National Cross-Sectional Survey of Surgical Education Fellowships in the US

BACKGROUND: Surgical education fellowships prepare future surgeon-educators, yet national data describing training requirements and institutional support are limited. We characterized fellowship structure, educational responsibilities, and resources to inform program development and prospective fellows. STUDY DESIGN: A national cross-sectional survey of accredited and non-accredited U.S. surgical education fellowships was conducted from April to December 2024. Representatives submitted collaborative program-level responses addressing structure, professional development, teaching, simulation, research infrastructure, and mentorship. Data were analyzed descriptively. RESULTS: Nineteen of 28 identified fellowships responded (68%), including 15 accredited and 4 non-accredited programs. Teaching was required by 16 programs (84%), simulation coordination and instruction by 17 (89%), and curriculum development by 15 (79%). However, only 10 programs (53%) reported departmental Education PhD support, and 12 (63%) provided access to statisticians at no cost. Sixteen programs (84%) offered fully funded fellowship positions. Three programs (16%) required completion of an advanced degree during the fellowship. Eight programs (42%) reserved positions for internal candidates. National conference attendance was required by 16 programs (84%). Fourteen programs (74%) had a single fellowship director; among directors with available data (n=21), median dedicated full-time equivalent was 0.2 (IQR 0,1). CONCLUSIONS: U.S. surgical education fellowships share substantial teaching and simulation responsibilities but differ in institutional resources, professional development opportunities, and leadership support. These national descriptive findings provide improved transparency for prospective applicants, inform future fellowship development and resource allocation, and can guide research on graduate outcomes and accreditation. Longitudinal research is needed to determine how program characteristics and accreditation relate to graduate outcomes.