Characteristics of Successful Integrated Plastic Surgery Applicants from US Allopathic Medical Schools without a Home Integrated Program

Unveiling the Need to Improve Personalized Applicant Tools: A Critical Evaluation of the Reliability of the Texas STAR database in Predicting Match Success for Plastic Surgery Applicants

OBJECTIVES

Using Texas STAR (seeking transparency in application to residency), we aimed to 1) examine predictors of matching success in integrated plastic surgery residency programs and 2) assess the reliability of the tool.

DESIGN, SETTING, AND PARTICIPANTS

A retrospective analysis of self-reported nationwide data of plastic surgery residency applicants between 2021 and 2023 across 146 participating medical schools were included. A comparison analysis was performed between matched and unmatched applicants using chi-squared tests, t-tests, and logistic regression models. NRMP data and literature were referenced to determine reliability.

RESULTS

Of the 209 plastic surgery resident applications, 147 matched (70.3%) and 62 went unmatched (29.7%). Average United States Medical Licensing Examination (USMLE) Step 1 and 2 scores were 248 and 257, respectively. Between matched and unmatched cohorts, no significant differences were observed in Alpha Omega Alpha (AOA) status, Gold Humanism Honor Society (GHHS) status, mean number of research experiences/presentations, volunteer experiences, leadership positions, and programs applied. Significant predictors of matching included taking a research year (OR 2.07, CI 0.99-4.34, p= 0.052), 8+ peer-reviewed publications (OR 2.29, CI 1.22-4.30, p = 0.009), geographic connection (p = 0.02), and 13+ interviews attended (OR 2.94, CI 1.56 -5.51, p < 0.001). These findings are consistent with current literature and the NRMP. Upon analysis of the qualitative free text responses on general recommendations for prospective applicants by users, subinternships, connections, interviews, research, letter of recommendation quality, home advantage, and mentorship were prominent themes of advice provided by both matched and unmatched cohorts.

CONCLUSIONS

Texas STAR is a resourceful and reliable tool. We conclude that a research year and geographic connections are strong predictors of matching in plastic surgery. However, more factors (e.g., applicants' home medical school, number of sub internships, and number of mentors) should be considered to make a well-informed decision on determining their own competitiveness, away rotations and residency programs.

Diversity, Equity, and Inclusion in Plastic Surgery: Where Do We Stand? Highlighting Overlooked Issues in Efforts to Improve Representation

OBJECTIVE

The lack of diversity among applicants successfully matching into integrated plastic surgery residency continues to be a topic of significant discussion, yet substantial improvements in representation remain elusive. This article aims to highlight the systemic barriers contributing to the decline in diverse plastic surgery trainees.

DESIGN

This perspective summarizes current and existing challenges in improving recruitment efforts of underrepresented in medicine (URiM) trainees and those from socioeconomically disadvantaged backgrounds.

CONCLUSIONS

While acknowledging current DEI initiatives, the authors point out those underappreciated modifiable and nonmodifiable obstacles that perpetuate the lack of equity and inclusivity in the match process. We emphasize the importance of continued commitment from program directors and chairs to these initiatives and its generational augmentative effects on achieving true and lasting diversity and equity.

An Update on the Independent Plastic Surgery Match (2019-2022): Trends, Predictors, and Program Leaders' Perspectives

Background

A previous study by the authors noted a decline in independent plastic surgery residency programs and rising applicant participation. This study provides updates on match trends and influential predictors, and gathers program leaders' views on the future of the independent track.

Methods

Match data (2019-2022) were obtained from the San Francisco match after American Council of Educators in Plastic Surgery approval. Variables influencing match success were analyzed, and program leaders were surveyed about desirable applicant traits and program trajectories.

