess the success in accessibility of educational and recruitment content of aesthetic surgery fellowship websites for prospective applicants. METHODS Websites of aesthetic surgery fellowships were eligible for study inclusion. Aesthetic fellowship websites (AFWs) were evaluated for content regarding fellow education and fellow recruitment. Website content was analyzed using Fisher exact test and analysis of variance. RESULTS Twenty-eight programs were compiled from the American Society of Aesthetic Plastic Surgery website. Regarding fellowship education, 35.7% of AFWs described operative experience and research requirements, and 28.6% of AFWs included information on didactics, but less than 11% outlined rotation schedules, annual meetings, or academic conferences. None listed fellow evaluation criteria. Regarding recruitment information, 85.7% of AFWs had program descriptions, but less than 33% listed affiliated hospitals, faculty, or current fellows. Of the 67.9% of AFWs that listed eligibility criteria, none listed selection criteria. When programs were stratified by the type of aesthetic training offered, fellowships that offered whole-body aesthetic training had significantly more recruitment content (P = 0.0394) on their websites than those specializing in facial aesthetics only. CONCLUSIONS There is a paucity of information regarding recruitment and education on AFWs. Programs should strive to create a comprehensive website to better attract and assist residents applying for fellowship.
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Affiliation(s)
- Rose S Maisner
- From the Division of Plastic and Reconstructive Surgery, Rutgers New Jersey Medical School, Newark
| | - Archana Babu
- From the Division of Plastic and Reconstructive Surgery, Rutgers New Jersey Medical School, Newark
| | - Haripriya S Ayyala
- From the Division of Plastic and Reconstructive Surgery, Rutgers New Jersey Medical School, Newark
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Ananthasekar S, Patel JJ, Patel NJ, Awad SK, Boyd CJ, King TW. The Content of US Plastic Surgery Private Practices' Websites. Ann Plast Surg 2021; 86:S578-S584. [PMID: 34100817 DOI: 10.1097/sap.0000000000002881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Connecting patients with healthcare providers continues to grow as the digital era evolves. A successful website has the power to influence patients on choosing a practice and provider. The objectives of this study were to characterize information provided on private practice websites of plastics surgeons in the United States and to assess the relationship among the websites based on the number of years that the physicians have been in practice. METHODS Newly board-certified plastic surgeons by the American Board of Plastic Surgery in 2005, 2010, and 2015 were identified. A Google search was conducted on all participants, and only those in private practice were included in this study. Each webpage was quantitatively and qualitatively assessed for the presence or absence of 23 criteria that were categorized as practice, physician, patient, or procedure information. χ2 was used for statistical analysis using Microsoft Excel (PSPP 1.2.0). A P value of less than 0.05 was considered statistically significant. RESULTS Most plastic surgeons in each cohort were currently in private practice. A total of 532 plastic surgery private practice websites were analyzed. The data points found on 100% of the websites were directions to the facility and the contact for any billing questions. Most websites provided information on the practice and its surgeons. The most common web-based data points included online consultations and links to their social media. Information on expenses incurred by patients, such as cancellation policies and consultation fees, was least commonly listed. CONCLUSIONS Our study shows that the number of years in practice is not associated with comprehensiveness of their website's content. This study provides insight into the content of plastic surgery private practices' websites in the United States in relation to the practice, the physician, the patient, and the procedures. This information may be useful for expanding and optimizing their websites. This has the potential to increase patient satisfaction and visibility of the practice. The success of these businesses is vital as the private sector in plastic surgery continues to grow.
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The Discrepancy Between Perceived Importance and Actual Delivery of Business Education in Residency: A Survey of Program Directors. Ann Plast Surg 2021; 85:468-471. [PMID: 32541537 DOI: 10.1097/sap.0000000000002429] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND In the contemporary healthcare environment, there is a need for physicians to understand business fundamentals. Nonsurgical residencies have implemented formal business education, but surgical training programs have been slower to adapt. Further research is needed to evaluate the status of business education in plastic surgery residency. METHODS A 12-question survey was created. Ninety program director (PD) e-mails were obtained and the survey was distributed using SurveyMonkey. The survey evaluated program demographics and current resources, commitments, and attitudes toward business training. The survey also identified the most important topics to include in a business curriculum. RESULTS Thirty-six surveys were completed (response rate = 40%). Whereas most PDs agreed that business education in plastic surgery residency was important (78%) and that their programs should have more business training (73%), only 39% currently offered business training. Only 42% of PDs believed that their chief residents were competent to handle the business aspects of plastic surgery upon graduation. No programs offered a formal gap year to pursue a professional business degree. The most important topics identified for a business curriculum were economics and finance (83.3%), management (64%), and marketing (53%). CONCLUSIONS There is disconnect between perceived importance and resources available for plastic surgery residents to receive business education. Increased attention is needed to resolve this discrepancy to ensure that future plastic surgeons are equipped to excel in their personal careers and stimulate the advancement of the field. Future research should aim to outline a business curriculum for plastic surgery trainees.
