Surgery Fellowship Program Directors Research Articles

Demographics and Characteristics of US-Based Minimally Invasive Gynecologic Surgery Fellowship Program Directors: A 2023 Descriptive Analysis

Fellowship program directors (FPDs) play an important role in the development of fellows and learners, but little is known about their demographics. This cross-sectional study aims to examine the characteristics of minimally invasive gynecologic surgery (MIGS) FPDs. A retrospective cross-sectional study. Data obtained from publicly available information on official websites of the program directors studied. MIGS fellowship program directors. All US-based MIGS programs affiliated with the AAGL in 2023 were included. Information about FPD gender, medical school attended and graduation year, residency program attended and graduation year, any additional graduate degrees earned, fellowship programs completed, and the year of their appointment as FPD was collected through publicly available sources. Scholarly activity was measured by peer-reviewed articles and the Hirsch index. Of the 54 FPDs, 28 (51.85%) were female and 26 (48.15%) were male. Male FPDs were significantly older (54.6 ± 8.7 years) than female FPDs (46.2 ± 5.0 years), p < 0.05. Average age at appointment was 43.1 ± 6.7 years, with female FPDs being appointed at significantly younger ages (39.4 ± 5.1 years) compared to male FPDs (44.5 ± 6.8 years), p < 0.05. Male FPDs had statistically significant higher Hirsch indices (14 ± 11.4) compared to female FPDs (8 ± 5.8), p < 0.05. Of the FPDs who completed a fellowship, 27 (50.00%) did so in MIGS, eight (14.81%) in Gynecologic-Oncology, six (11.11%) in Urogynecology, and four (7.41%) in Reproductive Endocrinology/Infertility. MIGS fellowships have a uniquely equal representation of male and female FPDs, as surgical subspecialties historically tend to be male dominant. Notably, there is diversity in the type of fellowship pursued by MIGS FPDs, with nearly half of FPDs completing a fellowship outside of MIGS. The reasons for differences in scholarly contributions, indicated by Hirsch index, of male versus female FPDs is unclear.

Descriptive Analysis of Vitreoretinal Surgery Fellowship Program Directors.

Purpose: To evaluate the demographic, educational, and scholarly characteristics of Association of University Professors of Ophthalmology-accredited vitreoretinal surgery fellowship program directors in the United States and Canada. Methods: Demographic, educational, and scholarly profiles of identified program directors were collated from online public resources. Characteristics were compared by sex, program size, ranking, and affiliation. Results: Eighty-one program directors (mean age [±SD] 54.7 ± 11.0 years) from 78 fellowship programs were identified. The minority were women (14.8%), who were on average 6 years younger than their male counterparts (P = .07). The majority of program directors had an academic affiliation (90.1%), most commonly professor (54.8%). The mean h-index, 5-year h-index, and m-quotient were 20.9 ± 14.9, 5.9 ± 4.4, and 0.82 ± 0.42, respectively. Compared with their counterparts, program directors of both "top 10" and large programs published more manuscripts (P < .05), accrued more citations (P < .05), and had a higher h-index (P < .05). Fellowship programs with female program directors had a significantly larger proportion of female retina faculty (P = .002). Conclusions: The backgrounds of vitreoretinal surgery program directors are diverse. However, women remain underrepresented in this position, highlighting an area with the potential for greater equity in ophthalmology.

A descriptive analysis of facial plastic and reconstructive surgery fellowship program directors

A descriptive analysis of facial plastic and reconstructive surgery fellowship program directors

Evaluation of Virtual Vitreoretinal Surgery Fellowship Interview and Match Experience.