Results

From 2019 to 2022, 243 of 428 applicants matched. Programs and positions declined by 10% and 9.5%, respectively. Applicants rose to 42.3%, but match rates fell from 82% to 56%. Osteopathic graduates doubled, whereas international graduates increased to 53.8%. Successful matches were associated with US allopathic medical school graduates, university-affiliated general surgery residencies, eight or more interviews, United States Medical Licensing Examination scores greater than 230, and high post graduate year (PGY)1-3 American Board of Surgery In-service Training Examination scores (PGY1-64.7%, PGY2-61.2%, PGY3-60.7%; P < 0.05). Of surveyed programs, 55.6% aimed to continue running the independent track in the next year. Conversely, 7.4% planned to discontinue in the next year, 22.2% within 2-5 years, 7.4% within the next decade, and 7.4% were unsure.

Conclusions

Although support for the independent plastic surgery track remains, program participation diminishes as applicant interest increases, intensifying match challenges. Increasing number of interviews improves match potential. Program leaders display varied commitments, with looming plans for some programs to discontinue offering this track. Applicant evaluation pivots on strong recommendations, research, and test scores.

The Law of Diminishing Returns in the Integrated Plastic Surgery Residency Match: A Deeper Look at the Numbers

Background

The highly competitive nature of the integrated plastic surgery residency match justifies the need for objective data that provide insights into some of the residents' selection criteria. Many studies have sought to provide information on these criteria, but to our knowledge, none has described the inflection point where the match probability does not further increase. Although our study provides this information to potential applicants, it will also help them assess and optimize their chances of a successful match.

Methods

We pooled and analyzed the data available on matched and unmatched integrated plastic surgery applicants on the national residency match program database between 2016 and 2022.

Results

Step 2 score of 250 or more (P < 0.0001), number of publications more than 15 (P = 0.0007), number of research experiences five or more (P = 0.018), number of contiguous ranks more than 10 (P < 0.0001), number of volunteer experiences five or more (P < 0.0001), being a US MD applicant (P < 0.0001), and Alpha Omega Alpha membership (P < 0.0001) were all associated with increased probability of matching into the integrated plastic surgery program. Match probability did not further increase after 15 publications, five research experiences, 15 contiguous ranks, and 10 volunteer experiences have been reached. Having a PhD (P = 0.149) or a non-PhD graduate degree (P = 0.07) was not associated with increased match probability.

Conclusion

The law of diminishing returns sets in for applicants to the integrated plastic surgery match after 15 publications, 15 contiguous ranks, five research experiences, and 10 volunteer experiences have been reached.

Students Matriculating into Integrated Plastic Surgery: Are all Medical Schools Equal?

INTRODUCTION

Becoming a craniofacial/pediatric plastic surgeon depends on completing a plastic surgery (PS) residency. As medical school curricula for PS exposure are highly inconsistent, the authors investigated whether there was an association between the presence of PS elective rotations and/or home programs in medical schools with the proportion of students matriculating into integrated PS residency.

METHODS

A list of 198 medical schools was compiled from the Association for American Medical Colleges and the American Association of Colleges of Osteopathic Medicine. Plastic surgery residency programs were identified by the American Society of Plastic Surgery and the American Council of Educators in Plastic Surgery. Plastic surgery elective rotation offerings and recent matches (2021-2022) were obtained from school websites. Mean proportions of students matriculating into PS between schools that did versus did not have PS elective rotations and/or home PS residency programs were compared.

RESULTS

One hundred fifty-nine medical schools were included. Seventy-seven of 159 (48%) had both PS elective rotations and home program(s), 63/159 (40%) offered PS elective rotations only, and 19/159 (12%) had neither. The mean proportions of students matriculating differed significantly ( P <0.001) among schools without PS electives or a home program [0.09%, 95% confidence interval (CI): -0.04% to 0.21%), PS elective only (0.51%, 95% CI: 0.25%-0.77%), and both PS elective and home program(s) (1.14%, 95% CI: 0.92%-1.37%).

CONCLUSION

The presence of elective PS rotations and a home PS residency program significantly increase the chances of matriculation into integrated PS residency programs.

