A Survey of Craniofacial Fellowships in North America: The Craniofacial Fellowship Experience Outside of the Operating Room

Residencies are governed by the Accreditation Council for Graduate Medical Education’s (ACGME) common program requirements to help ensure that residents are adequately trained to practice medicine independently. Fellowships either rely on ACGME accreditation for standardization, have developed their own specialty accreditation councils, or have no governing body to monitor programs, such as in craniofacial surgery. This study was designed to capture the clinical, educational, and scholarly experiences of craniofacial fellows to better understand the current craniofacial fellowship landscape. An anonymous online survey was sent to all North American craniofacial surgery fellowship program directors via email. The first question group focused on program characteristics: ACGME accreditation, core faculty, and patient population. The second question group focused on the fellow’s scholarly experience: educational meetings and research requirements. The third question group focused on the fellow’s non-operative experience: clinic participation and call experience. The fourth question group focused on the fellow’s international experience. A total of 22 of 31 programs directors (71%) responded to the survey. The majority of fellowship programs (95.5%) had an educational program of meetings. The majority of programs (82.8%) mandated clinic time for the fellows. Five programs (22.7%) had a fellow’s clinic. The majority of fellowship programs (95.5%) had research expectations for the fellow. Call type and frequency varied widely between fellowship programs. Less than half (47.6%) of programs had an international experience for the fellow. Three-fourths of fellows only interacted with subspecialties of the cleft and craniofacial multidisciplinary clinic during clinic time. A total of 16 fellowship programs (72.7%) were non-ACGME accredited. Despite rapid growth in craniofacial fellowships and a lack of current oversight as to content, programs provide a similar experience for fellows outside of the operating room. Areas for further discussion regarding standardizing programs may include international experiences and formal exposure to other disciplines within the cleft and craniofacial clinic.