Women in Microsurgery Fellowships: Trends and Impact on Future Practice Patterns

Background: While the number of female plastic surgeons has continued to increase over time, plastic surgery has historically been a male-dominated profession with only 15 percent of practicing plastic surgeons being female. Microsurgery, as a subspecialty, has been long perceived as an even more male centric career path. The objective of this study was to determine the representation of females in the subspecialty field of microsurgery and the impact of microsurgical fellowship training. Methods: A review of all microsurgery fellowship programs participating in the microsurgery fellowship match from 2010 to 2019 were analyzed. Fellows were identified through fellowship website pages or direct contact with fellowship program coordinators and directors. The current type of practice and performance of microsurgery were also identified through a web search and direct contact with fellowship program coordinators and directors. Results: A total of 21 programs and 317 fellows over a 10-year period were analyzed. Over this 10-year period, there was a total of 100 (31.5%) female microsurgery fellows and 217 (68.5%) male microsurgery fellows. There was a small, statistically insignificant increase in the yearly percentage of female microsurgery fellows over this 10-year period with an average yearly increase of 2.7% (p=0.60; 95% CI: -6.9 - 13.2%). There were significantly fewer females who continued to practice microsurgery compared to males (75 [75.0%] vs. 186 [85.7%], p=0.02). There was no significant difference in the current practice types (academic, private, and non-academic hospital) between females and males (p=0.29). Conclusions: Women are underrepresented in the field of microsurgery to a similar extent as they are underrepresented in overall plastic surgery. While there is a small insignificant increase in the number of female microsurgery fellows every year, a significantly smaller proportion of females continue to practice microsurgery compared to males.