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Adebagbo OD, Guo L. Diversity, Equity, and Inclusion in Plastic Surgery: Where Do We Stand? Highlighting Overlooked Issues in Efforts to Improve Representation. JOURNAL OF SURGICAL EDUCATION 2024; 81:1187-1194. [PMID: 39019706 DOI: 10.1016/j.jsurg.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/08/2024] [Accepted: 06/10/2024] [Indexed: 07/19/2024]
Abstract
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.
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Affiliation(s)
| | - Lifei Guo
- Division of Plastic and Reconstructive Surgery, Lahey Hospital & Medical Center, Burlington, Massachusetts; Tufts University School of Medicine, Boston, Massachusetts.
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Amro C, Ryan IA, McGraw JR, Broach RB, Kovach SJ, Serletti JM, Butler PD, Janis JE, Azoury SC. An Update on the Independent Plastic Surgery Match (2019-2022): Trends, Predictors, and Program Leaders' Perspectives. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e6030. [PMID: 39114802 PMCID: PMC11302939 DOI: 10.1097/gox.0000000000006030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 06/06/2024] [Indexed: 08/10/2024]
Abstract
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.
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Affiliation(s)
- Chris Amro
- From Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa
| | - Isabel A. Ryan
- From Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa
| | - J. Reed McGraw
- From Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa
| | - Robyn B. Broach
- From Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa
| | - Stephen J. Kovach
- From Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa
| | - Joseph M. Serletti
- From Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa
| | - Paris D. Butler
- Division of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn
| | - Jeffrey E. Janis
- Department of Plastic and Reconstructive Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Saïd C. Azoury
- From Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa
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George RE, Bay CC, Thornton SM, Zhong T, Feeley LP, Schappe AM, Dingle AM, Poore SO. Unmatched. What's Next? Is a Preliminary Year of Residency or Research Fellowship Better for Reapplicants to Plastic Surgery? PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5955. [PMID: 38974831 PMCID: PMC11224867 DOI: 10.1097/gox.0000000000005955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 05/10/2024] [Indexed: 07/09/2024]
Abstract
Background Plastic and reconstructive surgery is one of the most competitive residency programs, and given the increased number of applicants for a relatively fixed number of positions, successfully matching is a challenge. Match rates have declined since 2018, with a match rate of ~55% in 2022. Two common options before reapplying are a preliminary year of residency (preliminary year) or a research fellowship. This study investigated which option is more beneficial for reapplicants seeking a successful match. Methods This retrospective study included all applicants to an integrated plastic and reconstructive surgery residency from 2015 to 2023. Two cohorts based on reapplication strategy (research fellowship or preliminary year) were created. Demographic, applicant, and match data were collected. Pearson chi-squared, Fisher exact, and Wilcoxon rank sum testing were performed. Results In total, 125 reapplicants were included. Seventy-one (56.8%) reapplicants pursued a preliminary year, and 29 (23.2%) completed a research fellowship. Research fellowship reapplicants had a greater mean number of first author publications (8.8 versus 3.2, P < 0.001), non-first author publications (11.3 versus 5.9, P = 0.021), poster presentations (9.7 versus 6.0, P = 0.028), and oral presentations (11.8 versus 6.4, P < 0.001). Research fellowship reapplicants were more likely to match into plastic and reconstructive surgery (PRS) than preliminary year reapplicants, with 72.4% (n = 21) of research fellowship reapplicants matching into PRS compared with 39.4% (n = 28) of preliminary year reapplicants (P = 0.003). Conclusions Research fellowship reapplicants demonstrated greater research productivity and were almost twice as likely to match into PRS compared with preliminary reapplicants.
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Affiliation(s)
- Robert E. George
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health—Madison, Madison, Wis
| | - Caroline C. Bay
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health—Madison, Madison, Wis
| | - Sarah M. Thornton
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health—Madison, Madison, Wis
| | - Tammy Zhong
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health—Madison, Madison, Wis
| | - Lauren P. Feeley
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health—Madison, Madison, Wis
| | - Alyssa M. Schappe
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health—Madison, Madison, Wis
| | - Aaron M. Dingle
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health—Madison, Madison, Wis
| | - Samuel O. Poore
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health—Madison, Madison, Wis
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Elemosho A, Sarac BA, Janis JE. The Law of Diminishing Returns in the Integrated Plastic Surgery Residency Match: A Deeper Look at the Numbers. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5937. [PMID: 38962153 PMCID: PMC11221859 DOI: 10.1097/gox.0000000000005937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/09/2024] [Indexed: 07/05/2024]
Abstract
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.
