Trends in Pursuit of Otolaryngology Subspecialty Fellowship

Abstract

Objectives: (1) Examine resident interest in otolaryngology subspecialty fellowship and factors affecting that interest over time and throughout residency. (2) Examine changes in fellowship availability and match rate over time. Methods: Data regarding fellowship interest, influencing factors, and demographics were extracted from the 2008-2013 Section for Residents and Fellows-in-Training annual survey and examined in uni- and multivariate analyses. Historic fellowship match data available through match resources for pediatric otolaryngology, laryngology/broncho-esophagology surgery, rhinology, and neurotology were collected. Results: Over 6 years, a total of 1958 residents and fellows responded to the survey. A statistically significant decrease in fellowship interest was seen between junior (PGY-1 or PGY-2/3) and senior residents (PGY-4/5), with 79.9%, 73.3%, and 61.6% of PGY-1, PGY-2/3, and PGY-4/5 residents, respectively, planning to pursue subspecialty training ( P < .001). Of the portion planning fellowship training, choice of the subspecialty did not change throughout residency. No difference was found in the percentage of residents interested in fellowship from 2008 to 2013. The most important factors in choosing a subspecialty were consistently type of surgical cases and nature of clinical problems. The number of fellowship positions in facial plastic surgery, pediatric otolaryngology, and rhinology have increased over the past decade. Conclusions: Interest in fellowship continues to be high, but desire to pursue fellowship training decreases with increased residency training. This decision is multivariate in nature. While most subspecialties have grown slowly over time, the match rate continues to be variable due to fluctuations in application numbers.