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Abstract
BACKGROUND The impact of residency training on academic productivity and a career in academic plastic surgery remains uncertain. Previous literature has explored the influence of training institutions on academic careers in surgery. The aims of the study were to assess research productivity during plastic surgery residency training and to illustrate how differences in training programs impact resident research productivity. METHODS Academic plastic surgery faculty that graduated in the past 10 years were identified through an Internet search of all Accreditation Council for Graduate Medical Education-accredited residency and fellowship training programs. Research productivity was compared based on h-index, number, and quality of peer-reviewed articles published during residency. RESULTS Three hundred seventy-five academic plastic surgeons were identified and produced 2487 publications during residency. The 10 most productive training institutions were Johns Hopkins, Georgetown, University of Michigan, Stanford, University of California Los Angeles, Northwestern, Harvard, New York University, University of Pennsylvania, and Baylor. Academic productivity was higher among integrated residents (integrated = 8.68 publications, independent = 5.49 publications, P < 0.0001). The number of publications positively correlated to faculty size (r = 0.167, P = 0.0013), National Institute of Health (NIH) funding (r = 0.249, P < 0.0001), residency graduation year (r = 0.211, P < 0.0001), and negatively correlated with Doximity ranking (r = -0.294, P < 0.0001). H-index was positively correlated with number of publications (r = 0.622, P < 0.0001), faculty size (r = 0.295, P < 0.0001), and NIH funding (r = 0.256, P < 0.0001) and negatively correlated with Doximity ranking (r = -0.405, P < 0.0001) and residency graduation year (r = -0.163, P < 0.0001). CONCLUSIONS Our study has found that there is an elite cohort of programs that are the most productive research institutions. Resident research productivity is higher among integrated residents, recent graduates, and programs that are larger in size, with a higher Doximity ranking and NIH funding. This study can guide medical students and future applicants who are interested in a career in academic plastic surgery in the selection of programs that match their career aspirations.
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McGlone KL, Ngaage LM, Steinberg JP, Lifchez SD, Slezak S, Rasko YM. Academic Productivity Among Plastic Surgery Subspecialty Fellowship Applicants. Ann Plast Surg 2021; 86:371-375. [PMID: 32881746 DOI: 10.1097/sap.0000000000002502] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Plastic surgery subspecialty fellowships are highly competitive. Academic productivity is an objective metric that can be used to compare candidates. This study aims to evaluate intersubspecialty differences in academic profiles of plastic surgery fellows. METHODS We performed a cross-sectional analysis of the plastic surgery fellows in the United States from 2015 to 2019. We used the San Francisco Match website and individual program websites to obtain details of fellowship programs (microsurgery, aesthetic, hand, and craniofacial) and plastic surgery fellows. Bibliometric data at the time of fellowship application were obtained for each fellow. RESULTS A total of 235 fellows were included. There was a significant difference in the median number of publications (P = 0.0067) and h-index (P = 0.0229) across subspecialties. Multivariate analysis demonstrated that dedicated research time was predictive for a high publication count (odds ratio [OR], 3.59; P = 0.0007) and h-index (OR, 4.88; P < 0.0001) at the time of fellowship application. Although international residency and aesthetic fellowship application were predictive of a reduced number of publications (OR, 0.17; P < 0.0001, and OR, 0.43; P = 0.0190, respectively), H-index was increased by possession of an advanced degree (OR, 2.00; P = 0.0291) and decreased with international residency (OR, 0.26, P = 0.0021). CONCLUSIONS All plastic surgery fellows have highly qualified academic profiles at the time of fellowship application. Academic productivity differs between subspecialty fellowships. Those wishing to match into competitive subspecialties should consider taking dedicated time for research or attaining an advanced degree.