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Affiliation(s)
- Abdulaziz Elemosho
- From the Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Benjamin A. Sarac
- From the Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jeffrey E. Janis
- From the Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Hallman TG, Qureshi U, Soltani H, Gutowski KS, Arcelona C, Donaldson R, Mihalic AP, Gosain AK. Predictors of Plastic Surgery Applicant Success: An Analysis of the Texas STAR Database. J Craniofac Surg 2024; 35:1084-1088. [PMID: 38709027 DOI: 10.1097/scs.0000000000010153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/16/2024] [Indexed: 05/07/2024] Open
Abstract
INTRODUCTION Integrated plastic surgery residency is one of the most competitive medical specialties. Although previous studies have surveyed integrated plastic surgery residency program directors regarding desired applicant characteristics, there is a paucity of literature assessing detailed application characteristics and reported match outcomes from applicants in recent application cycles. This study examines application characteristics associated with matching into integrated plastic surgery residency from 2017 to 2023. METHODS The authors accessed the Texas Seeking Transparency in Application to Residency database, which contains survey information from graduating medical students nationwide regarding residency application characteristics and specialties/programs to which applications were submitted. Characteristics of matched versus unmatched applicants between 2017 and 2023 were compared using χ 2 and 2-sided, independent t tests. Univariate logistic regression models were used to assess predictors of a successful match. RESULTS A total of 381 integrated plastic surgery residency applicants responded to the Texas Seeking Transparency in Application to Residency survey from 2017 to 2023. Mean United States Medical Licensing Exam Step 2 CK scores; the number of away rotations, interview offers, and honored clerkships; and Alpha Omega Alpha membership rate were significantly associated with and predictive of matching. Preference signaling of programs was associated with an increased interview offer rate. CONCLUSIONS Higher board examination scores, increasing numbers of honored clerkships, away rotations, and Alpha Omega Alpha membership were identified as statistically significant predictors of matching into integrated plastic surgery residency. Prospective applicants should use this information to help guide their efforts in these areas that appear to be associated with a successful transition to residency.
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Affiliation(s)
- Taylor G Hallman
- Division of Plastic Surgery, Ann & Robert H. Lurie Children's Hospital, Northwestern Feinberg School of Medicine, Chicago, IL
| | - Umer Qureshi
- Division of Plastic Surgery, Ann & Robert H. Lurie Children's Hospital, Northwestern Feinberg School of Medicine, Chicago, IL
| | - Hannah Soltani
- Division of Plastic Surgery, Ann & Robert H. Lurie Children's Hospital, Northwestern Feinberg School of Medicine, Chicago, IL
| | - Kristof S Gutowski
- Division of Plastic Surgery, Ann & Robert H. Lurie Children's Hospital, Northwestern Feinberg School of Medicine, Chicago, IL
| | - Christian Arcelona
- Division of Plastic Surgery, Ann & Robert H. Lurie Children's Hospital, Northwestern Feinberg School of Medicine, Chicago, IL
| | - Rachel Donaldson
- Division of Plastic Surgery, Ann & Robert H. Lurie Children's Hospital, Northwestern Feinberg School of Medicine, Chicago, IL
| | - Angela P Mihalic
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX
| | - Arun K Gosain
- Division of Plastic Surgery, Ann & Robert H. Lurie Children's Hospital, Northwestern Feinberg School of Medicine, Chicago, IL
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Sergesketter AR, Song E, Shammas RL, Tian WM, Eberlin KR, Ko JH, Momoh AO, Snyder-Warwick A, Phillips BT. Preference Signaling and the Integrated Plastic Surgery Match: A National Survey Study. JOURNAL OF SURGICAL EDUCATION 2024; 81:662-670. [PMID: 38553367 DOI: 10.1016/j.jsurg.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/20/2024] [Accepted: 01/25/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE Rooted in economics market strategies, preference signaling was introduced to the Plastic Surgery Common Application (PSCA) in 2022 for integrated plastic surgery residency applicants. This study surveyed program and applicant experience with preference signaling and assessed how preference signals influenced likelihood of interview invitations. DESIGN Two online surveys were designed and distributed to all program directors and 2022-2023 applicants to integrated plastic surgery. Opinions regarding the utility of preference signaling were solicited, and the influence of preference signals on likelihood of interview offers was assessed. SETTING All integrated plastic surgery programs. PARTICIPANTS All 88 program directors and 2022-2023 applicants to integrated plastic surgery. RESULTS A total of 45 programs and 99 applicants completed the survey (response rates, 54.2% and 34.2%, respectively). Overall, 79.6% of applicants and 68.9% of programs reported that preference signals were a useful addition to the application cycle. Programs reported that 41.4% of students who sent preference signals received interview offers, compared to 84.6% of home students, 64.8% of away rotators, and 7.1% of other applicants; overall, students who signaled were 5.8 times more likely to receive an interview offer compared to students who were not home students and did not rotate or signal. After multivariable adjustment, programs with higher Doximity rankings, numbers of away rotators, and numbers of integrated residents per year received more preference signals (all p < 0.05). CONCLUSIONS Applicants and programs report that preference signaling was a useful addition to the integrated plastic surgery application cycle. Sending preference signals resulted in a higher likelihood of interview offers among nonrotators. Preference signaling may be a useful tool to reduce congestion in the integrated plastic surgery application cycle.
