Philadelphia, Pa.
From the Perelman School of Medicine at the University of Pennsylvania.
Plast Reconstr Surg. 2018 May;141(5):768e-774e. doi: 10.1097/PRS.0000000000004336.
The purposes of this study were to (1) determine the proportion of plastic surgery residents pursuing subspecialty training relative to other surgical specialties, and (2) analyze trends in Accreditation Council for Graduate Medical Education accreditation of plastic surgery subspecialty fellowship programs.
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 surgery, hand surgery, 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).
Most integrated and independent plastic surgery residents pursued fellowship training (61.8 percent versus 49.6 percent; p = 0.014). Differences existed by specialty from a high in orthopedic surgery (90.8 percent) to a low in colon and rectal surgery (3.2 percent). From 2005 to 2015, the percentage of accredited craniofacial fellowship programs increased, but was not significant (from 27.8 percent to 33.3 percent; p = 0.386). For hand surgery, the proportion of accredited programs that were plastic surgery (p = 0.755) and orthopedic surgery (p = 0.253) was stable, whereas general surgery decreased (p = 0.010). Subspecialty areas with added-certification options had more accredited fellowships than those without (100 percent versus 19.2 percent; p < 0.001).
There has been slow adoption of accreditation among plastic surgery subspecialty fellowships, but added-certification options appear to be highly correlated.
本研究旨在：(1) 确定与其他外科专业相比，从事整形外科研修培训的住院医师比例；(2) 分析整形外科研修专业认证委员会认证的整形外科研修计划的趋势。
美国医学协会提供了 2014 年至 2016 年毕业的外科住院医师主任职业意向数据。按专业比较住院医师接受研修培训的比例。分析颅面外科、手外科和显微外科认证计划中比例的趋势。在手外科（有附加认证选择）和颅面外科和显微外科（无附加认证选择）的亚专业之间比较认证计划的比例。
大多数综合和独立的整形外科住院医师都接受了研修培训（61.8%对 49.6%；p=0.014）。各专业之间存在差异，骨科（90.8%）最高，结肠和直肠外科（3.2%）最低。从 2005 年到 2015 年，颅面外科认证研修计划的比例有所增加，但没有统计学意义（从 27.8%到 33.3%；p=0.386）。对于手外科，认证计划中整形外科（p=0.755）和骨科（p=0.253）的比例稳定，而普通外科则下降（p=0.010）。有附加认证选择的专业领域比没有附加认证选择的专业领域拥有更多的认证进修（100%对 19.2%；p<0.001）。
整形外科研修专业的认证采用缓慢，但附加认证选择似乎高度相关。
