Attrition in Academic Research Among Plastic Surgeons: A Longitudinal Cohort Study Across 3 Decades

Attrition from academic research, defined as cessation of publication, may be influenced by access barriers to professional and academic development. It is currently unknown how these considerations affect plastic surgeons, despite trends of increasing research demands in the field. This study quantifies trends in academic attrition among currently practicing plastic surgeons across three decades.

A longitudinal cohort study was conducted with a cohort of American plastic surgeons with academic publications since 2000. The main outcome of interest was attrition, quantified as a lack of academic publication in the last three years or more. The probability of attrition over time was measured with Kaplan-Meier curves, and predictors of attrition were evaluated with a Cox proportional hazards model (p<0.05).

The final cohort included 1,681 currently practicing plastic surgeons. The overall rate of attrition was 57.6%. Male gender (HR: 0.76, 95% CI: 0.65-0.89, p<0.001), academic affiliation (HR: 0.74, 95% CI: 0.64-0.86, p<0.001), and certain types of fellowship training (p<0.05) independently predicted a lower likelihood of attrition over time. In a sensitivity analysis that included only those who began publishing in 2010 or later, gender was no longer a significant predictor of attrition (HR: 0.98, 95% CI: 0.75-1.29, p = 0.90).

Attrition rates are predicted by surgeon gender, academic affiliation, and fellowship training. These trends highlight continued gender imbalances in the field of plastic surgery and the need for organizational shifts that foster growth for all physicians who desire to continue academic research.