Impact of Subspecialty Fellowship Training on Research Productivity Among Academic Plastic Surgery Faculty in the United States

Aditya Sood, MD, MBA; Paul J. Therattil, MD; Stella Chung, BA; Edward S. Lee, MD

Disclosures

ePlasty. 2015;15 

In This Article

Results

A total of 590 academic plastic surgeons from 80 residency programs were identified and evaluated after our exclusion criteria. Thirty-one percent (n = 183) were professors, 24% (n = 140) were associate professors, and 45% (n = 267) were assistant professors. Among them were 81 chiefs and chairpersons. Seventeen percent (n = 101) were female and 83% (n = 489) were male.

Seventy-two percent (n = 426) of academic surgeons have trained in at least 1 plastic subspecialty fellowship (vs 28% or n = 164 with no subspecialty training). The mean h-index in the fellowship group versus the "no-fellowship" group was 9.3 versus 8.4 (P = .11; Fig 1). Within the fellowship-trained cohort, multiple fellowships (n = 118) were the most common, followed by hand (n = 97), craniofacial (n = 92), microsurgery (n = 62), research (n = 33), cosmetic (n = 13), burn (n = 9), and wound healing (n = 2) (Fig 2). Total mean h-index was 9.10. Research fellowship-trained surgeons had a mean h-index value of 12.5, the highest value among all other subspecialties (Kruskal-Wallis test and Mann-Whitney U test, P < .05). The second highest mean h-index of 10.4 was observed in the multiple fellowships group (P < .05; Fig 3).

Figure 1.

Mean h-indices of academic plastic surgeons organized by fellowship experience. n represent sample size, error bars represent standard error of the mean. P value calculated from the Kruskal-Wallis and Mann-Whitney U tests. P = .11.

Figure 2.

Subspecialty composition of plastic and reconstructive surgeons studied (n = 590).

Figure 3.

Mean h-indices of the academic plastic surgeons organized by plastic subspecialty. Error bars represent standard error of the mean. P < .05.

Surgeons were further distributed by academic rank. Fellowship-trained surgeons comprised 70% (129/183) of professors, 72% (101/140) of associate professors, and 73% (196/267) of assistant professors. Wound healing and research fellowships had the largest proportions of professorship and associate professorship, whereas more than half of cosmetic and microsurgery fellowship-trained surgeons were assistant professors (Fig 4). Professors had significantly higher mean h-indices than the junior academic ranks across all fellowship categories except in burn and wound healing (Kruskal-Wallis test and Mann-Whitney U test, P < .05; Fig 5).

Figure 4.

Academic rank breakdown of plastic surgeons. Green bar represent proportion of professor faculty, red bar represents proportion of associate professor faculty, blue bar represents proportion of assistant professor faculty, and n represents absolute number.

Figure 5.

Mean h-index of plastic surgeons stratified by academic rank and fellowship training. Green dots represent professor faculty, red bars represent associate professor faculty, blue dots represent assistant professor faculty, error bars represent standard error of the mean. P value between senior and junior ranks calculated from the Kruskal-Wallis test with a subsequent Mann-Whitney U test. * P > .05.

There was a positive correlation between h-index growth and time since medical school graduation (P > .05 for 1950s, P < .05 for 1960–2000s; Fig 6). Twelve surgeons were excluded from this analysis because of the lack of available information regarding their medical school graduation year.

Figure 6.

Mean h-index of plastic surgeons distributed by year of medical school graduation. Error bars represent standard error of the mean. P value between senior and junior graduates calculated from the Kruskal-Wallis test with a subsequent Mann-Whitney U test. * P > 0.05.

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