Craniomaxillofacial Surgery Job Opportunities

BACKGROUND: Craniomaxillofacial (CMF) fellowship training increasingly spans pediatric, adult reconstructive, and aesthetic domains, yet the job market is perceived as constrained. We performed a longitudinal analysis of craniofacial-aligned plastic surgery job postings and compared trends with fellowship capacity and program director-reported competencies. METHODS: The American Council of Educators in Plastic Surgery (ACEPS) and the American Society of Plastic Surgeons (ASPS) postings (2007 to 2024) were extracted, deduplicated, and classified as Tier 1 (pediatric/transcranial cleft craniofacial), Tier 2 (adult or mixed craniofacial reconstruction), or Tier 3 (all remaining plastic surgery postings without craniofacial content). Linear regression assessed temporal trends, and multivariable logistic regression tested predictors of Tier 1 postings. SF Match reports (2007 to 2024) described positions offered/filled, and program directors completed a binary survey across 13 of the American Society of Craniofacial Surgeons (ASCFS) competency domains. RESULTS: Of 4566 unique plastic surgery postings, 170 (3.7%) were Tier 1, 317 (6.9%) were Tier 2, and 4079 (89.3%) were Tier 3 (Tier 1+2: 10.7%). Tier 1 increased by 1.51 postings/year ( P