The Influence of Training Pathway, Institution Type, Gender, and a Global Pandemic on Post Graduation Career Plans in Plastic Surgery

BACKGROUND: Anecdotal statements are often made about what percentage of residents go into fellowship versus private practice versus academia after graduation. However, few objective studies have been completed on this topic. This project is designed to shed light on the career choices of plastic surgery residents immediately after graduation from 2018 to 2022. A secondary objective was to determine whether the COVID-19 pandemic had any measurable impact on postgraduation plans. METHODS: After obtaining institutional review board approval, publicly available data were obtained from institution websites or via program queries. Comparison between pre-COVID-19 and post-COVID-19 (2018–2019 versus 2020–2022), integrated versus independent, and private versus public cohorts were analyzed using Fisher exact test. A two-sided P value less than 0.01 was considered statistically significant. RESULTS: Data were collected for 690 graduates across 64 plastic surgery training programs. Responses were obtained from 60 of 88 (68%) integrated and 30 of 47 (64%) independent programs. Most graduates pursued fellowship training (61%), followed by private practice (28%), academic practice (5%), or military post (1%). Independent residents were more likely to pursue private practice (40% versus 26%, P = 0.001), whereas integrated residents were more likely to pursue fellowship (49% versus 70%, P < 0.0001). Public institution graduates were more likely to go into private practice (37% versus 23%, P = 0.0002), whereas private institution residents were more likely to pursue fellowship (55% versus 72%, P < 0.0001). Public institutions were more likely to graduate women (45% versus 35%, P = 0.009). The COVID-19 pandemic (P = 0.31) had no impact on postgraduation plans. CONCLUSIONS: This study demonstrates that training pathway and institution type have a significant impact on postgraduation plans, whereas a global pandemic does not. This information can be used by educators, residents, and medical students as they plan for the future.