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Affiliation(s)
| | - Ledibabari M Ngaage
- Division of Plastic Surgery, Department of Surgery, University of Maryland School of Medicine
| | - Jordan P Steinberg
- Department of Reconstructive and Plastic Surgery, Johns Hopkins Hospital, Baltimore, MD
| | - Scott D Lifchez
- Department of Reconstructive and Plastic Surgery, Johns Hopkins Hospital, Baltimore, MD
| | - Sheri Slezak
- Division of Plastic Surgery, Department of Surgery, University of Maryland School of Medicine
| | - Yvonne M Rasko
- Division of Plastic Surgery, Department of Surgery, University of Maryland School of Medicine
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Ovadia SA, Thaller SR. Outlook for Independent Plastic Surgery Training: A Survey of Plastic Surgery Program Directors. Ann Plast Surg 2021; 86:78-81. [PMID: 32349081 DOI: 10.1097/sap.0000000000002378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Traditionally, plastic surgery training occurs through the independent model after completion of another surgical residency. Training is a minimum of 3 years in duration. Integrated training in contrast commences upon completion of medical school and is a minimum of 6 years. Independent programs have increasingly been converting positions to integrated positions. Our survey was designed to evaluate possible plans for further conversion of independent positions to integrated positions. METHODS An electronic survey was prepared using the online survey platform Qualtrics. The survey questions were designed to solicit information regarding plans to convert independent positions to integrated positions. The survey was distributed by e-mail to program directors of the independent programs participating in the 2019 match. A reminder was sent 3.5 weeks after initial distribution, and results were collected for an additional 3 weeks. RESULTS Sixteen program directors responded to our survey including 15 complete responses and 1 partial response representing a 40% response rate. Four respondents reported that they are considering decreasing their independent program by 1 position and converting the position to an integrated position. Three respondents reported that they are considering eliminating their independent program and converting to an integrated program. Each of these programs reported their independent program as having 1 position per year. With only a 40% response rate, 7 or more positions may be converted to integrated positions in the coming years. CONCLUSIONS Independent programs have been converting some or all positions to integrated positions. Although most plastic surgery positions were previously through the independent model, in 2019, 172 positions were offered through the integrated match compared with 63 for the independent match. Results of our study indicate that independent positions will continue to be converted to integrated positions for the next few years.
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Affiliation(s)
- Steven A Ovadia
- From the DeWitt-Daughtry Family Department of Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, University of Miami, Leonard Miller School of Medicine, Miami, FL
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Luby AO, Ranganathan K, Matusko N, Buchman SR. Assessing the Key Predictors of an Academic Career after Craniofacial Surgery Fellowship. Plast Reconstr Surg 2020; 146:759e-767e. [PMID: 33234966 DOI: 10.1097/prs.0000000000007340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND As craniofacial fellowship positions outnumber the availability of academic craniofacial jobs, it is important to understand the factors associated with securing an academic position after fellowship. The purpose of this study was to evaluate the impact of bibliometric indices and trainee demographics on the ability to obtain a full-time academic plastic surgery position on completion of a craniofacial fellowship. METHODS Craniofacial fellowship graduates between 2009 and 2018 (n = 182) were identified. Initial job placement and demographic data were collected; bibliometric indices at fellowship completion were calculated. Chi-square and Fisher's exact tests and multivariable logistic regression were used to assess the association of select factors with job placement. RESULTS Of the 48.9 percent of fellows that secured academic positions, 39.3 percent trained at five fellowship institutions. The majority of those completing residency at top institutions for academic surgery and research entered academic positions at fellowship completion. Geography influenced academic placement, as 72.7 percent of trainees in the Northeast secured academic positions. Only 20.3 percent of fellows completed dedicated postgraduate research time, but among these, 70.3 percent entered academic jobs. The h-index (OR, 1.14; p = 0.01) and total manuscripts (OR, 1.04; p = 0.02) were significantly associated with academic practice while adjusting for other covariates. CONCLUSIONS Although residency training institution, geographic location, and postgraduate research may influence academic placement, the h-index and total manuscripts represent the best predictors of academic careers after craniofacial fellowship. This information is valuable for applicants who aspire to be academic craniofacial surgeons, and for programs and educators who can use these data to identify applicants with a propensity for academics.
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Affiliation(s)
- Alexandra O Luby
- From the Department of Surgery, Section of Plastic and Reconstructive Surgery, Craniofacial Research Laboratory, University of Michigan Health System
| | - Kavitha Ranganathan
- From the Department of Surgery, Section of Plastic and Reconstructive Surgery, Craniofacial Research Laboratory, University of Michigan Health System
| | - Niki Matusko
- From the Department of Surgery, Section of Plastic and Reconstructive Surgery, Craniofacial Research Laboratory, University of Michigan Health System
| | - Steven R Buchman
- From the Department of Surgery, Section of Plastic and Reconstructive Surgery, Craniofacial Research Laboratory, University of Michigan Health System
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Abstract
BACKGROUND The limited supply of academic plastic surgery positions has led to increased demand and strong competition for these desired positions. Residents and students now seek out academic opportunities earlier in their training to account for this employment shortage. Training pathways and locations play an extremely important role in obtaining an academic position at most institutions. This study aimed to evaluate the training patterns of academic plastic surgeons in an attempt to elucidate its value and role for trainees interested in pursuing future academic careers. METHODS All full-time faculty members at currently accredited integrated and independent plastic surgery programs were included in the study; clinical affiliates were excluded. These institutions' websites were then queried to obtain the training history of the surgeons meeting inclusion criteria. Data were entered into a centralized database from which descriptive statistics were obtained. RESULTS In the 741 surgeons included in the study, 514 (69.4%) completed the independent plastic surgery track and 227 (30.6%) completed the integrated pathway. Residents completing the independent track had 20.8% and 31.7% employment at the same institution where they finished their general and plastic surgery residency, respectively. Of those completing the integrated pathway, 33.9% are employed at the same institution where they graduated from residency. In addition, 47.9% of the surgeons included in the study completed medical school, residency, or fellowship at the current institution at which they are employed. Lastly, 512 surgeons (69.4%) completed at least 1 postresidency fellowship. CONCLUSIONS Academic surgeons commonly complete a postresidency fellowship and are often employed at institutions where they have formerly trained. Trainees considering an academic career should consider these patterns when planning their future careers.
