Factors Influencing Practice Decisions Among Plastic Surgery Residents and Early-Career Plastic Surgeons in Canada

Introduction: Trends within the Canadian plastic surgery workforce demonstrated that most work in academic or medium-large community practice. Recent studies observed more plastic surgeons are incorporating aesthetics into their practice. This study aims to identify factors influencing how plastic surgery residents and early-career plastic surgeons in Canada choose their eventual practice with respect to practice type and practice location. Methods: A REDCap survey was distributed to plastic surgery residents and early-career plastic surgeons across Canada between February and May 2024. Demographics, training information, career information, and Likert-scale questions for factors involved in decision-making were surveyed. Data analysis included descriptive statistics and Fisher exact tests. Results: There were 45 residents and 30 early-career plastic surgeon respondents. Mixed practices that included aesthetics were the most popular practice types among residents (73%) and early-career surgeons (77%). Half (53%) of early-career surgeons were working in urban settings with more than 1 million people, and 44% of residents desired these locations. Hometown factors heavily influenced practice type and location (P < .0001), more than training experiences. Positive interactions (94%), operating time (90%), partner opinion (87%), and hospital resources (86%) were ranked as the most important factors involved in practice decisions. Conclusion: Mixed practices that include aesthetics were the most popular among our up-and-coming Canadian workforce, especially in urban settings. These changing practice trends may impact our ability as a specialty to adequately meet the needs of the Canadian population. Recruitment efforts should focus on promoting a supportive workplace and local environment, with adequate operating time and resources.