Purpose: To evaluate applicants' and programs' experiences during the 2019 and 2020 fellowship application seasons. Methods: An anonymous survey of vitreoretinal surgery fellowship program directors (PDs) (n = 21) and applicants from the 2019 traditional (n = 24) and 2020 virtual (n = 17) match cycles (before and during COVID-19 pandemic, respectively) was conducted. The questions assessed demographics, interview experiences, and overall interview costs. Statistical significance was determined using unpaired and paired 2-sided t tests for applicants and PDs, respectively (P < .05). Results: In 2020, 17.6% of applicants and 15.8% of PDs strongly agreed that they were able to convey themselves well during the interview compared with 50% and 73.7%, respectively, in 2019 (P = .002 and P < .001, respectively). In 2020, 5.9% of applicants and 10.5% of PDs strongly agreed that they gained a good understanding of their counterpart compared with 41.7% and 47.4%, respectively, in 2019 (P < .001 and P = .01, respectively). Regarding cost, 83.3% of applicants and 21.1% of programs spent more than $2000 in 2019, whereas 17.6% of applicants and no program did so in 2020. Conclusions: Although virtual interviews allowed fellowship recruitment to continue during the pandemic, both applicants and PDs expressed uncertainty regarding their abilities to portray themselves and gauge those with whom they interviewed. The benefits of virtual interviews, including decreased cost, increased efficiency, and convenience, must be weighed against these factors.

Evaluation of Financial Relationships Between US Colorectal Surgery Fellowship Program Directors and Industry

This cross-sectional study evaluates the financial relationships between colorectal surgery fellowship program directors and industry.

Evaluating the gender of vascular surgery residency program directors in the United States

ObjectiveWomen in vascular surgery, especially those in leadership positions, are historically sparse but have the potential to make significant contributions to diversifying the future cohort of vascular surgeons. We aimed to analyze the current demographics of integrated vascular surgery residency (0+5) and fellowship (5+2) program directors (PDs) in the United States. MethodsA cross-sectional study of all active Accreditation Council for Graduate Medical Education-accredited 0+5 and 5+2 programs was performed. Program and PD data were obtained in February 2023 using publicly accessible sources. Program accreditation date, affiliation type, female faculty, and female trainees were collected. PD data included medical degree, training pathway, country of training, gender (male vs female), current age, appointment age, duration between training and appointment, research output, and H-index. ResultsSeventy-four 0+5 programs and 117 5+2 programs were included. Most programs were university-affiliated (164/191; 86%). Seventy-six percent (146/191) of PDs were identified as male, with the remaining 24% female. The mean age was 52 ± 7 years, and the age at PD appointment was 46 ± 7 years. The time between training completion and PD appointment was 11 ± 7 years, and the mean term length was 4 ± 3.5 years. Female PDs were younger overall (49 ± 6 vs 53 ± 7 years; P = .04) and at age of appointment (41 ± 5 vs 48 ± 7 years; P = .03). There was a trend of female PDs having longer term lengths compared with male PDs (6 ± 4 vs 4 ± 3 years; P = .08). Forty percent of residents were female, and 26% of full-time faculty were female. 5+2 female PDs were in programs with more female faculty (P = .001). Female department leaders had double the number of female PDs compared with male department leaders. Male PDs had a higher mean number of publications and Hirsch index compared with female PDs. However, these differences were not statistically significant when adjusting for age and age at position appointment. ConclusionsMost 0+5 and 5+2 PDs were men, and the overwhelming majority of department or division leaders in vascular surgery were male. Although the majority of PDs were male, female PDs were appointed earlier in their career. The current state of diversity in vascular surgery leadership has improved over the past decade; however, there still needs to be more female vascular surgeons, especially in leadership positions. Continuing institutional and societal efforts to recruit female trainees and promote women to leadership is essential to improve the diversification of vascular surgeons.

An Analysis of Academic Background and Research Activity Among Pediatric Orthopaedic Surgery Division Chiefs and Fellowship Program Directors