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Affiliation(s)
- Amanda R Sergesketter
- Division of Plastic, Oral, and Maxillofacial Surgery, Duke University, Durham, North California
| | - Ethan Song
- Division of Plastic, Oral, and Maxillofacial Surgery, Duke University, Durham, North California
| | - Ronnie L Shammas
- Division of Plastic, Oral, and Maxillofacial Surgery, Duke University, Durham, North California
| | - William M Tian
- Division of Plastic, Oral, and Maxillofacial Surgery, Duke University, Durham, North California
| | - Kyle R Eberlin
- Division of Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - Jason H Ko
- Division of Plastic Surgery, Northwestern University, Chicago, Illinois
| | - Adeyiza O Momoh
- Section of Plastic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Alison Snyder-Warwick
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University, St. Louis, Missouri
| | - Brett T Phillips
- Division of Plastic, Oral, and Maxillofacial Surgery, Duke University, Durham, North California.
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Asghari A, Hines E, Mocharnuk J, Leis A, Wang ED. Update on the Selection Criteria of Plastic Surgery Residents: A Survey of Program Directors and Associate Program Directors. Ann Plast Surg 2024; 92:S327-S330. [PMID: 38369381 DOI: 10.1097/sap.0000000000003801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
BACKGROUND Plastic and reconstructive surgery (PRS) is recognized as a highly competitive specialty. Since the first assessment of resident selection criteria in 2007, PRS residency programs have adopted holistic review processes and adapted to changes such as a decline in medical schools participating in the Alpha Omega Alpha Honor Medical Society as well as the recent transition to pass/fail grading for the United States Medical Licensing Examination (USMLE) step 1 examination (Schultz et al. Plast Reconstr Surg Glob Open . 2020;8:e2892; Tadisina et al. Plast Reconstr Surg . 2017;139:330e-331e). This study was devised to evaluate current PRS residency criteria in light of these changes. METHODS An anonymous, 12-item, electronic survey was generated and distributed using Alchemer. An email was sent to 171 program directors (PDs) and associate program directors (APDs) of PRS residency programs. Survey questions were developed to collect data regarding respondent demographics and their desired criteria when assessing residency applicants. Complete responses were collected and analyzed with summary statistics and multivariate logistic regression using RStudio (version 1.3.109). RESULTS In total, 44 (25.7% response rate) of the 171 PDs and APDs completed the survey. Of the 16 programs (36.4%) with a USMLE cutoff score, 7 (43.8%) reported a range of 230 to 239 and 6 (37.5%) reported a range of 240 to 249. Without a score for step 1, the majority (48.8%) of respondents believe that step 2 scores will replace step 1 scores in terms of assessment criteria, and the content of recommendation letters was selected as the criterion with the greatest increase in weight (66.7%). In addition, 27.3% of programs require a step 2 score at the time of interview. The top 3 academic criteria in order of decreasing importance were the content of recommendation letters, clinical grades, and letter writers, whereas the top 3 nonacademic criteria were subinternship performance, maturity, and interview performance. CONCLUSIONS Plastic and reconstructive surgery remains a highly competitive specialty for residency applicants. Our findings suggest that Alpha Omega Alpha membership remains diminished in importance, whereas USMLE cutoff scores have increased. With recent changes in the step 1 grading system, PDs and APDs will rely more heavily on step 2 scores and the content of recommendation letters.
