The Pursuit of Otolaryngology Subspecialty Fellowships

Objectives: To examine otolaryngology resident interest in subspecialty fellowship training and factors affecting interest over time and over the course of residency training

Study design: Cross-sectional study of anonymous online survey data.

Setting: Residents and fellows registered as members-in-training through the American Academy of Otolaryngology-Head and Neck Surgery.

Subjects and methods: Data regarding fellowship interest and influencing factors, including demographics, were extracted from the Section for Residents and Fellows Annual Survey response database from 2008 to 2014.

Results: Over 6 years, there were 2422 resident and fellow responses to the survey. Senior residents showed a statistically significant decrease in fellowship interest compared with junior residents, with 79% of those in postgraduate year (PGY) 1, 73% in PGY-2 and PGY-3, and 64% in PGY-4 and PGY-5 planning to pursue subspecialty training (P < .0001). Educational debt, age, and intended practice setting significantly predicted interest in fellowship training. Sex was not predictive. The most important factors cited by residents in choosing a subspecialty were consistently type of surgical cases and nature of clinical problems.

Conclusions: In this study, interest in pursuing fellowship training decreased with increased residency training. This decision is multifactorial in nature and also influenced by age, educational debt, and intended practice setting.