EP400 - A Regional Assessment of Institutional Characteristics, Fellowship Opportunities, and Faculty Experience within U.S. Academic Colorectal Surgery Programs

Purpose/Background: The landscape of academic surgery in the United States has been a topic of considerable discussion as currently >65% of surgical residents pursue fellowship training. Although a 2024 study reported no significant sex-based differences in match rates for colorectal surgery (CRS) fellowship within a recent cohort, a notable difference persists in program faculty representation. Moreover, there is little data on the transition from fellowship to academic positions. Our study aims to provide a comprehensive snapshot of CRS programs across the nation to identify regional variations in institutional representation, fellowship availability, faculty experience, and retention that may affect opportunities for career advancement within academic colorectal surgery.

Methods/Interventions: We utilized the Fellowship and Residency Electronic Interactive Database (FREIDA), developed by the American Medical Association (AMA), to compile a list of all active APDCRS fellowship programs in the United States. Programs were separated into four (4) geographic regions as defined by the U.S. Census Bureau: Northeast, South, Midwest and West. Each program’s official website was reviewed to collect data on core faculty, including sex, years of experience, and retention. For each program, we determined a female-to-male faculty sex ratio. Faculty experience was defined as number of years since completion of a CRS fellowship. Faculty retention was defined as having completed residency or fellowship at the same institution where the faculty member currently practices. Number of fellowship positions offered at each institution was also recorded.

Results/Outcomes: A total of 74 active APDCRS fellowship programs comprised of 484 colorectal surgeons were included in the study. The West region had the highest female-to-male faculty ratio (0.59) while the Midwest had the lowest (0.48). Notably, Virginia Commonwealth University [South] and Louisiana State University SOM [South] had a 100% female faculty composition. Overall, nineteen programs (25.7%) had female faculty representation equal to or greater than that of male faculty.

Faculty experience ranged from a mean of 7.25 years (University of Washington, West) to 27.7 years (Cleveland Clinic Florida, South). Regionally, the Northeast had the highest cumulative mean faculty experience at 16.8 years.

Faculty retention was highest in the Midwest (0.51) and lowest in the West (0.22). The South offered the greatest number of CRS fellowship positions annually (42), while the West offered the fewest (17). While most programs offered only one (1) fellowship position per year, Cleveland Clinic Foundation (Ohio) and University of Minnesota stood out with six (6) and five (5) positions, respectively.

Conclusion/Discussion: Our results reveal significant regional and institutional differences in faculty sex representation, experience, retention, and fellowship availability across academic CRS programs. Despite recent trends toward gender parity in the fellowship match, the faculty female-to-male ratio remains approximately 1:2. These persistent differences may impact access to mentorship, opportunities for academic advancement, and long-term career outcomes within academic CRS.