Assessing the Key Predictors of an Academic Career After Craniofacial Surgery Fellowship

Abstract

PURPOSE: Craniofacial surgery fellowship positions continue to outnumber the availability of academic craniofacial jobs. Therefore, it is important to understand the factors that affect the likelihood of securing an academic position. This information is not only valuable for applicants who aspire to be academic surgeons but also for fellowship programs and educators who can utilize these data to identify applicants with a propensity for academics. The purpose of this study was to evaluate the impact of bibliometric indices and other trainee demographics on the ability to obtain a full-time academic plastic surgery position upon completion of craniofacial surgery fellowship. METHODS: Craniofacial fellowship graduates between 2009 and 2018 (n = 182) were identified. Job placement out of fellowship, training information, and demographic data were collected. Bibliometric indices, total publications, and total citations were calculated up to and including the year of fellowship completion. Groups were stratified according to the trainee’s initial job placement as academic or nonacademic. Chi-square and/or Fisher’s exact tests and multinomial logistic regression were used to evaluate the relationship between job placement and selected factors. RESULTS: Of the 45.1% of fellows that secured academic positions, 43.9% trained at 6 fellowship institutions. Completing residency at a top tier (P < 0.001) and integrated (P = 0.001), plastic surgery program was associated with academic placement. The odds of academic job placement increased with each unit increase in h-index (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.10–1.29; P < 0.001), g-index (OR, 1.07; 95% CI, 1.03–1.11; P < 0.001), hinorm (OR, 1.33; 95% CI, 1.17–1.51; P < 0.001), total manuscripts (OR, 1.04; 95% CI, 1.02–1.07; P < 0.001), and total citations (OR, 3.29; 95% CI, 1.78–6.08; P < 0.001). Of the craniofacial fellows entering academics, 24 (29.3%) were female, 10 (12.2%) had other fellowship training, and 20 (24.4%) earned advanced degrees; these factors were not associated with job placement. Geography was significantly associated with placement (P = 0.018), as 63.6% of trainees in the Northeast secured academic positions. Craniofacial fellows (20.3%; n = 37) completed dedicated postgraduate research time. Among these, 70.3% (n = 26) went into academics; dedicated postgraduate research time was associated with academic placement (P = 0.001). CONCLUSIONS: The findings of this study are important for plastic surgery faculty, training surgeons, and medical students alike. We conclude that residency training institution, type of residency training program, fellowship geographic location, and dedicated postgraduate research time can significantly impact one’s ability to secure an academic position upon craniofacial fellowship completion. Additionally, this study identifies bibliometric indices as objective measures of academic productivity and predictors of an academic job after completion of craniofacial surgery fellowship. It is our hope that these findings may serve to guide program directors in selecting applicants with higher likelihood of future academic practice, and plastic surgery residents, fellows, and medical students who aspire to be craniofacial surgeons at an academic center.