Development of "Explore Plastic Surgery": An Educational Program for Medical Students Without Home Residency Programs

BACKGROUND

Medical students who attend institutions without plastic surgery residency programs are at a disadvantage in the plastic surgery match. We developed an educational program for medical students without home programs called Explore Plastic Surgery to provide an overview of the steps toward a career in plastic surgery. The purpose of this study was to assess the impact, utility, and success of the novel program.

METHODS

Pre- and postevent surveys were distributed to participants. Survey data were analyzed including participant demographics, perceptions of barriers unique to those without home programs, and the overall event utility.

RESULTS

Two hundred seventeen students registered for the program. Ninety-five participants completed the pre-event survey (44%), and of those, 57 participants completed the post-event survey (60%). There was an increase in understanding of the steps toward a career in plastic surgery ( P < 0.001), confidence in overcoming barriers ( P = 0.005), and level of comfort in reaching out to faculty for opportunities ( P = 0.01). There was a decrease in the perceived negative impact that attending medical schools without a home program will have on their abilities to pursue careers in plastic surgery ( P = 0.006).

CONCLUSIONS

After the event, participants demonstrated an increase in their confidence in overcoming barriers and a decrease in their perceptions that attending an institution without a home program would negatively impact their ability to pursue plastic surgery. Initiatives focused on early exposure and recruitment of medical students may be important to promote accessibility and diversity within plastic surgery.

Doctors of Osteopathic Medicine as Plastic Surgery Residents: Demographics, Credentials, and Pathways to Residency

OBJECTIVE

Doctors of Osteopathic Medicine (DOs) are sparsely represented within plastic and reconstructive surgery (PRS) and recent changes including the elimination of step 1 scoring have further disadvantaged DO applicants. The demographics, degrees, and scholarly output of DO PRS trainees were compared to that of Doctors of Medicine (MDs) to identify areas of focus which could be used to increase competitiveness of DO applications.

DESIGN

A cross-sectional study was created, including ACGME-accredited PRS program trainees during the 2020 to 2021 academic year. DO and MD trainee demographics and scholarly accomplishments were compared using t-test and chi-squared analysis.

SETTING

Web-based publicly available information was collected for subjects.

PARTICIPANTS

A total of 1092 PRS MD and DO trainees were identified. DOs made up only 2.7% (n = 30) and MDs made up 97.3% (n = 1062).

RESULTS

More DOs trained in independent programs (63.3%) than integrated (36.7%) compared to MDs (88.2% v. 11.8%, p < 0.001) and more DOs trained at lower ranked PRS programs (60.0% of DOs and 18.1% of MDs trained at Q4 programs, p < 0.001). DOs had fewer publications (median, IQR: 1, [0-2]) compared to MDs (3, [1-8]), fewer citations (0, [0-6]) vs. (10, [1-56]) and lower H-index (1, [0-1]) vs. (1, [1-3]).

CONCLUSION

DO candidates should consider research years in the field of PRS and optimize clinical experience opportunities to increase the competitiveness of their PRS applications. Special attention should be paid to providing networking and research opportunities to DOs who lack home institutions.

Independent Plastic Surgery Match Regional Trends Comparing In-person and Virtual Interview Cycles

Background

There is a trend toward matching in a different region than previous training for the independent plastic surgery match cycles from 2019 to 2021, which differs from the trend to match within the same region for integrated plastic surgery programs. Notably, residency interviews transitioned from in-person to virtual in 2020 due to the coronavirus pandemic. Therefore, we compared in-person versus virtual interview match trends from 2019 to 2023.

Methods

Zip codes and regions of each successfully matched plastic surgery applicant's medical school, residency, and plastic surgery program were gathered from publicly available data for the 2019 and 2020 in-person interview cycles and 2021, 2022, and 2023 virtual interview cycles.

Results

Although regions did not differ significantly in the proportions of positions each year (P = 0.85), there was a trend toward fewer positions in each region from 2019 to 2022. Overall, applicants were more likely to match in a different region as their medical school or residency during virtual compared with in-person interviews (P = 0.002 and P = 0.04). Applicants matched to programs further from their medical school zip code in virtual interview years (P = 0.02). There was no significant difference in distance between surgical residencies and plastic surgery residencies between the two time periods (P = 0.51).