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Atia A, Langdell HC, Hollins A, Shammas RL, Glener A, Marks C, Lee BT, Phillips BT. Microsurgery Fellowship Website and Social Media Presence: Are Programs Optimizing Recruitment Strategy? J Reconstr Microsurg 2020; 37:380-384. [PMID: 32992375 DOI: 10.1055/s-0040-1717152] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Microsurgery fellowship applicants make decisions for future training based on information obtained from colleagues, mentors, and microsurgery fellowship program Websites (MFWs). In this study, we sought to evaluate the accessibility and quality of available information by microsurgery programs by analyzing the most commonly used web resources and social media outlets for applicants. METHODS The San Francisco (SF) Match and American Society of Reconstructive Microsurgery Websites were queried in April 2020 for microsurgery fellowship programs (MFPs) participating in the SF Match. Twenty-two independent variables of information were assessed on MFWs based on previously published data. Social media presence was also assessed by querying Facebook, Instagram, and Twitter for official hospital, plastic surgery residency, and microsurgery fellowship accounts. RESULTS All 24 MFWs participating in the SF Match had a webpage. Program description, faculty listing, operative volume, and eligibility requirements were listed for all programs (100%). The majority of MFWs listed affiliated hospitals (75%), provided a link to the fellowship application (66.7%), listed interview dates (66.7%), and highlighted research interests (50%). A minority of MFWs provided information on conference schedule (37.5%), current fellow listing (25%), previous fellow listing (16.67%), and positions held by previous fellows (8.33%). No MFWs (0%) presented information on selection process, or rotation schedule.All hospitals with an MFP had a Facebook page and nearly all had Instagram (83.3%) and Twitter accounts (95.8%). Plastic surgery residency programs at the same institution of an MFP had social media presence on Facebook (38.9%), Twitter (38.9%), and Instagram (66.7%). Only three MFPs had Facebook accounts (12.5%) and none had Instagram or Twitter accounts. CONCLUSION As the field of microsurgery continues to grow, the need for effective recruitment and training of microsurgeons continues to be essential. Overall, we conclude that both the accessibility and quality of information available to applicants are limited, which is a missed opportunity for recruitment.
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Affiliation(s)
- Andrew Atia
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Hannah C Langdell
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Andrew Hollins
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Ronnie L Shammas
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Adam Glener
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Caitlin Marks
- Duke University School of Medicine, Durham, North Carolina
| | - Bernard T Lee
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Brett T Phillips
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
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Comparing Independent and Integrated Plastic Surgery Residency Models: A Review of the Literature. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2897. [PMID: 32802640 PMCID: PMC7413769 DOI: 10.1097/gox.0000000000002897] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/14/2020] [Indexed: 11/25/2022]
Abstract
There are currently 2 approved residency training models in the United States conferring eligibility for the American Board of Plastic Surgery examination—the integrated pathway and the independent pathway. While both pathways allow for board certification, there has been much debate regarding the effectiveness of one training model over the other. In this article, we review the existing literature to compare these pathways with regard to quality of trainees, proficiency of graduates, and practice or career outcomes. Ongoing studies are strongly encouraged to continue to identify areas of improvement for both types of training programs.
