The Continued Value of the Independent Training Pathway and Impact on Career Trajectory.

Abstract

Background: The independent pathway is the traditional model for plastic surgery training. Although previous studies have compared independent and integrated training pathways, none have controlled for institutional influence on outcomes. This study evaluates the continued value of the independent pathway by examining fellowship matriculation and academic practice rates of independent graduates and comparing these rates with integrated graduates from these same programs.

Methods: A retrospective review was performed on all independent plastic surgery programs with residents graduating from 2018 to 2024. Independent graduate year, training pathway, fellowship matriculation, fellowship type, and academic practice status were collected from publicly available data. The same data collection was performed for programs that also had integrated graduates during this time. Standard statistical analyses were performed.

Results: A total of 34 independent programs were included, 21 of which also had an integrated program. The overall independent graduate fellowship matriculation rate was 42.6%. Among programs that produced both independent and integrated graduates, integrated graduates were more likely to pursue a fellowship (70.6%, P < 0.001). There was no significant difference in academic practice between independent (24.0%) and integrated graduates (33.0%) within these programs (P = 0.13).

Conclusions: This study evaluated fellowship matriculation and academic practice rates of graduates from independent plastic surgery programs. Although integrated graduates from these programs were more likely to matriculate into fellowship, they were not more likely to enter academic practice. As discussions around the future of independent programs evolve, it is important to acknowledge their continued contributions to academic plastic surgery.