Craniofacial Fellowship Training: How Are We Doing?

Abstract

Objective

As a follow-up study, we solicited opinions a decade later from fellowship-trained craniofacial surgeons to explore shifting perspectives on their training and assess the impacts on careers and practice patterns.

Design

An anonymous 26-question survey was sent to all surgeons completing craniofacial fellowships in 2013. Additionally, current craniofacial fellowship descriptions were tabulated to assess variations in program experiences.

Results

With a 47% response rate out of 30 original respondents, 14% reported no longer practicing craniofacial surgery. Among those still engaged, 42% described no longer performing intracranial/midfacial osteotomies, with 21% desiring more intracranial/midfacial volumes, 29% more cleft/orthognathic, and 30% less pediatric plastic surgery. Surprisingly, 31% reported in retrospect they would have chosen a different training program. Fifty percent had changed jobs since fellowship, with 50% practicing at centers with an average of 4.5 craniofacial surgeons. A review of current craniofacial fellowship descriptions revealed aside from intracranial/midface and cleft training, an additional 29 different surgical procedure types were advertised.

Conclusions

This follow-up assessment suggests most trainees remain active in craniofacial surgery, but many expressed dissatisfaction with their training. Almost one-third indicated they would have selected a different program, raising questions about the perceived quality of training. Considering the diversity of procedures currently falling under the craniofacial marque, a clearer description of expected case volumes might improve reported levels of fulfillment. An additional consideration is restricting the term craniofacial to programs focused on intracranial/midfacial surgery, while developing more descriptive alternative labels that better reflect the unique surgical experiences provided at each center.