Changes in Subspecialty Interest of Plastic Surgery Residents With Progression of Training: Impact on Academic Attrition

Generation Z in Plastic Surgery: Challenges, Solutions and New Horizons - A European and transatlantic overview

INTRODUCTION

  The entrance of Generation Z (born 1997-2012) into professional life, including the practice of medicine, marks a transformational shift in priorities and values. This generation, shaped by digital immersion and a strong focus on work-life balance, is redefining the landscape of Plastic Surgery. Their preferences for inclusivity, innovation, and structured working hours challenge traditional models of mentorship, patient care, and surgical training. The aim of this survey was to explore the impact of Generation Z on the field of Plastic Surgery through insights offered by leaders of major Plastic Surgery societies in Europe and the United States, who together provide a comprehensive perspective on generational change and its implications for clinical practice, education, and healthcare systems in Plastic Surgery.

METHODS

  In October 2024 eight leaders of national Plastic Surgery societies and associations were invited to complete a structured questionnaire with five open-ended questions. They provided detailed responses on challenges, opportunities, and structural changes needed to address Generation Z's influence.

RESULTS

  Key findings highlight a generational shift in the approach to professional life, with an emphasis on digital innovation, work-life balance, and the interaction with social media. Respondents noted an increased interest in aesthetic over reconstructive surgery and a preference for private practice among younger surgeons, raising concerns about workforce shortages in public healthcare. Advances in digital learning and simulation-based training were identified as opportunities to facilitate medical education. However, the ethical challenges of misinformation on social media and a decline in hierarchical mentorship were emphasized as critical concerns. Despite generational tensions, the integration of Generation Z's strengths in technology and advocacy for systemic reform holds promise for addressing burnout and enhancing healthcare delivery.

CONCLUSION

  The arrival of Generation Z in Plastic Surgery represents a possible pivotal moment to reimagine traditional models of surgical education, patient care, and professional priorities. Collaboration between generations and proactive adaptation to these changes is an imperative to ensure a dynamic, inclusive, and sustainable future for the specialty.

Career Paths of Young Fellowship-Trained Microsurgeons

BACKGROUND

 Microsurgery is a highly specialized field requiring years of dedicated training and proper support to sustain a practice. We sought to describe the career paths of young microsurgeons and investigate factors associated with switching jobs.

METHODS

 Public data on surgeons who completed a microsurgery fellowship between 2016 and 2020 were collected. Analysis of job switching was determined using the Kaplan-Meier method.

RESULTS

 One hundred and sixty-seven graduates were analyzed. Most initially practiced microsurgery (92.2%) and 61.7% went into academics. Fifty-two (31.4%) have switched jobs and Kaplan-Meier estimates that 36.0% will switch by 5 years into practice. Over half (58%) changed practice setting type, 19% left academics, and 12% stopped performing microsurgery.Gender, residency training type, taking a job where they trained, and the presence of a microsurgery fellowship had no effect on job switching (p = 0.74, 0.95, 0.71, 0.26). Surgeons in academics were significantly more likely to change jobs (p = 0.04).Gender, residency training type, or taking a job where they trained had no effect on leaving academics (p = 0.89, 0.42, 0.37). Taking a first job where a microsurgery fellowship was present was significantly associated with staying in academics (p = 0.04) CONCLUSION:  Most microsurgery fellows take jobs performing microsurgery. Thirty-six percent will switch jobs in 5 years, more than half will change practice setting type, and about 20% will leave academics. A minority will stop performing microsurgery. Surgeons in academics are more likely to switch jobs. Taking a job where there is a microsurgery fellowship is significantly associated with staying in academics during the switch.

Trends in American Plastic Surgery Procedures (2005-2019): Observing the Growth Rate of Maxillofacial Surgery and Cosmetic Minimally Invasive Procedures in ASPS Data

BACKGROUND

This study explores the dynamic changes in plastic surgery practices, focusing on the growth rates across different subcategories, particularly highlighting the trends in the United States.

OBJECTIVES

To analyze evolving trends in plastic surgery using statistical methods, providing insights into the changes and growth patterns in various segments over time.

MATERIALS AND METHODS

Utilizing data from 2005 to 2019 from the American Society of Plastic Surgeons, the authors, conducted a comprehensive statistical analysis using the SPSS program to investigate trends in plastic surgery procedures.

RESULTS

Our analysis revealed no significant differences in year-on-year growth rates between cosmetic and reconstructive surgery. However, in reconstructive surgery subcategories, maxillofacial surgery showed the highest mean growth rate at 11.61%, though this was not statistically significant. In cosmetic minimally invasive procedures, soft tissue filler injections and botulinum toxin A injections experienced notably higher growth trends compared with microdermabrasion.

CONCLUSION

The findings suggest that practitioners considering a career in plastic surgery should not focus solely on choosing between reconstructive and cosmetic surgery. Recognizing substantial growth in cosmetic minimally invasive procedures, especially botulinum toxin A injections and fillers, is vital for making informed career decisions.

International Microsurgery Club and World Society for Reconstructive Microsurgery Webinar: Career Building in Microsurgery

Career building can be challenging for young surgeons, especially when topics such as lifestyle, work-life balance and subspecialization arise. Suggestions and advice from senior colleagues is very valuable but many young surgeons do not have such opportunities or are limited to a few senior surgeons. The International Microsurgery Club (IMC), in collaboration with the World Society of Reconstructive Microsurgery, organized a combined webinar for this topic and invited world renowned microsurgery masters polled by the IMC members to join, including Prof. Peter Neligan (Emeritus from University of Washington, United States), Prof. Raja Sabapathy (Ganga Hospital, India), Dr. Gregory Buncke (The Buncke Clinic, United States), Prof. Isao Koshima (Hiroshima University Hospital, Japan), Prof. David Chwei-Chin Chuang (Chang Gung Memorial Hospital, Taiwan), and Prof. Eric Santamaria (Hospital General Dr. Manuel Gea Gonzalez, Mexico) on May 1, 2022. Prof. Joon-Pio Hong (Asan Medical Center, South Korea) and Prof. Fu-Chan Wei (Chang Gung Memorial Hospital, Taiwan) were also selected but unfortunately could not make it and were therefore invited to another event in April 2023, summarized in a recently published paper. There is ample literature reporting on different aspects of developing a microsurgical career but the goal of this session was to offer an opportunity for direct exchange with experienced mentors. Moreover, insights from experienced microsurgeons from different part of the world were more likely to offer different perspectives on aspects such as career building, failure management, and team culture. This webinar event was moderated by Dr. Jung-Ju Huang (Taiwan), Dr. Susana Heredero (Spain), and Dr. Wei F. Chen (United States).