Conclusions

Trends toward matching into a different region than prior training after the switch to virtual interviews could be attributed to applicant accessibility to interview broadly. However, this could also be due to the decreased number of independent residency positions over the years, requiring applicants to move regions and travel further from where they began their training.

Identifying Barriers Faced by Applicants without a Home Residency Program when Matching into Plastic Surgery

Background  Applying into plastic surgery (PS) is competitive. Lacking a home residency program (HRP) is another barrier. Our goal is to characterize challenges faced by PS applicants without HRPs and identify solutions. Methods  Surveys were designed for current integrated PS residents and applicants in the 2022 Match without HRPs. Surveys were distributed electronically. Only U.S. allopathic graduate responses were included. Results  Of 182 individuals surveyed, 74 responded (39%, 33 residents, 41 applicants). Sixty-six percent reported feeling disadvantaged due to lack of an HRP. Seventy-six percent of applicants successfully matched. Of these, 48% felt they required academic time off (research year) versus 10% of unmatched applicants. Ninety-seven percent of matched applicants identified a mentor versus 40% of unmatched applicants ( p  < 0.05). Matched applicants identified mentors through research (29%) and cold calling/emailing (25%). Matched versus unmatched applicants utilized the following resources: senior students (74 vs. 10%, p  < 0.05) and social media (52 vs. 10%, p  < 0.05). Among residents, 16 had PS divisions (48%). Thirty-six percent with divisions felt they had opportunities to explore PS, compared with 12% without divisions. Residents without divisions felt disadvantaged in finding research (94 vs. 65%, p  < 0.05), delayed in deciding on PS (50 vs. 28%), and obtaining mentors (44 vs. 35%) and letters of recommendation (31 vs. 24%). Conclusion  PS residents and applicants without HRPs reported feeling disadvantaged when matching. The data suggest that access to departments or divisions assists in matching. We identified that external outreach and research were successful strategies to obtain mentorship. To increase awareness for unaffiliated applicants, we should increase networking opportunities during local, regional, and national meetings.

Deconstructing the Excellent Plastic Surgeon: A Survey of Key Attributes

Background

Most plastic surgeons practice in nonacademic settings, leaving a small subset of academic plastic surgeons with the responsibility of selecting the future generation of plastic surgeons without representation from a majority of our field. This raises questions as to whether the academic attributes valued during residency selection are valid predictive markers of who will become an excellent plastic surgeon. A survey was conducted of both academic and nonacademic plastic surgeons, as well as trainees, to determine what traits are considered most essential to being an excellent plastic surgeon.

Methods

An electronic survey was distributed before the American Council of Academic Plastic Surgeons 10th Annual Winter Meeting. Demographics and information regarding the respondents' training and academic status were collected. Respondents were asked to select five traits that they considered most important to be an excellent plastic surgeon from a list of 20 preselected traits. Chi-square and Fisher exact tests were used to perform subgroup analyses.

Results

A total of 187 responses were received from meeting attendees, representing an 89.0% response rate. Overall, the five values endorsed as most important for a plastic surgeon were being technically sound (53%), collaborative (48%), ethical (44%), compassionate (37%), and emotionally intelligent (33%). However, the emphasis placed on these different attributes differed significantly amongst different demographic groups.

Conclusion

It is important that we use methods such as holistic review when evaluating plastic surgery applicants to ensure our selection process is congruent with the traits we value.

The Effectiveness of a Self-Directed e-Learning Module on Trainee Knowledge and Confidence during Plastic Surgery Clinical Rotations

Background

Exposure to plastic surgery is limited during medical school. This makes rotations for clinical clerks and off-service residents challenging. Available resources are often too detailed and overwhelming. Having an accessible, concise, and interactive plastic surgery e-learning module reviewing core plastic surgery topics could help prepare incoming trainees for their rotations.