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Single-Payer Health Care in the United States: Implications for Plastic Surgery. Plast Reconstr Surg 2020; 145:1089e-1096e. [DOI: 10.1097/prs.0000000000006804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The Value of Business Training in the Quest for Sustainable Health Care Delivery in Plastic Surgery. Ann Plast Surg 2019; 83:121-122. [PMID: 31295168 DOI: 10.1097/sap.0000000000002010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- Foad Nahai
- Professor of Plastic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta GA
- Editor-in-Chief of Aesthetic Surgery Journal
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DeSerres JJ, Curran MWT, Fung EH, Tredget EE, Wilkes GH, Olson JL. Advanced Training and Job Satisfaction Among Recent Canadian Plastic Surgery Graduates. Plast Surg (Oakv) 2019; 27:223-229. [PMID: 31453142 DOI: 10.1177/2292550319826089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background In order to increase one's competitiveness in the current job market, Canadian plastic surgery graduates may complete additional degrees and multiple fellowships. The authors sought to determine the impact of this additional training on the practice profile of recent graduates and determine the current state of job satisfaction among this group. Methods An anonymous cross-sectional online survey was created and sent to all 250 graduates of Canadian plastic surgery residencies from 2005 to 2015. Demographics were collected and questions grouped into clinical, teaching, research, and administrative components. Questions pertaining to job satisfaction were also included. Results The response rate to the survey was 39%. Sixty-nine (71%) respondents had permanent attending positions at the time of survey completion, while the remaining 28 respondents did not. Among those with permanent positions, 59 (86%) completed at least one fellowship and 30 (43%) have an advanced degree. Of those who did fellowship training, 76% practice primarily in their area of subspecialty. Having an advanced degree showed a trend to a higher percentage of practice dedicated to research (5.6% vs 1.9%; P = .074) and more publications per year were seen among this group (1.31 vs 0.30; P = .028). Eighty-six percent of respondents are satisfied with their current attending position. Conclusions The majority of recent Canadian plastic surgery graduates are undergoing fellowship training and are practicing primarily in their fields of subspecialty training. Having a postgraduate degree was associated with a higher number of publications per year as an attending surgeon. Job satisfaction is high among recent graduates.
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Affiliation(s)
- Joshua J DeSerres
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Matthew W T Curran
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Eric H Fung
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Edward E Tredget
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,Wound Healing Research Group, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,Division of Critical Care, Department of Medicine, University of Alberta Hospital, Edmonton, Canada
| | - Gordon H Wilkes
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,Institute for Reconstructive Sciences in Medicine, Misericordia Hospital, Edmonton, Canada
| | - Jaret L Olson
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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Oxley PJ, Lotto JA. Factors Influencing Plastic Surgeons When Selecting New Colleagues. Plast Surg (Oakv) 2018; 27:112-117. [PMID: 31106167 DOI: 10.1177/2292550318800321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction As plastic surgeons are continuing to form larger groups, it is essential to select candidates who will contribute to a positive work environment. This article shows which traits may be the most valuable when selecting candidates and in which ways a selection committee may want to focus their search. Methods For the study, the Canadian Society of Plastic Surgeons' members answered a survey containing questions about demographics, the factors which influence the selection process, and their hiring experiences. Responses were separated and compared in groups based on gender, practice type, group size, and years practising. Significance was established if P < .05 using the χ2 test. Results The most and least important factors regarding hiring a new group member were established. Statistically significant results were obtained between several different factors, including hiring a non-Canadian, the importance of the candidate's professional reputation, the number of publications by the candidate, and the presence or absence of program director letters. A majority (54%) of society members regret having hired a candidate, with the vast majority of these (75%) indicating personality and work ethic issues as opposite to professional skills as the uncomplimentary feature. Conclusion This study has identified the key features which influence hiring new candidates. The need to develop a more efficient hiring process has been identified and has highlighted the difficulty faced by Canadian plastic surgery groups when recruiting new members.
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The Evolving Presence of Women in Academic Plastic Surgery: A Study of the Past 40 Years. Plast Reconstr Surg 2018; 141:1304-1310. [PMID: 29697636 DOI: 10.1097/prs.0000000000004337] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Among surgical subspecialties, plastic surgery holds the highest percentage of women, and, the female contingent of board-certified plastic surgeons and trainees has grown steadily. However, their academic impact has been underestimated. We present the academic footprint of female plastic surgeons over the past 40 years. METHODS A list of female plastic surgeons currently active at, and retired from, Accreditation Council for Graduate Medical Education-accredited plastic surgery residency programs was compiled. Each surgeon was searched on PubMed to gather their total number of publications, journals, and topics of research after completion of training. Date of publication and 5-year impact factor for each journal were recorded. Publications were organized into 10-year periods (1976 to 1985, 1986 to 1995, 1996 to 2005, and 2006 to 2016). RESULTS One hundred fifty-five currently active and 80 retired academic female plastic surgeons were identified, who published 2982 articles in 479 peer-reviewed journals. The average 5-year impact factor was 4.093. The number of publications increased with each decade: 37 (1976 to 1985), 218 (1986 to 1995), 472 (1996 to 2005), and 2255 (2006 to 2016). The most commonly published areas were hand/nerve (22 percent), craniofacial (21 percent), and breast (20 percent). Over time, publications in hand/nerve research decreased (76, 60, 38, and 14 percent, respectively); craniofacial-related publications increased (8, 11, 18, and 23 percent, respectively); and publications in breast research increased (0, 8, 9, and 24 percent, respectively). The 2006 to 2016 period yielded the most even distribution of research topics. CONCLUSION The academic contribution of female plastic surgeons has substantially increased in number and has become more evenly distributed across subspecialty topics.
