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Career Plans of Graduating Plastic Surgery Trainees in 2009: The Impact of an Uncertain Economic Climate

Imahara, Scott D., M.D.; Scott, Jeffrey R., M.D.; Neligan, Peter C., M.D.

Plastic and Reconstructive Surgery: December 2009 - Volume 124 - Issue 6 - p 2173-2178
doi: 10.1097/PRS.0b013e3181bcf5e7

Background: Trainees in plastic surgery graduating in the midst of the current economic recession face unique financial challenges. These issues have the potential to affect future training and practice plans.

Methods: A 13-item questionnaire regarding issues influencing career plans was administered to senior plastic and reconstructive surgery trainees attending the 2009 American Society of Plastic Surgery Senior Residents Conference, in Austin, Texas.

Results: Of 97 conference attendees, 57 (58.7 percent) completed the survey representing all regions of the United States (33.3 percent of trainees nationwide). Trainees in the traditional training model (i.e., plastic surgery fellowship after surgery residency) were significantly less likely to pursue additional subspecialty training (29.6 percent) compared with trainees in integrated (76.9 percent) or combined programs (58.8 percent) (p = 0.012). Trainees who have dependents were significantly more likely to go into practice without fellowship (69 versus 38.2 percent, p = 0.031). Outstanding educational debt (>$50,000 or >$100,000) did not influence future practice plans. Trainees who are concerned about the national economic recession trended toward entering practice without fellowship training (70.0 versus 40.5 percent, p = 0.052). Of the factors surveyed, only anticipated fellowship training was significantly associated with plans to pursue academic practice (p = 0.002).

Conclusions: The majority of graduating trainees enter private practice without additional subspecialty fellowship training. Neither exceptional debt nor concern about the current economic recession was the primary determinant of future career plans, whereas trainees in a traditional model of plastic surgery and trainees with dependents were more likely to enter practice without further fellowship training.

Seattle, Wash.; and Arlington Heights, Ill.

From the Division of Plastic and Reconstructive Surgery, University of Washington, and the Plastic Surgery Educational Foundation.

Received for publication February 16, 2009; accepted May 6, 2009.

Disclosure:This research was not supported by commercial funding, and the authors have no financial interest to report.

Scott D. Imahara, M.D., Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Washington, 325 9th Avenue, Box 359796, Seattle, Wash. 98103,

©2009American Society of Plastic Surgeons