Methods

An e-learning module was created using text, images, and in-house recorded video recordings. Two cohorts were recruited: control cohort (n = 9), who completed their plastic surgery rotation without use of the module, and an interventional cohort (n = 18), who completed the rotation with use of the module. A demographic survey, a 20-question multiple-choice knowledge test, and self-reported confidence score were completed by both cohorts at the end of their plastic surgery rotations. The intervention cohort also completed the knowledge test at the beginning of their rotation to establish baseline. Knowledge and confidence scores were compared using two-tailed, unpaired, nonparametric analyses (Mann-Whitney test).

Results

Learners from the intervention cohort reported a 95% module completion rate and found the resource "extremely helpful" (average Likert of 4.8/5). Learners indicated that they were very likely to recommend the resource to others (average Likert 4.9/5). The intervention cohort scored significantly higher on the knowledge test compared with the control cohort (P = 0.008), and on average reported higher confidence levels; however, this was not statistically significant (P = 0.057).

Conclusion

An accessible and concise module on core plastic surgery concepts enhances learner knowledge and confidence during plastic surgery clinical rotations.

Perceptual Barriers to Becoming a Plastic Surgeon among Underrepresented Medical Students

Background

The field of plastic surgery has experienced difficulty increasing diversity among trainees, despite significant efforts. Barriers to recruitment of underrepresented in medicine (URM) students are poorly understood. This study assesses URM students' exposure to plastic surgery, access to mentors and research opportunities, and the importance of diversity in the field.

Methods

A survey was designed and distributed to members of the Student National Medical Association over 3 months. Survey data were collected using Qualtrics and descriptive statistics, and logistical regressions were performed using SAS.

Results

Of the 136 respondents, 75.0% identified as Black (n = 102/136), and 57.4% (n = 66/115) reported a plastic surgery program at their home institution. Of the total respondents, 97.7% (n = 127/130) were concerned about racial representation in plastic surgery, and 44.9% (n = 53/114) would be more likely to apply if there were better URM representation. Most respondents disagreed that there was local (73.4%, n = 58/79) or national (79.2%, n = 57/72) interest in URM recruitment. Students whose plastic surgery programs had outreach initiatives were more likely to have attending (OR 11.7, P < 0.05) or resident mentors (OR 3.0 P < 0.05) and access to research opportunities (OR 4.3, P < 0.05).

Conclusions

URM students feel there is an evident lack of interest in recruiting URM applicants in plastic surgery. Programs with outreach initiatives are more likely to provide URM students access to mentorship and research opportunities, allowing students to make informed decisions about pursuing plastic surgery.

The Utility of the Plastic Surgery Standardized Letter of Recommendation Form in Predicting Residency Match Outcomes

BACKGROUND

Letters of recommendation play an important role in resident selection. While plastic surgery's Standardized Letter of Recommendation (SLOR) form most commonly serves as an adjunct to narrative letters, the SLOR provides objective data in the review process and could eventually replace narrative letters. The utility of the SLOR in predicting Match outcomes has not been studied.

METHODS

Applicant data from 225 first-time residency applicants in 2020-21 were collected. Logistic regression modeling was used to predict Match outcomes. This model was validated using 100 randomly selected applicants from 2019-20.

RESULTS

Rank placement (SLOR Question 6) was the most important factor when predicting Match outcomes (p<0.0001). All other SLOR questions were not predictive and subject to notable score inflation. No SLOR score differences were noted based on race; female applicants were rated higher in two of ten domains (p<0.05).

CONCLUSIONS

One question on the plastic surgery SLOR was highly predictive of an applicant matching. However, the remaining SLOR questions had little utility and were subject to gross score inflation. Further work should be done to optimize the utility of the SLOR in differentiating applicants. This has important implications in ensuring the selection of professional, competent residents according to the aims of the Accreditation Council of Graduate Medical Education.

