Trends in ACGME Accreditation for Subspecialty Fellowship Training in Plastic Surgery

Background: Increasingly, surgical residents in the U.S. pursue subspecialty fellowship training. The purpose of this study was to 1) determine the proportion of plastic surgery residents pursuing subspecialty training relative to other surgical specialties, and 2) analyze trends in ACGME accreditation of plastic surgery subspecialty fellowship programs. Methods: The American Medical Association provided data on career intentions of surgical chief residents graduating from 2014 to 2016. The percentage of residents pursuing fellowship training was compared by specialty. Trends in the proportion of accredited fellowship programs in craniofacial, hand, and microsurgery were analyzed. The percentage of accredited programs was compared between subspecialties with added-certification options (hand surgery) and subspecialties without added-certification options (craniofacial surgery and microsurgery). Results: Most integrated and independent plastic surgery residents pursued fellowship training (61.8% vs 49.6%, p = 0.014). Differences existed by specialty from a high in orthopaedic surgery (90.8%) to a low in colon & rectal surgery (3.2%). From 2005 to 2015, the percentage of accredited craniofacial fellowship programs increased, but was not significant (27.8% to 33.3%, p = 0.386). Accredited programs were not found for microsurgery. For hand surgery, the proportion of accredited programs that were plastic surgery (p = 0.755) and orthopaedic surgery (p = 0.253) was stable while general surgery decreased (p = 0.010). Subspecialty areas with added-certification options had more accredited fellowships than those without (100% vs 19.2%, p