Aesthetic Specialization: A Comparative Study Across Medical and Surgical Specialties

Background: Post-residency fellowship training has become increasingly popular as a career option. Specifically, the subspecialty of aesthetic surgery has grown tremendously over the past two decades within several fields, including plastic and reconstructive surgery (PRS), otolaryngology, dermatology, and ophthalmology. However, the popularity of aesthetic specialization through fellowship remains unknown. The present study aims to analyze trends in aesthetic specialization across these specialties and compare its popularity to other fellowships. Methods: A retrospective review of data from the San Francisco Match, National Resident Matching Program, American Society for Dermatologic Surgery, and the Accreditation Council for Graduate Medical Education was performed. Data on graduating residents and applicants to fellowship were collected. ANOVA and t-tests were used to compare differences between groups. Results: Significant disparities were observed in applicants and matched applicants to aesthetic fellowships among the four residencies (p<0.001). Aesthetic fellowship was the most popular option after otolaryngology residency (12.5%-27% depending on the year) and second most popular choice after PRS (8%-17%) and dermatology (2%-5%). A comparison between PRS and otolaryngology demonstrated a significantly higher percent of the latter choosing aesthetic fellowship over time (p<0.001). However, no significant difference in applicants to aesthetic fellowship was found between dermatology and ophthalmology (t-test, p=0.060). Conclusions: The number of applicants to aesthetic fellowship has increased over time across all eligible residencies with the more surgical heavy specialties (ENT and PRS) having the highest percent of applicants. Differences in aesthetic training between fields was also observed, which may reflect underlying variations in training and residency exposure.