Mentorship Over Infrastructure: What Drives Dermatology Residents to Pursue Pediatric Dermatology Fellowship

The pediatric dermatology workforce shortage threatens equitable access to specialized care for children. We conducted a national survey of dermatology residents (n = 202) to examine the relative influence of mentorship, educational exposure, training satisfaction, and financial considerations on fellowship decision-making. In multivariable analysis, mentorship emerged as the primary predictor of fellowship pursuit (OR: 6.034, 95% CI: 2.315-19.648, p = 0.013), while structural program features such as in-house fellowships and faculty availability improved training satisfaction but did not independently drive fellowship intentions. These findings support workforce strategies that prioritize structured mentorship pathways alongside compensation models that sustain the pediatric dermatology faculty base.