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Evolution in Fellowship Selection during General Surgery Residencies

Evolution in Fellowship Selection during General Surgery Residencies. Laura R. Vick, MD Karen R. Borman, MD University of Mississippi Medical Center, Jackson, MS. Background. Increasing numbers of graduating residents are pursuing fellowships PGY-5 choices are heterogeneous

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Evolution in Fellowship Selection during General Surgery Residencies

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  1. Evolution in Fellowship Selection during General Surgery Residencies Laura R. Vick, MD Karen R. Borman, MD University of Mississippi Medical Center, Jackson, MS

  2. Background • Increasing numbers of graduating residents are pursuing fellowships • PGY-5 choices are heterogeneous • Individual variables (e.g. - gender) • Residency characteristics (e.g. - program location) • Over time

  3. Background • PGY-1 fellowship choices unreported • For this study • PGY-1 future fellowship choices from ‘93 - ‘07 • Changes in preferences • over time • as residents progress during training • Fellowship choices as related to demographic variables • Gender • Program type, size and location

  4. Methods ABSITE examination data – last 15 years = “Any Fellowship”

  5. All residents 1993 - 2007 Dataset 1 Dataset 3 Dataset 2 Remove Designated Preliminary / Hand Residents applying for ABS Qualifying Exam by July 2007 Paired PGY-1 and PGY-5 responses Methods - Datasets PGY-5 1993 - 2005 PGY-1 1993 - 2003

  6. Dataset 1: > 80,000 responses > 20,000 PGY-1 responses PGY-1 PGY-2 PGY-3 PGY-4 PGY-5 Results Undecided Responses 1993, 2000, 2007 all PGY levels

  7. Results Any Fellowship for PGY-1

  8. Results Any Fellowship for all PGY years PGY-5 PGY-4 PGY-3 PGY-2 PGY-1

  9. Results No Fellowship for all PGY years PGY-5 PGY-4 PGY-1 PGY-2/3

  10. Results Dataset 2: > 19,000 responses • 9,000 PGY-1 responses Female % Responses by Gender for all years 1993 - 2003 Male %

  11. Results

  12. Results Program Type

  13. Results Program Size

  14. Results Program Location over all years

  15. Results Dataset 3: 12,259 paired responses • 6,111 PGY-1 chose Undecided (50%) • Of the Undecided No Fellowship (24%) Vascular Surgery (12%) Other Fellowship (12%) Only 22% of all PGY-1 residents accurately identified their final post-residency plans

  16. Conclusions • Majority of incoming residents are Undecided • Fellowship choices evolve as PGY level advances • Evolution occurs at variable rates • Uncertainty for PGY-1 residents is desirable, reflecting open-mindedness • Junior residents should experience the full spectrum of potential fellowship areas

  17. Discussion • The number of residents choosing fellowships are increasing • Fellowships chosen have changed over time • PGY-1 residents unsure whether to pursue fellowship • Alternative educational pathways are being evaluated and implemented

  18. Discussion • Educational models featuring early specialty tracking continue to proliferate • These models should include exposure to all areas of specialization • Examination of PGY-1 fellowship training choices could contribute to the ongoing process of residency redesign • Further studies underway to determine the final plans of the 78% percent of residents who change their mind

  19. University of Mississippi Medical Center

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