Changes in Subspecialty Interest of Plastic Surgery Residents With Progression of Training: Impact on Academic Attrition

Abstract

Background: 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 through the American Society of Plastic Surgeons Resident Council to assess interest in 6 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: Two hundred seventy-six plastic surgery residents of 593 potential respondents (46.5% response rate) completed the survey. 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 esthetic, 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 esthetic surgery. Conclusions: Plastic surgery subspecialties associated with academia, such as craniofacial surgery, suffer from resident attrition due to a variety of factors. Increased retention of trainees in craniofacial surgery, microsurgery, and academia could be improved through dedicated mentorship, improved job opportunities, and advocacy for fair reimbursement.

Trends in American Plastic Surgery Procedures (2005–2019): Observing the Growth Rate of Maxillofacial Surgery and Cosmetic Minimally Invasive Procedures in ASPS Data

“…12 Plastic surgery subspecialties connected to academia, such as craniofacial surgery, face challenges with resident attrition due to various factors. 13 Nevertheless, the growing prominence and evident upward trend in maxillofacial surgery, reflected in notable annual growth rates, highlight its significance. These findings stress maxillofacial surgery's evolving and crucial nature within the broader field.…”

International Microsurgery Club and World Society for Reconstructive Microsurgery Webinar: Career Building in Microsurgery

“…completing the existing literature focused on factors impacting the choice of a microsurgical career. 2 3 4 . The introduction was an open discussion about change, innovation, and dogma.…”