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Sun HH, Pourtaheri N, Janis JE, Becker DB. Do Academic Health Care Systems Really Value Education? A Survey of Academic Plastic Surgeons. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 6:e1948. [PMID: 30534496 PMCID: PMC6250485 DOI: 10.1097/gox.0000000000001948] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/27/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although education is critical to the mission of academic medical centers in the United States, it is often not quantified and monetized as are their research and clinical missions. We undertook this survey to assess the perceived valuation of educational endeavors of plastic surgeon faculty at the U.S. academic medical centers. METHODS A survey using Qualtrics software (Qualtrics, Provo, UT) was distributed to faculty members of the American Council of Academic Plastic Surgeons by electronic mail in February 2015. A total of 16 questions included both demographic information and Likert-item questions of perception of valuation of educational activities. For analysis, responses were grouped according to an adapted Net Promoter Score including "unsupportive" (0-6), "neutral" (7-8), and "supportive" (9-10). RESULTS Sixty-five surveys were completed out of a total of 406, with an overall response rate of 16%. Kruskal-Wallis statistical analysis demonstrated that region and rank were not significant in perception of hospital or departmental support for educational activities. Respondents rated their departments as more supportive than their institutions (P < 0.05), and average perceived value rating of institutions was "unsupportive." Financial support was associated with higher ratings with respect to support of institutions and departments. Mid-career faculty displayed a trend toward lower ratings of perception of support. CONCLUSIONS The majority of respondents perceived their institutions and departments as unsupportive of educational effort. Direct compensation to physicians for teaching efforts may improve faculty retention in academia and reduce physician burnout.
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Affiliation(s)
- Helen H. Sun
- From the Case Western Reserve University School of Medicine, Department of Plastic Surgery, Cleveland, Ohio
| | - Navid Pourtaheri
- Department of Plastic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Jeffrey E. Janis
- Department of Plastic Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Devra B. Becker
- From the Case Western Reserve University School of Medicine, Department of Plastic Surgery, Cleveland, Ohio
- Department of Plastic Surgery, University of Pittsburgh Medical Center; Pittsburgh, Pa
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Trends in Accreditation Council for Graduate Medical Education Accreditation for Subspecialty Fellowship Training in Plastic Surgery. Plast Reconstr Surg 2018; 141:768e-774e. [DOI: 10.1097/prs.0000000000004336] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10 Years Later: Lessons Learned from an Academic Multidisciplinary Cosmetic Center. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2017; 5:e1459. [PMID: 29062640 PMCID: PMC5640337 DOI: 10.1097/gox.0000000000001459] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 07/06/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND In 2006, a Centers for Medicare and Medicaid Services-accredited multidisciplinary academic ambulatory surgery center was established with the goal of delivering high-quality, efficient reconstructive, and cosmetic services in an academic setting. We review our decade-long experience since its establishment. METHODS Clinical and financial data from 2006 to 2016 are reviewed. All cosmetic procedures, including both minimally invasive and operative cases, are included. Data are compared to nationally published reports. RESULTS Nearly 3,500 cosmetic surgeries and 10,000 minimally invasive procedures were performed. Compared with national averages, surgical volume in abdominoplasty is high, whereas rhinoplasty and breast augmentation is low. Regarding trend data, breast augmentation volume has decreased by 25%, whereas minimally invasive procedural volume continues to grow and is comparable with national reports. Similarly, where surgical revenue remains steady, minimally invasive revenue has increased significantly. The majority of surgical cases (70%) are reconstructive in nature and insurance-based. Payer mix is 71% private insurance, 18% Medicare and Medicaid, and 11% self-pay. Despite year-over-year revenue increases, net profit in 2015 was $6,120. Rent and anesthesia costs exceed national averages, and employee salary and wages are the highest expenditure. CONCLUSION Although the creation of our academic cosmetic ambulatory surgery center has greatly increased the overall volume of cosmetic surgery performed at the University of Wisconsin, the majority of surgical volume and revenue is reconstructive. As is seen nationwide, minimally invasive cosmetic procedures represent our most rapidly expanding revenue stream.