Recent Trends and Future Directions for the Integrated Plastic Surgery Match

The integrated plastic surgery residency match has risen to be the most competitive specialty in the 2022 match. This reality has prompted medical students to reach a high level of personal achievements, including pursuing research fellowships to boost research productivity. The competitive nature of this specialty has highlighted several barriers for applicants, such as those from groups underrepresented in surgery, of lower socioeconomic backgrounds, or without a home program. In recent years, there have been several changes to the match that stand to attenuate disparities among applicants, such as the transition to virtual interviews and the shift of the United States Medical Licensing Examination Step 1 score to pass-fail. The introduction of the Plastic Surgery Common Application and standardized letters of recommendation has altered the application process for the plastic surgery match. Given these recent trends, evaluating the current landscape and looking toward future directions for the integrated plastic surgery match becomes necessary. Understanding these changes will not only benefit medical students by giving them a transparent look into the match process but also provide a framework for other specialties to follow to increase accessibility to their specific specialty.

The West Coast Plastic Surgery Mentorship Program: Successes, Failures, and Future Growth

BACKGROUND

Students who are underrepresented in medicine experience limited access to mentorship throughout medical school and when applying to plastic surgery residency. This study describes the creation, growth, and results of the multi-institutional West Coast Plastic Surgery Mentorship Program (WCPSMP), specifically reflecting on barriers to implementation and room for future improvement.

METHODS

Students were eligible to apply to the plastic surgery mentorship program if they were first-, second-, or third-year medical students in a US medical school interested in plastic surgery. Preference was given to students who are (1) underrepresented-in-medicine racial/ethnic minorities; (2) first generation, low income; (3) lesbian, gay, bisexual, transgender, queer; and/or (4) without a home integrated plastic surgery program. Preprogram and postprogram surveys were analyzed.

RESULTS

The 2021-2022 cycle of the WCPSMP included 30 resident mentors and 30 resident mentees, with a 1:1 mentor-to-mentee relationship. The second annual Mentor-Mentee Day was hosted on June 25, 2022, in San Diego, California, with attendance from 18 mentees. There was a 63% response rate in the presurvey and postsurvey. Most students endorsed gaining didactic skills, technical skills, and networking, but only a few gained research opportunities.

CONCLUSION

The WCPSMP is a promising venue to offer underrepresented medical students valuable resident mentorship, as well as acquire surgical knowledge and skills. Further development of the program includes implementing a curriculum for residents on how to be an effective mentor and offering more research opportunities.

Trends in Integrated Plastic Surgery Applicant, Resident, and Junior Attending Research Productivity

INTRODUCTION

Research productivity is critical for matching into integrated plastic surgery residency. This study will identify how pre and intraresidency research productivity correlate with resident/junior attending productivity.

MATERIALS AND METHODS

Retrospective review from 2006 to 2015 issues of the American Board of Plastic Surgery's Annual Newsletter to Diplomates was performed to identify newly board certified plastic surgeons. Only surgeons from US medical schools matching directly into integrated programs were included. Residency type/length, graduation year from medical school, and publication counts were recorded for each surgeon. Publications were categorized as preresidency, intraresidency, and junior attending (6 y post residency/fellowship training).

RESULTS

Six hundred fifty-five integrated plastic surgery graduates were analyzed. The median number of total publications (preresidency, intraresidency, and junior attending) was 4 (interquartile range [IQR], 1 to 10). Linear regression revealed negligible correlation between preresidency and junior attending publications (r = 0.019, P = 0.002). Total publications and increasing graduation y had a significant correlation of 0.89 (P < 0.001). Graduates of fellowships had significantly increased median total publications compared to those without fellowships (7 IQR, 3 to 18 versus 3 IQR, 1 to 7, respectively, P < 0.001). Dedicated research years during residency were associated with significant (P < 0.001) increases in median total and junior attending publications. Total publications ranged from 3 (IQR, 1 to 6) to 8 (IQR, 7 to 18) for those who completed 5- and 8-y residencies, respectively.

CONCLUSIONS

Increased preresidency research productivity is not strongly associated with increased junior attending productivity in integrated plastic surgery. Better markers are completing dedicated research years in residency or fellowship after residency.