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Affiliation(s)
- Arya Asghari
- From the California Northstate University College of Medicine, Elk Grove
| | - Eric Hines
- Department of Plastic Surgery, University of California, Irvine, Orange, CA
| | | | - Amber Leis
- Department of Plastic Surgery, University of California, Irvine, Orange, CA
| | - Eric D Wang
- Department of Plastic Surgery, University of California, Irvine, Orange, CA
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Shaffrey EC, Edalatpour A, Nicksic PJ, Nkana ZH, Michelotti BF, Afifi AM. Rise Above the Competition: How Do Plastic Surgery Residency Applicants with NCAA Experience Fare in the Residency Match? Aesthetic Plast Surg 2024; 48:1867-1873. [PMID: 37500905 DOI: 10.1007/s00266-023-03513-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/30/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND The integrated plastic surgery residency match continues to be highly competitive. Every year, some candidates are former NCAA athletes. While it is challenging to balance academic and athletic responsibilities, participation in NCAA sports may be predictive of continued success. OBJECTIVES This study aimed to evaluate the impact of participation in collegiate athletics on applicant anticipated rank and academic success. METHODS All applications received from 2017 to 2020 at a single institution were reviewed for participation in NCAA athletics (Division I-III). Our primary outcome of interest was applicant anticipated rank by letter of reference writers. Applications were also examined for demographic information, membership in AOA, number of research publications, and USMLE board certification examination scores. RESULTS After reviewing 885 applications, 61 applicants (6.89%) were former NCAA athletes. Former NCAA involvement was associated with the highest effect on anticipated ranking (- 0.22, p=0.001). Former NCAA involvement demonstrated the highest odds of receiving an anticipated ranking in the top 5 (OR 1.83, p=0.025). We found no significant difference in research productivity between the two groups, including first authorships or USMLE Step 1 board certification exam scores. A significant difference was seen in race distribution, with forty-five (80.4%) of athlete applicants identifying as Caucasian, while 430 (56.5%) of non-athletes identified as Caucasian (p=0.012). CONCLUSION Former athletes applying to become integrated plastic surgery residents overcome the challenges of balancing athletic and academic pursuits with a higher anticipated rank in the integrated plastic surgery match while having comparable academic achievement. Former collegiate athletes have demonstrated greater success in and after residency. Former NCAA participation demonstrated the highest odds of receiving a top-5 rank. Former NCAA applicants showed no difference in academic productivity LEVEL OF EVIDENCE V: Case series study. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Ellen C Shaffrey
- Division of Plastic and Reconstructive Surgery, University of Wisconsin Hospitals and Clinics, 600 Highland Ave. CSC G5/361, Madison, WI, 53792, USA
| | - Armin Edalatpour
- Division of Plastic and Reconstructive Surgery, University of Wisconsin Hospitals and Clinics, 600 Highland Ave. CSC G5/361, Madison, WI, 53792, USA
| | - Peter J Nicksic
- Division of Plastic and Reconstructive Surgery, University of Wisconsin Hospitals and Clinics, 600 Highland Ave. CSC G5/361, Madison, WI, 53792, USA
| | - Zeeda H Nkana
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Brett F Michelotti
- Division of Plastic and Reconstructive Surgery, University of Wisconsin Hospitals and Clinics, 600 Highland Ave. CSC G5/361, Madison, WI, 53792, USA
| | - Ahmed M Afifi
- Division of Plastic and Reconstructive Surgery, University of Wisconsin Hospitals and Clinics, 600 Highland Ave. CSC G5/361, Madison, WI, 53792, USA.
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Raborn LN, Elmorsi R, Smith BT, Asaad M, Kelley R, Egro FM. Doctors of Osteopathic Medicine as Plastic Surgery Residents: Demographics, Credentials, and Pathways to Residency. JOURNAL OF SURGICAL EDUCATION 2024; 81:607-615. [PMID: 38388309 DOI: 10.1016/j.jsurg.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/18/2023] [Accepted: 01/13/2024] [Indexed: 02/24/2024]
Abstract
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.
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Affiliation(s)
- Layne N Raborn
- Division of Plastic Surgery, University of Rochester Medical Center, Rochester, New York
| | - Rami Elmorsi
- Department of Plastic Surgery, MD Anderson Cancer Center, Houston, Texas
| | - Brandon T Smith
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Malke Asaad
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Rebecca Kelley
- Department of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Francesco M Egro
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
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Mullen SA, