The Decline Of MD/PhD Surgeon-scientists In Plastic And Reconstructive Surgery
Mytien Nguyen, MS1, Wendy Chen, MD, MS2, Luis A. Gonzalez, BS1, Henry C. Hsia, MD, FACS3.
1Yale School of Medicine, New Haven, CT, USA, 2The University of Texas Health Science Center at Houston, Houston, TX, USA, 33Division of Plastic & Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
PURPOSE: Surgeon-scientists play a critical role in innovation in plastic and reconstructive surgery (PRS). Despite recent calls to develop the pipeline for PRS surgeon-scientists, trends in recruitment of MD-PhD surgery residents remain unknown.
METHODS: We obtained data of PGY1 and total MD-PhD residents from the Association of American Medical Colleges Reports on Residents from 2012 to 2019. Surgical specialties include PRS, General Surgery, Neurological Surgery, Orthopaedic Surgery, Ophthalmology, Otolaryngology, Vascular Surgery, Thoracic Surgery, and Urology. Descriptive statistics and Pearson correlations were performed to determine significant changes in proportion of MD-PhD residents in surgery and PRS over time.
RESULTS: Between 2012 and 2019, the proportion of MD-PhD PGY1 residents in surgery increased slightly from 10.5% to 12.5% (p=0.13, Fig1a), while the overall proportion of MD-PHD residents in surgery across all PGYs remained the same (14.0% vs. 14.9%, Fig1a). Despite a consistent representation of MD-PhD residents in surgery, the proportion of MD-PhD PGY1 PRS residents decreased more than 3-fold over the same period (5.5% in 2012 vs. 1.5% in 2019, p=0.03, Fig1b). As a result, among the nine surgical specialties, PRS had the 3rd-lowest number of MD-PhD residents across all PGYs in 2019 (Fig1c).
CONCLUSION: There has been a dramatic decline in proportion of PRS MD-PhD residents in recent years, which raises concerns for the future of innovative discovery that has been a cornerstone of PRS legacy. 
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