The Role of Dedicated Research Training in Promoting Academic Success in Plastic Surgery: Analysis of 949 Faculty Career Outcomes

This study aimed to analyze the association between completion of research training and career success in American plastic surgery faculty to aid trainees in their decisions to perform research fellowships.

Methods

A cross-sectional analysis of attending academic plastic surgeons in the United States was conducted. Outcomes were compared between faculty who completed research training (research fellowship, PhD, or MPH) and those who did not. Outcomes included promotion to full professor and/or department chair, h-index, and attainment of National Institutes of Health funding. Outcomes were analyzed using chi-squared tests, t tests, and multivariable regressions.

Results

A total of 949 plastic surgery faculty members were included, and of those, 185 (19.5%) completed dedicated research training, including 13.7% (n = 130) who completed a research fellowship. Surgeons who completed dedicated research training were significantly more likely to achieve full professorship (31.4% versus 24.1%, P = 0.01), obtain National Institutes of Health funding (18.4% versus 6.5%, P < 0.001), and have a higher mean h-index (15.6 versus 11.6, P < 0.001). Dedicated research fellowships were independently predictive of achieving full professorship (OR = 2.12, P = 0.002), increased h-index (β = 4.86, P < 0.001), and attainment of National Institutes of Health funding (OR = 5.06, P = 0.01). Completion of dedicated research training did not predict an increased likelihood of becoming department chair.

Conclusion

The performance of dedicated research training was predictive of improved markers of career success in plastic surgery and should be considered beneficial in both the short and long term.

Mentorship is Critical: An Analysis of the 2022 Plastic Surgery Match

BACKGROUND

As the second cycle impacted by COVID-19, the 2022 Plastic and Reconstructive Surgery (PRS) Match maintained virtual interviews while offering a modest lift of subinternship restrictions. The residency application process continues to evolve, with changes such as pass/fail United States Medical Licensing Examination Step 1 reporting prompting programs to reconsider metrics of applicant success. It is critical to address the impact of board scores, mentorship, and resource availability on a diverse applicant population in the PRS Match.

METHODS

A survey was electronically administered to students applying to a single institutional PRS residency program. The survey inquired about demographics, application statistics, mentorship experience, and match outcomes. Logistic regressions were modeled to assess for odds of matching into plastic surgery.

RESULTS

In total, 151 responses were analyzed, a 49.7% response rate. Most participants were female (52.3%), White (68.9%), and not Hispanic/Latino (84.8%). The largest percentage of respondents had a faculty mentor only from their home institution (55.0%) and a resident mentor from only their home institution (32.3%). Participants with a faculty mentor from both a home and outside institution had 7.4 times the odds of matching into PRS (P = 0.02) than students with no faculty mentorship. Students with dual-institution resident mentorship had 18.5 times higher the odds of matching compared with students with no resident mentorship (P < 0.001).

CONCLUSIONS

Subjective metrics, rather than objective scores, had the most influence on successfully matching into plastic surgery. As the PRS Match continues to become increasingly competitive, it behooves programs to provide equitable access to resources such as mentorship.

Strategies to Reduce Congestion in the Resident Match: What Can Plastic Surgery Learn from Other Specialties?

Many medical specialties are experiencing congestion in the residency match process because of increasing competition amongst applicants to secure a training position. With rising application numbers for a stable number of positions, the result is an inefficient use of time and financial resources on behalf of both the residency applicants and programs. Solutions to address congestion in the match process have been proposed in the literature, and other specialties have implemented specialty-wide reforms.

Methods

The Pubmed and Web of Science databases were queried using keywords related to the residency match and resident selection. The initial search yielded 372 results. Titles and abstracts were evaluated for inclusion and 93 articles met criteria for full-text evaluation. The bibliographies of these publications were reviewed for additional references.

Results

Numerous strategies to reduce congestion in the match were identified across specialties. Implemented reforms include a centralized preference signaling system, an interview cap, a staged or consortia match, and publication of transparent program-specific resident selection criteria. We discuss pros and cons of different strategies to reduce congestion in the match and summarize the effects that recent reforms have had on other specialties.

