Changes In Subspecialty Interest Of Plastic Surgery Residents With Progression Of Training: Impact On Academic Attrition
Jenna R. Stoehr, BA1, Elbert Vaca, MD2, Jonathan Bacos, MD3, Sarah Applebaum, MS, MS1, Joseph Lopez, MD4, Yuyang Chu, BS1, Arun Gosain, MD5.
1Northwestern University, Chicago, IL, USA, 2Private Practice, Boca Raton, FL, USA, 3Medical College of Wisconsin, Milwaukee, IL, USA, 4Yale University, New Haven, CT, USA, 5Ann & Robert Lurie Children's Hospital of Chicago, Chicago, IL, USA.
PURPOSE: Plastic surgery residency applicants often express interest in academic subspecialties, but only a small percentage of graduating residents pursue academic careers. Identifying reasons for academic attrition may help training programs address this discrepancy.
METHODS: A survey was sent to plastic surgery residents via the American Society of Plastic Surgeons Resident Council to assess interest in six plastic surgery subspecialties during junior and senior years of training. If a resident changed their subspecialty interest, the reasons for change were recorded. The importance of different career incentives over time were analyzed with paired t-tests.
RESULTS: 276 plastic surgery residents completed the survey. Most (77%) reported initial interest in an academic career. Out of 150 senior residents, 60 residents reported changing interests from their junior to senior years. Craniofacial and microsurgery were identified as the specialties with the highest attrition of interest, while interest in aesthetic, gender affirmation, and hand surgery increased. For residents who left craniofacial and microsurgery, the desire for higher compensation, to work in private practice, and the desire for improved job opportunities significantly increased. The desire for improved work/life balance was a prominent reason for subspecialty change among senior residents who changed to aesthetic surgery.
CONCLUSION: Plastic surgery subspecialties associated with academia suffer from resident attrition due to a variety of factors. Increased retention of trainees in academia, microsurgery, and craniofacial surgery could be improved through dedicated mentorship, improved job opportunities, and advocacy for fair reimbursement.
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