Background: Pediatric orthopedics has seen a large increase in the number of practicing surgeons. As a field that is concentrated at tertiary referral centers, research productivity can be a critical component of academic advancement for pediatric orthopedics. Little has been published on the academic profiles of pediatric orthopedic leaders, and therefore, this study sought to highlight the demographics of these individuals. Methods: Pediatric orthopedic division chiefs and fellowship program directors (PD) were identified for all Pediatric Orthopedic Society of North America (POSNA) accredited fellowship programs in the 2020-21 application cycle. A combination of organizational and public websites was used to compile the academic profiles of these leaders, including demographic variables and research productivity. Division chiefs and PDs were then compared, as were leaders when stratified by fellowship size. Results: A total of 46 POSNA-accredited fellowships were identified. As 12 surgeons held dual roles as division chief and PD, 46 division leaders and 34 PDs formed the groups for comparison. Division chiefs had greater median years-in-practice (24.0 vs 13.0, p&lt;0.001), PubMed publications (56.0 vs 27.0, p=0.037), and more frequently were appointed as “Professor” (54.3% vs 23.5%, p=0.013) compared to fellowship PDs. Leaders working at programs with &gt;1 spot/year were more likely to have completed fellowship at their home program (40.0% vs 8.0%, p=0.001) and had higher research productivity across all metrics (all p&lt;0.002) than leaders at programs with 1 position/year. Female representation among division chiefs and fellowship PDs was 10.9% and 14.7%, respectively. Conclusions: When compared to fellowship PDs, pediatric division chiefs had higher research productivity and academic appointments. Division leaders at larger programs additionally had higher research output and more commonly trained at their current institution. Female representation among pediatric orthopedic leaders was higher than the field of orthopedics at large, but lagged behind reported POSNA membership.

Perceived Barriers to Increasing Diversity within Oculofacial Plastic Surgery.

Purpose Physician diversity is limited in ophthalmology and oculofacial plastic surgery. Determination of barriers within the application process for oculofacial plastic surgery may help target efforts to improve the recruitment of underrepresented groups. This study aimed to illuminate perceived barriers to increasing diversity in oculofacial plastic surgery trainees, according to the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) fellows and fellowship program directors (FPDs). Methods During the month of February 2021, we sent surveys out to 54 current oculofacial plastic surgery fellows and 56 FPDs at 56 oculofacial plastic surgery programs recognized by the ASOPRS nationwide using a 15-question Qualtrics survey. Results Sixty-three individuals (57%) responded to the survey: 34 fellows (63%) and 29 FPDs (52%). Eighty-eight percent of fellows and 68% of FPDs identified as non-underrepresented in medicine (UiM). Forty-four percent of fellows and 25% of FPDs identified as men. FPDs most commonly noted, "Not enough minorities applying to our program" and "The objective data (Ophthalmic Knowledge Assessment Program score, United States Medical Licensing Examination Step scores, clinical honors, Alpha Omega Alpha status, letter of recommendation) for minority applicants often do not meet the threshold required to offer an interview or to be ranked to match" as barriers. Among fellows, the lowest-rated considerations when applying to oculofacial plastic surgery were "Racially/ethnically diverse faculty" and "Perceptions of minority candidates by fellowship programs," whereas "Likelihood of matching in program of choice" was ranked highest in considerations. Fellows identifying as men indicated greater concern for "Financial factors related to fellowship (e.g., loans, salary, cost of living, or cost of interviewing)" compared to fellows identifying as women who noted greater concern for "Program or preceptor acceptance of starting or having a family during fellowship." Conclusion Responses from FPDs suggest that efforts focused on recruiting and supporting diverse students to medicine and ophthalmology, mentoring applicants interested in oculofacial plastic surgery, and restructuring the application process to decrease bias, may improve diversity within the subspecialty. The lack of UiM representation in this study, 6% fellows and 7.4% FPDs identified as UiM, shows both the stark underrepresentation and the need for further research into this topic.

An Analysis of Ophthalmic Plastic and Reconstructive Surgery Fellowship Program Directors in the United States.

PurposeThis study aims to examine the demographic features, academic backgrounds, and scholarly achievements of ophthalmic plastic and reconstructive surgery (OPRS) fellowship program directors (PDs) in the United States.MethodsIn this cross-sectional analysis, publicly accessible sources were accessed in March 2022 to collate the demographic and academic profiles of PDs of American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS)-accredited OPRS fellowships. Differences by gender and program rank were assessed using the Mann-Whitney Utest.ResultsFifty-four PDs were identified, the majority of whom were males (88.89% (n = 48)). The average age was 58.48 years. Of the PDs, 96.3% (n = 53) obtained a medical degree, and all completed residency training in the United States. In addition, 9.26% (n = 5) had another degree, either a Doctor of Philosophy (n = 3) or master’s degree (n = 2). A substantial proportion of individuals completed medical school (20.37% (n = 11)), residency (20.37% (n = 11)), or fellowship (31.48% (n = 17)) at an institution affiliated with the program where they were PDs. The most common additional fellowship obtained was neuro-ophthalmology (16.67% (n = 9)). The average h-index was 19.30 (range, 0-60), average five-year h-index was 4.85 (range, 0-36), and average m-quotient was 0.63 (range, 0-2.22). A significant difference in the median five-year h-index was observed between females and males (7 (range, 3-36) versus 4 (range, 0-10); p= 0.038).ConclusionsThis analysis indicated that OPRS PDs in the United States were principally males with extensive scholarly productivity. As women remain underrepresented in OPRS, increased gender parity at this leadership position should be encouraged in order to expand the recruitment of women into the field.