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Silvestre J, Runyan C, Taylor JA. Analysis of Practice Settings for Craniofacial Surgery Fellowship Graduates in North America. JOURNAL OF SURGICAL EDUCATION 2017; 74:181-186. [PMID: 27687540 DOI: 10.1016/j.jsurg.2016.08.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 07/01/2016] [Accepted: 08/28/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE In North America, the number of craniofacial surgery fellowship graduates is increasing, yet an analysis of practice settings upon graduation is lacking. We characterize the practice types of recent graduates of craniofacial fellowship programs in the United States and Canada. DESIGN A 6-year cohort of craniofacial fellows in the United States and Canada (2010-2016) were obtained from craniofacial programs recognized by the American Society of Craniofacial Surgery. Practice setting was determined at 1 and 3 years of postgraduation, and predictors of practice setting were determined. RESULTS A total of 175 craniofacial surgeons were trained at 35 fellowship programs. At 1 year of postgraduation, 33.6% had an academic craniofacial position and 27.1% were in private practice (p = 0.361). A minority of graduates pursued additional fellowships (16.4%), nonacademic craniofacial positions (10.0%), academic noncraniofacial positions (5.7%), and international practices (7.1%). At 3 years of postgraduation, the percentage of graduates in academic craniofacial positions was unchanged (34.5% vs 33.6%, p = 0.790). The strongest predictors of future academic craniofacial practice were completing plastic surgery residency at a program with a craniofacial fellowship program (odds ratio = 6.78, p < 0.001) and completing an academic craniofacial fellowship program (odds ratio = 4.48, p = 0.020). CONCLUSIONS A minority of craniofacial fellowship graduates practice academic craniofacial surgery. A strong academic craniofacial surgery background during residency and fellowship is associated with a future career in academic craniofacial surgery. These data may assist trainees choose training programs that align with career goals and educators select future academic surgeons.
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Affiliation(s)
- Jason Silvestre
- Division of Plastic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Jesse A Taylor
- Division of Plastic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
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Hu J, Zhen M, Olteanu C, Avram R. An evaluation of accessibility and content of microsurgery fellowship websites. Plast Surg (Oakv) 2016; 24:187-190. [PMID: 28439508 PMCID: PMC5395059 DOI: 10.4172/plastic-surgery.1000974] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Websites for residency and fellowship programs serve as effective educational and recruitment tools. OBJECTIVE To evaluate the accessibility and content of fellowship websites that are commonly used by microsurgery applicants for career development. METHODS A list of one-year microsurgery fellowship websites (MFWs) was compiled by visiting the centralized American Society for Reconstructive Microsurgery (ASRM) website, followed by performing an extensive 'Google' search in October 2015. Accessibility of MFWs was assessed. Website content regarding key recruitment and education variables was also comprehensively reviewed. Website content was correlated with program characteristics using t tests and ANOVA (two-tailed; P<0.05 was considered to be statistically significant). RESULTS A list of 53 eligible programs was compiled. Only 15 of 51 (29%) ASRM program links were functional. On average, the combined content from ASRM website and individual MFWs had 2.91 of 6 recruitment variables and 1.32 of 6 education variables, respectively. The majority of programs listed 'eligibility criteria' (87%) and 'general information' (87%). 'Evaluation criteria' were most poorly reported (4%). Recruitment score was higher for United States programs compared with international counterparts (51% versus 33%, respectively; P=0.02). It was also higher in programs that focus on 'extremity' versus 'breast' (58% versus 37%; P=0.0028). Education scores did not differ according to location, program size, subspecialty of focus or participation in the Microsurgery Match process. CONCLUSION Information regarding recruitment and education on most MFWs is scarce. Academic institutions should keep website content up to date and comprehensive to better assist candidates in the application process.
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Affiliation(s)
- Jiayi Hu
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario
| | - Meng Zhen
- Faculty of Medicine, McMaster University, Hamilton, Ontario
| | | | - Ronen Avram
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario
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Hu J, Zhen M, Olteanu C, Avram R. An evaluation of accessibility and content of microsurgery fellowship websites. Plast Surg (Oakv) 2016. [DOI: 10.1177/229255031602400301] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Websites for residency and fellowship programs serve as effective educational and recruitment tools. Objective To evaluate the accessibility and content of fellowship websites that are commonly used by microsurgery applicants for career development. Methods A list of one-year microsurgery fellowship websites (MFWs) was compiled by visiting the centralized American Society for Reconstructive Microsurgery (ASRM) website, followed by performing an extensive ‘Google’ search in October 2015. Accessibility of MFWs was assessed. Website content regarding key recruitment and education variables was also comprehensively reviewed. Website content was correlated with program characteristics using t tests and ANOVA (two-tailed; P<0.05 was considered to be statistically significant). Results A list of 53 eligible programs was compiled. Only 15 of 51 (29%) ASRM program links were functional. On average, the combined content from ASRM website and individual MFWs had 2.91 of 6 recruitment variables and 1.32 of 6 education variables, respectively. The majority of programs listed ‘eligibility criteria’ (87%) and ‘general information’ (87%). ‘Evaluation criteria’ were most poorly reported (4%). Recruitment score was higher for United States programs compared with international counterparts (51% versus 33%, respectively; P=0.02). It was also higher in programs that focus on ‘extremity’ versus ‘breast’ (58% versus 37%; P=0.0028). Education scores did not differ according to location, program size, subspecialty of focus or participation in the Microsurgery Match process. Conclusion Information regarding recruitment and education on most MFWs is scarce. Academic institutions should keep website content up to date and comprehensive to better assist candidates in the application process.
