2019 HSC Section 2 - Practice Management

Otolaryngology–Head and Neck Surgery 154(6)

Table 4. Predictors of Pursuing Fellowship from Multivariate Binary Logistic Regression Model. a,b

Variable

Odds Ratio

95% CI

P Value

Age, y

25-29 30-33 34-37

Reference

Reference 0.37-0.76 0.19-0.62 0.05-0.68 Reference 0.52-1.27 0.19-0.54 0.13-2.41 Reference 0.23-0.78 0.23-0.80 0.27-0.83 0.19-0.52 0.32-0.93 0.25-0.79 Reference 0.43-1.35 0.39-1.22 0.66-5.19

0.53 0.35 0.18

.001

\ .0001

38

.012

Training level PGY-1

Reference

PGY-2/3 PGY-4/5 PGY-6 1

0.82 0.32 0.56

.369

\ .0001

.436

Educational debt, US dollars None

Reference

$ 0-$50,000

0.42 0.43 0.47 0.31 0.55 0.45

.006 .008 .009

$50,000-$100,000 $100,000-$150,000 $150,000-$200,000 $200,000-$250,000

\ .0001

.025 .005

. $250,000

Dedicated research time during residency, mo None

Reference

1-3 4-6 . 6

0.76 0.69 1.85

.348 .693 .242

Intended practice setting Private, hospital, military, or other

Reference

Reference

\ .0001

Academic

23.0

15.26-34.72

Abbreviations: CI, confidence interval; PGY, postgraduate year. a c -Index of final model = 0.86. b Variables reaching statistical significance ( P \ .05) are shown in bold lettering.

Each of the factors listed here could be studied in greater depth. In addition, factors brought up by other editorials and studies should be examined, such as effect of mentors, implications regarding additional board certification, perceptions regarding decreased litigation, job security, ability to secure leadership positions, and academic progression. The SRF will continue to collect survey data and modify the questions asked in an attempt to better understand this topic. Conclusions The AAO-HNS SRF Annual Survey has been able to collect informative data regarding otolaryngology residents’ fellowship interests since 2008. More than half of residents express interest in pursuing fellowship training, but desire to pursue fellowship training decreased with increased years of residency training. This decision to pursue fellowship is multifactorial in nature and was shown in this study to also be influenced by age, train- ing level, educational debt, and intended practice setting. Acknowledgments We thank Bethany Clifton and Richard Carson for their help in execution of the SRF Annual Survey each year.

Author Contributions Meghan N. Wilson , conception, study design, data collection, interpretation of data, manuscript preparation and final approval; Peter M. Vila , study design, data collection, interpretation of data, manuscript preparation and final approval; David S. Cohen , inter- pretation of data, manuscript preparation and final approval; John M. Carter , interpretation of data, manuscript preparation and final approval; Claire M. Lawlor , interpretation of data, manuscript pre- paration and final approval; Kara S. Davis , interpretation of data, manuscript preparation and final approval; Nikhila P. Raol , concep- tion, study design, data collection, Interpretation of data, manuscript preparation and final approval.

Disclosures Competing interests: None. Sponsorships: None. Funding source: None.

References

1. Bailey BJ. Fellowship proliferation: impact and long-range impli- cations. Arch Otolaryngol Head Neck Surg . 1994;120:1065-1070.

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