Gender Diversity in Hand Surgery Leadership.

Diversity in leadership drives innovation; however, women are underrepresented in leadership positions across academic medicine. The aim of this study was to assess the current gender representation in hand surgery leadership positions. This was a cross-sectional analysis of leaders in hand surgery. Leaders were defined as President, Board and Committee members of the American Society for Surgery of the Hand and the American Association for Hand Surgery, as well as hand surgery fellowship program directors and physician lead editors of peer-reviewed hand journals. The representation of women in leadership was compared to the percentage of female hand fellows over the same period. Years in practice, academic rank, additional degrees, h-index, m-index, National Institutes of Health (NIH) funding, publications, and citations were compared between male and female leaders. Twenty-nine of 213 leadership positions (13.6%) are held by women which is fewer than would be expected based on hand surgery fellowship composition. Female leaders were earlier in practice than their male counterparts (13.5 ± 5.7 versus 20.8 ± 11.1 years, P < .01). Women were more likely to hold position of assistant professor and less likely to be full professors (P < .05). There was no gender difference in NIH funding, h-index, m-index, publications, or citations. The greatest gender disparity was at the level of National Society President, which is a title held by only 2 women and 119 men. Gender disparities in hand surgery exist and are accentuated at the leadership level. Further work is needed to decrease leadership promotion disparities between men and women.

Diversity among transplant surgery fellowship program directors: a call to action.

The diversity among general surgery residency, HPB and other fellowship program directors has been previously analyzed. However, the diversity in abdominal transplant surgery fellowship program directors remains unknown. Abdominal transplant fellowship programs and the corresponding program directors were identified from the American Society of Transplant Surgeons website. Demographic and training information for the members was compiled through internet searches and analyzed. 72 program directors were included. 83.33% were male. 63.9% were non-Hispanic White, 25% were Asian, along with 5.56% Hispanic and Black each. Male program directors were more likely to be Associate Professor (p=0.041), while females were more likely to be Assistant Professor (p=0.021). 66% of female program directors were non-Hispanic White. Transplant surgery fellowship programs are primarily led by male and non-Hispanic White surgeons. Female representation as leaders is on par with their membership in the transplant surgery workforce. There is a deficiency of both male and female underrepresented minorities in program director positions.

Factors Considered in Ranking Pediatric Orthopaedic Surgery Fellowship Applicants

Background: Pediatric orthopaedic surgery is a competitive orthopaedic subspecialty that has seen a rise in the number of applications submitted per applicant over the past decade. Surveys of fellowship program directors in other orthopaedic subspecialties including orthopaedic trauma, spine, sports medicine, and hip and knee arthroplasty have demonstrated differing opinions regarding the factors considered most important when ranking applicants. The selection criteria considered most important by pediatric orthopaedic surgery fellowship program directors have not yet been evaluated. Methods: A web-based questionnaire was sent to the program directors of all pediatric orthopaedic surgery fellowship programs that participate in the San Francisco (SF) Match program. In addition to providing information about program size, number of applicants interviewed, and number of applicants ranked, program directors were presented with 12 selection criteria based on previous surveys of orthopaedic fellowship directors and were asked to rank them in order of importance. A weighted score for each selection criteria was calculated using the following scale: 5 points for each criterion ranked 1st, 4 points for 2nd, 3 points for 3rd, 2 points for 4th, and 1 point for 5th. The total weighted score of each criterion was calculated. Results: Of the 45 program directors that we contacted, 36 responded (80% response rate). A plurality of programs both interviewed and ranked between 16 and 20 applicants. The interview and letters of recommendation were the most important selection criteria according to program directors. Other selection criteria deemed important included the applicant’s residency program, personal connections, and life experience. Conclusions: Pediatric orthopaedic surgery fellowship program directors consider the interview, letters of recommendation, and the applicant’s residency program to be the most important factors when ranking fellowship candidates. These findings may be useful to orthopaedic residents interested in pursuing fellowship training in pediatric orthopaedic surgery by providing applicants with a better understanding of which areas to focus on when preparing for the fellowship interview and subsequent match process.

Letters of recommendation for pediatric surgery fellowship: Analysis of linguistic differences based on gender of the applicant

Background: Gender bias in letters of recommendation (LOR) has been reported for candidate selection in academic medicine, typically with females frequently described with communal terms (e.g. helpful, kind, interpersonal) and males described more with agentic terms (e.g. assertive, intellectual, ambitious). This study examined the presence of linguistic gender differences in LOR for Pediatric Surgery Fellowship. Methods: LOR submitted to a single pediatric surgery fellowship program between 2014 and 2018 were retrospectively reviewed and analyzed using a previously validated Linguistic Inquiry and Word Count Software (LIWC) program. Descriptive statistics and bivariate analysis were employed in our analysis. Multivariable logistic regression models were built to assess independent association of LIWC variables with applicant gender, LOR writer gender, and applicant-writer gender concordance. Results: 1264 LOR from 325 applicants (51% female) were analyzed. Of the letter writers, 83% were male, 57% were professors, and 7.6% were Pediatric Surgery Fellowship Program Directors. The overall median average word count was 518 words, with no significant difference in LOR word count between applicant genders. Compared to male applicants, female applicants were described significantly more with work words (e.g. excellent, work; p = 0.04). Male LOR writers used authentic words (e.g. honest, humble; p = 0.006) and home words (e.g. family, house; p = 0.04) significantly more than female LOR writers. There were no significant differences in the use of agentic and communal words between genders. Conclusion: While there are linguistic differences in LOR for candidates in the Pediatric Surgery match based on gender, previously described overt gender bias was not seen in this study. Interestingly, female candidates were described more with work words, like excellent; a reversal of previously described gender bias in academic medicine. These findings may be due to the unique interpersonal and multidisciplinary skills required in pediatric surgery and may represent a unique form of gender bias that warrants further study.

Factors Considered in Ranking Spine Surgery Fellowship Applicants: A Survey of Program Directors.

Cross-sectional study. To determine which factors spine surgery fellowship program directors (PDs) consider most important when ranking applicants. Spine surgery is a popular orthopedic subspecialty. As such, the spine fellowship match process is highly competitive. Surveys of fellowship PDs in orthopedic sports medicine and hand surgery have demonstrated differing opinions regarding factors considered most important when ranking fellowship applicants. The factors considered important to spine surgery fellowship PDs have not been evaluated. A web-based questionnaire was sent to the PDs of all spine surgery fellowships participating in the San Francisco (SF) Match Program. The questions were designed to identify criteria considered most important in ranking spine surgery fellowship applicants. A list of 12 criteria was presented and PDs were asked to rank these in order of importance. A weighted score for each criterion was calculated using the following scale: 5 points for each criterion ranked 1st, 4 points for 2nd, 3 points for 3rd, 2 points for 4th, and 1 point for 5th. Of the 73 PDs queried, 52 responded (71% response rate). The interview was the most important factor when ranking fellowship applicants. The other criteria deemed most important in order of weighted scoring were letters of recommendation and personal connections to the applicant and/or familiarity with the applicant's letter writer(s). Spine surgery fellowship PDs consider the interview, letters of recommendation, and personal connections with the applicant/letter writers to be the most important factors when ranking candidates. These results may be valuable to orthopedic residents and mentors of those pursuing fellowship training in spine surgery.Level of Evidence: 4.

State of Microsurgery Training in 2020: Survey of Hand Surgery Fellowship Program Directors.

Given the current national conundrum of decreasing microsurgery case volume performed by hand surgery fellows despite interest, program directors were surveyed to evaluate opinions of exposure gaps in training and to determine the current state of microsurgery training in 2020. Anonymous national surveys were distributed to hand surgery fellowship program directors by the American Society for Surgery of the Hand. Subgroups were compared by training location and size of the fellowship program. Accreditation Council for Graduate Medical Education public national data on graduate case log procedures by hand surgery fellows were reviewed. Eighty-eight surveys were distributed by the American Society for Surgery of the Hand to hand surgery fellowship program directors with a 44% (n = 39) response rate. Hand surgery fellowship programs from 19 US states participated. Most program's fellows had previous orthopedic surgery residency training with 41.03% of programs surveyed having 100% orthopedic surgery-trained fellows. The average number of weekly vascular microsurgical cases ranged from 25% of fellowships having no microsurgery cases per week, 46.2% having 1 per week, and only 7.7% having 5 or more cases per week. However, 60.5% of program directors prioritized a microvascular surgery case as the most valuable educational opportunity for fellows. Most program directors agreed (79.5%) that a 1-year hand surgery fellowship is sufficient to train a competent hand surgeon, who is proficient in microsurgery. In contrast, the majority disagreed (53.8%) that hand surgery microsurgery skills after a 1-year hand surgery fellowship are equivalent among graduates, regardless of a prior plastic surgery or orthopedic surgery residency training. There was a statistically significant difference in program directors' responses by geographic location regarding prior residency background impacting microsurgical skills (Kendall τ, -0.439; P = 0.001). Graduate case log data revealed an increasing trend in the number of microsurgery procedures performed by orthopedic hand surgery fellows until 2014, with a decline in cases per year and stagnating trend at 7% thereafter. In 2020, most hand surgery fellowship program directors highly value and prioritize microsurgery exposure for their hand surgery fellows' education despite the decrease in case volume for hand surgery fellows.

Factors Considered in Ranking Orthopaedic Trauma Fellowship Applicants: A Survey of Program Directors.

More than 90% of orthopaedic surgery graduates pursue fellowship training after residency. Previous investigations have examined factors considered important by orthopaedic sports medicine and hand surgery fellowship program directors (PDs). This study sought to identify which factors orthopaedic trauma fellowship PDs deem most important when evaluating applicants. A web-based survey was sent to all 59 orthopaedic trauma fellowship PDs. PDs were given a list of 12 factors, which they ranked in order of importance. A weighted score for each factor was calculated. PDs could also write-in additional factors they considered important when ranking applicants. The overall response rate was 83% (49/59 PDs). Forty-five percent of responding PDs listed the interview as the most important factor when ranking applicants. Other factors considered most important included letters of recommendation, personal connections to the applicant and/or letter writers, and the applicant's background in trauma. Results of the weighted score calculation again identified the interview as the most important factor when ranking applicants, followed by letters of recommendation, personal connections to the applicant/letter writers, the applicant's residency program, strength of the applicant's background in trauma, and research experience. Orthopaedic trauma fellowship PDs consider the interview, letters of recommendation, and personal connections to the applicant/letter writers to be the most important factors when ranking fellowship applicants.

A Survey of Craniofacial Fellowships in North America: The Craniofacial Fellowship Experience Outside of the Operating Room

Residencies are governed by the Accreditation Council for Graduate Medical Education’s (ACGME) common program requirements to help ensure that residents are adequately trained to practice medicine independently. Fellowships either rely on ACGME accreditation for standardization, have developed their own specialty accreditation councils, or have no governing body to monitor programs, such as in craniofacial surgery. This study was designed to capture the clinical, educational, and scholarly experiences of craniofacial fellows to better understand the current craniofacial fellowship landscape. An anonymous online survey was sent to all North American craniofacial surgery fellowship program directors via email. The first question group focused on program characteristics: ACGME accreditation, core faculty, and patient population. The second question group focused on the fellow’s scholarly experience: educational meetings and research requirements. The third question group focused on the fellow’s non-operative experience: clinic participation and call experience. The fourth question group focused on the fellow’s international experience. A total of 22 of 31 programs directors (71%) responded to the survey. The majority of fellowship programs (95.5%) had an educational program of meetings. The majority of programs (82.8%) mandated clinic time for the fellows. Five programs (22.7%) had a fellow’s clinic. The majority of fellowship programs (95.5%) had research expectations for the fellow. Call type and frequency varied widely between fellowship programs. Less than half (47.6%) of programs had an international experience for the fellow. Three-fourths of fellows only interacted with subspecialties of the cleft and craniofacial multidisciplinary clinic during clinic time. A total of 16 fellowship programs (72.7%) were non-ACGME accredited. Despite rapid growth in craniofacial fellowships and a lack of current oversight as to content, programs provide a similar experience for fellows outside of the operating room. Areas for further discussion regarding standardizing programs may include international experiences and formal exposure to other disciplines within the cleft and craniofacial clinic.

