The impact of fellowship training on current practice patterns and the job market: a survey of Fellowship Council graduates

Background

General surgery has changed significantly over the last decades, with the need for advanced training and expertise. The Fellowship Council (FC) accredits fellowships that train approximately 200 fellows annually. This study aimed to analyze FC graduates’ perceptions of training, current practices, and the job market.

Methods

Data were collected between May 2022 and June 2022 via a survey (SurveyMonkey; Momentive Inc) distributed via email to 2119 previous FC graduates from 2012 to 2021.

Results

There were 257 respondents. However, less than half of the respondents (47%) came from surgeons within the first 3 years after training. Of the respondents, 38% had advanced gastrointestinal (GI) minimally invasive surgery (MIS) training, 26% had bariatric surgery training, 14% had foregut surgery training, and the remaining 22% had hepatobiliary, advanced/complex GI, advanced endoscopy, and colorectal surgery training. Most respondents performed acute care surgery (ACS) as part of their training. Of note, 75% of respondents take ACS call, and 55% of respondents do not perform some operations that they trained in during their fellowship. More than 60% of surgeons had difficulty securing employment.

Conclusion

Despite niche training, there exists a demand for ACS care. There may be an underutilization of advanced training, or this may reflect how surgeons enter practice and gain experience. The challenge in obtaining employment may be due to the saturation of the market, selectivity of the applicants, or hiring challenges during the COVID-19 pandemic. Most surgeons who undertook FC training practice surgery within their domains of training and with some components of ACS. Despite the desire to hire fellowship-trained surgeons, most FC graduates experience difficulty securing employment.