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Affiliation(s)
- Jiayi Hu
- Division of Plastic Surgery, Department of Surgery
| | - Meng Zhen
- Faculty of Medicine, McMaster University, Hamilton
| | | | - Ronen Avram
- Division of Plastic Surgery, Department of Surgery
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Lopez J, Ameri A, Susarla SM, Reddy S, Soni A, Tong JW, Amini N, Ahmed R, May JW, Lee WPA, Dorafshar A. Does Formal Research Training Lead to Academic Success in Plastic Surgery? A Comprehensive Analysis of U.S. Academic Plastic Surgeons. JOURNAL OF SURGICAL EDUCATION 2016; 73:422-428. [PMID: 26796512 DOI: 10.1016/j.jsurg.2015.12.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 10/29/2015] [Accepted: 12/02/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION It is currently unknown whether formal research training has an influence on academic advancement in plastic surgery. The purpose of this study was to determine whether formal research training was associated with higher research productivity, academic rank, and procurement of extramural National Institutes of Health (NIH) funding in plastic surgery, comparing academic surgeons who completed said research training with those without. METHODS This was a cross-sectional study of full-time academic plastic surgeons in the United States. The main predictor variable was formal research training, defined as completion of a postdoctoral research fellowship or attainment of a Doctor of Philosophy (PhD). The primary outcome was scientific productivity measured by the Hirsh-index (h-index, the number of publications, h that have at least h citations each). The secondary outcomes were academic rank and NIH funding. Descriptive, bivariate, and multiple regression statistics were computed. RESULTS A total of 607 academic surgeons were identified from 94 Accreditation Council for Graduate Medical Education-accredited plastic surgery training programs. In all, 179 (29.5%) surgeons completed formal research training. The mean h-index was 11.7 ± 9.9. And, 58 (9.6%) surgeons successfully procured NIH funding. The distribution of academic rank was the following: endowed professor (5.4%), professor (23.9%), associate professor (23.4%), assistant professor (46.0%), and instructor (1.3%). In a multiple regression analysis, completion of formal research training was significantly predictive of a higher h-index and successful procurement of NIH funding. CONCLUSION Current evidence demonstrates that formal research training is associated with higher scientific productivity and increased likelihood of future NIH funding.
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Affiliation(s)
- Joseph Lopez
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | - Afshin Ameri
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | - Srinivas M Susarla
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | - Sashank Reddy
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | - Ashwin Soni
- Division of Plastic Surgery, University of Washington Medical Center, Seattle, Washington
| | - J W Tong
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | - Neda Amini
- Department of General Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | - Rizwan Ahmed
- Department of General Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | - James W May
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - W P Andrew Lee
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | - Amir Dorafshar
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland.
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Jumaily JS, Spiegel JH. The Unique Practice Needs of Academic Facial Plastic and Reconstructive Surgeons. JAMA FACIAL PLAST SU 2016; 17:384-5. [PMID: 26042832 DOI: 10.1001/jamafacial.2015.0452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jeffrey S Jumaily
- Boston Medical Center, Boston, Massachusetts2Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Jeffrey H Spiegel
- Boston Medical Center, Boston, Massachusetts2Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine, Boston, Massachusetts
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Abstract
BACKGROUND Orthopedic and plastic surgery residents receive unique training yet often compete for similar hand surgery fellowships. This study compared didactic hand surgery training during orthopedic and plastic surgery residency. METHODS The Plastic Surgery In-Service Training Exam and Orthopaedic In-Training Examination were analyzed for hand content for the years 2009 to 2013. Topics were categorized with the content outline for the Surgery of the Hand Examination. Differences were elucidated by means of Fisher's exact test. RESULTS Relative to the Orthopaedic In-Training Examination, the Plastic Surgery In-Service Training Exam had greater hand representation (20.3 percent versus 8.1 percent; p < 0.001) with more annual hand questions (40 ± 3 versus 24 ± 2; p < 0.001). The Plastic Surgery Exam questions had more words, were less often level I-recall type, and were less often image-based. The questions focused more on finger and hand/palm anatomy, whereas the Orthopaedic examination was more wrist-focused. The Plastic Surgery Exam emphasized wound management and muscle/tendon injuries, but underemphasized fractures/dislocations. References differed, but Journal of Hand Surgery (American Volume) and Green's Operative Hand Surgery were common on both examinations. The Plastic Surgery Exam had a greater publication lag for journal references (10.7 ± 0.5 years versus 9.0 ± 0.6; p = 0.035). CONCLUSIONS Differences in didactic hand surgery training are elucidated for plastic surgery and orthopedic residents. Deficiencies in the Plastic Surgery In-Service Training Exam hand curriculum relative to the Orthopaedic In-Training Examination may underprepare plastic surgeons for the Surgery of the Hand Examination. These data may assist future modifications to hand surgery training in the United States.
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