Participation of Pediatric Surgery Training Programs in Fertility Preservation Initiatives

Purpose: The significant reduction in childhood cancer mortality has allowed for greater emphasis on survivorship issues, including infertility. This study evaluated the participation of pediatric surgery training programs in fertility preservation (FP) and exposure of fellows to adnexal cases. Materials and Methods: A survey was distributed to pediatric surgery fellowship program directors in the United States and Canada through email. Questions focused on FP participation, operative cases, FP program limitations, and fellow completion of adnexal cases. Results: Survey participation was 49% (28/57). Overall, 43% (12/28) of training programs report participation in FP initiatives. Of those who participated, the most common procedures performed were testicular tissue biopsy (58%) and testicular sperm extraction (42%) in males, and surgical transposition of the ovaries (83%) and laparoscopic oophorectomy (67%) in females. The greatest cited limitations on participation were that FP was another department's responsibility (50%) and lack of multidisciplinary team (31%). Notably, lack of operative experience in benign ovarian and testicular procedures (0%) was not a limitation. All programs, regardless of participation in FP, noted that their fellows performed benign and malignant adnexal cases. Conclusion: Less than half of pediatric surgery training programs participate in FP initiatives, despite adequate advanced minimally invasive training of fellows to perform these procedures.

Fellow Selection Protocols in Facial Plastic Surgery: A National Survey of Facial Plastic Surgery Program Directors.

Background: Despite its popularity among otolaryngology residents, there is currently a paucity of knowledge on the match in facial plastics surgery fellowships and the selection criteria that drive the match process. To increase the understanding of this process and to improve the manner in which candidates are vetted, a survey study was designed. Methods: A 24-question online survey was designed to discern desired qualities regarding fellow selection, interview processes, fellow participation, and program director satisfaction with the current process. This survey was sent to all American Academy of Facial Plastic and Reconstructive Surgery fellowship program directors in the United States. Results: Overall, 40 of the 64 fellowship directors responded to the survey for a total response rate of 62.5%. Most fellowship directors reported that the reputation of an applicant's residency was an important component of the selection criteria with 34 of 40 of those who responded rating it at least "somewhat important." With regard to the otolaryngology trainee examination, nearly all fellowship directors (39/40) reported that there was no minimum cutoff score to be offered an interview. When fellowship directors were asked to rank the academic components of an application that they viewed as most important, they most commonly reported that the strength of an applicant's letters of recommendation were most important. Conclusions: With the increasing popularity of fellowships within the field of otolaryngology, having an understanding of which components of the application process are viewed as most important by fellowship directors is crucial in applicants matching into the fellowship of their choice.

Gender differences among surgical fellowship program directors

BackgroundAlthough women are increasingly represented in American surgery, data regarding sex and academic rank of the leadership of fellowship programs are lacking. MethodsDemographics and academic ranks for fellowship program directors were analyzed for 811 surgery fellowship programs across 14 specialties. Associations between academic rank and sex were assessed using a χ2 independence test. Correlation between subspecialty compensation and percentage of female fellowship program directors was assessed using Pearson r. ResultsWomen represented 18% of all fellowship program directors. Eighteen percent of fellowship program directors were assistant professors (25% women vs 17% men, P = .049), 36% were associate professors (39% women vs 35% men, P = .379), and 46% were full professors (36% women vs 48% men, P = .018). The percentage of women program directors was greatest in breast surgery (65%) and least in minimally invasive surgery (6%). There was a negative correlation between subspecialty compensation and percentage of female fellowship program directors (r = –0.62, P = .04). ConclusionWomen are underrepresented among surgery fellowship program directors. Female fellowship program directors had lesser academic ranks compared with males. It remains unclear whether women surgeons achieve program director appointments at lesser academic ranks or if promotion among fellowship program directors is influenced by sex.