Employment and Migration Patterns of Recent Micrographic Surgery and Dermatologic Oncology Fellowship Graduates.

BACKGROUND: There is currently an uneven distribution of the Mohs surgery workforce, with a dearth in nonurban areas. The relationship between training and employment locations of Mohs surgeons has not been studied. OBJECTIVE: To analyze the employment location of recent micrographic surgery and dermatologic oncology (MSDO) graduates in reference to residency and fellowship locations. MATERIALS AND METHODS: Data collection of training and practice locations of 421 MSDO fellowship graduates from 2012 to 2017. RESULTS: Thirty-two percent (n = 136) and 53% (n = 225) of MSDO fellowship graduates' first employment locations were located within 10 and 100 miles of either their residency or fellowship locations. Ninety-six percent of graduates were employed in a metropolitan location. Female graduates worked closer to training sites than male graduates, with 62% (n = 124) versus 46% (n = 102) working within 100 miles of either training site. Analysis by fellowship census region showed that graduates clustered around training sites in all regions, with 45% to 60% of graduates working within 100 miles of either training site. CONCLUSION: The majority of graduates chose to work in a metropolitan area. Training location strongly predicts employment location. More than 45% of graduates in any region worked within 100 miles of their residency or fellowship site, and a sizeable portion worked within 10 miles.

Physical Medicine and Rehabilitation: Trends in Graduate Medical Education and Subspecialization Amid Changing Demographics.

With an aging and growing US population, American healthcare faces an impending physician shortage. This is important for the field of physical medicine and rehabilitation, because physiatrists' skills in managing chronic conditions and functional outcomes are especially relevant to an older population. The present study was designed to better understand the future physical medicine and rehabilitation workforce, by recording and analyzing the quantities of Accreditation Council of Graduate Medical Education-accredited physical medicine and rehabilitation graduate medical education programs and positions between 2001-2002 and 2017-2018. Results indicated that physical medicine and rehabilitation graduate medical education has grown since 2001-2002, especially in subspecialties such as pediatric rehabilitation and sports medicine. However, the growth in physical medicine and rehabilitation residency positions has been three-fold lower than that of total graduate medical education. In addition, subspecialization has become increasingly prevalent, and residency positions have declined relative to the population of older adults. The future identity of physical medicine and rehabilitation will continue to develop as professional and demographic trends shape this important medical specialty.