Conclusions

Plastic surgery as a field is at a distinct advantage to be a leader in transforming the residency match process, as we are a small and historically innovative group. We hope to spark discussion amongst students, residents, and program faculty with the goal of creating a more efficient match process.

Evolution of a Plastic Surgery Summer Research Program: Lessons Learned from Programmatic Evaluation and Quality Enhancement

Early surgical exposure and research fellowships can influence medical students' specialty choice, increase academic productivity, and impact residency match. However, to our knowledge, there is no published guidance on the programmatic evaluation and quality enhancement necessary for the sustainability of formal plastic surgery summer research programs for first year medical students. We present seven years (2013-2020) of institutional experience in an effort to inform program development at other institutions.

Methods

From 2013 to 2016, a sole basic science research arm existed. In 2017, a clinical research arm was introduced, with several supplemental activities, including surgical skills curriculum. A formalized selection process was instituted in 2014. Participant feedback was analyzed annually. Long-term outcomes included continued research commitment, productivity, and residency match.

Results

The applicant pool reached 96 applicants in 2019, with 85% from outside institutions. Acceptance rate reached 7% in 2020. With adherence to a scoring rubric for applicant evaluation, good to excellent interrater reliability was achieved (intraclass correlation coefficient = 0.75). Long-term outcomes showed that on average per year, 28% of participants continued involvement in departmental research and 29% returned for dedicated research. Upon finishing medical school, participants had a mean of 7 ± 4 peer-reviewed publications. In total, 62% of participants matched into a surgical residency program, with 54% in integrated plastic surgery.

Conclusions

A research program designed for first year medical students interested in plastic surgery can achieve academic goals. Students are provided with mentorship, networking opportunities, and tools for self-guided learning and career development.

Disparities in Research during Plastic Surgery Training: How Can We Level the Playing Field?

Background:

Methods:

Results:

Conclusions:

Matching into Plastic Surgery: Insights into the Data

Matching into plastic and reconstructive surgery residency, whether integrated or independent, is a competitive process. This article serves to examine, review, and summarize data published on both residency application processes. Through the results summarized, applicants should carefully review the objective and subjective factors used in evaluation to strategize how to make themselves as competitive as possible. Specifically, though, early review of the data presented may allow applicants time to focus on what modifiable factors still remain before their respective application seasons.

Medical Students' Exposure to Plastic Surgery: A Cross-sectional Review of Scholarly and Academic Opportunities

Specialty exposure is most influential in a medical student's decision to pursue plastic surgery training. We aimed to understand what opportunities exist for students through national plastic surgery organizations.

Methods

The American Board of Plastic Surgery, American Society of Plastic Surgeons, and The Aesthetic Society provide online lists of related organizations. Cross-referencing lists yielded 47 unique organizations. Screening for presence of annual meeting and relevance to student and resident education yielded 14 organizations. Bylaws/web-domains were reviewed for information related to the annual meeting, leadership opportunities, membership, grants, and travel scholarships. If available, previrtual/in-person and virtual meeting prices were collected. Lastly, discrepancies between webpage information and phone/email correspondence were noted.

Results

All (100%) organizations welcomed students at annual meetings. Eleven promoted student presentation/submission. Average student registration fee was $109.3 ± SD$136.5 compared with $181.20 ± SD$157.20 for residents. Of organizations providing previrtual and virtual pricing (n = 10, 71.4%), there was an average price reduction in student registration of $92 (range: $0-375). Average student membership was $31.70/year ± SD $45.50 compared with $38.80 per year ± SD $65.90 for residents. The percentages of organizations offering student research grants, travel scholarships, and national student leadership were 21.4% (n = 3), 35.8% (n = 5), and 28.6% (n = 4) respectively. No organizations had student chapters/committees. All organizations (100%) contained at least one discrepancy between webpage/bylaw and email/phone.

Conclusions

Our results suggest that although national opportunities seem to be limited, a role exists for further engagement, with interested students eager to take the initiative. Virtual conferences present a lower-cost alternative for students and residents.