Equitable Access to Research Opportunities in Plastic Surgery: Development of a Research Fellowship Database.

Abstract

Participation in a plastic surgery research fellowship is associated with an increased chance of matching into integrated plastic surgery residency.1 From our experience, students identify research fellowship opportunities through personal connections, medical school advisors, and at times, “googling” available applications. When personal connections and mentor relations are utilized as a primary mode of information transmission, knowledge may be passed less frequently to women and students underrepresented in medicine, both groups who may be less likely to form strong mentorship relationships.2,3 In addition, highly motivated trainees from medical schools and hospital systems with less rigorous research infrastructure or a less developed plastic surgery program may not access the information. This problem of equitable knowledge transmission is important, especially within the plastic and reconstructive surgical field, where there are smaller numbers of Black and Hispanic surgeons relative to other surgical specialties.4 With this background in mind, and many inquiring emails from students across the country, we identified the need for a centralized research fellowship database. A survey was distributed to research fellowship directors through the American College of Academic Plastic Surgeons’ email list. A database of 18 research fellowships was compiled with information about each program’s research focus, number of positions, funding structure, fellowship components, and application requirements. (See Table, Supplemental Digital Content 1, which shows data on 18 research fellowships, https://links.lww.com/PRS/E734.) Basic survey data collected from the participating programs further elucidated demographic characteristics and research productivity of past and present research fellows. Research fellowship directors indicated that the majority of their fellows were 25 to 28 years old and identified mainly as White/Caucasian, followed by Hispanic/Latino and Asian/Pacific Islander. Native American and Black/African American trainees were the least represented in our data. The majority of fellowship directors stated that between 25 percent and 50 percent or 50 percent and 75 percent of their fellows are female, with only one program stating that less than 5 percent of their current or past fellows were female. Three fellowship directors stated they currently had or have had LGBTQ+ fellows, while 12 fellowship directors were unsure of the sexual orientation of their fellows. The majority of fellowship directors stated fellows submitted 11 to 15 or 16 to 20 abstracts, with an average of six to 10 submitted manuscripts. All plastic surgery fellowship directors indicated that fellowship participation makes trainees stronger applicants during the plastic surgery residency selection process, with seven fellowship directors citing a 100 percent match rate and two fellowship directors citing an 85 percent to 95 percent match rate. The database entry form continues to be available for additional programs to add themselves as they develop. As Ramanadham and Rohrich5 astutely stated, mentorship can no longer “occur in happenstance.” The same is true of access to career-advancing opportunities such as research fellowships. If research fellowships, as demonstrated by our data and those of other groups, function as a sort of pipeline into the field, we should take a closer look at who can enter the pipeline. We believe this database will be useful to both sides of the research fellowship supply/demand curve—it provides all trainees, regardless of background or home institution, with a clearinghouse of opportunities and fellowship directors with a larger, more diverse applicant pool. DISCLOSURE The authors have no financial or nonfinancial conflicts of interest related to this work.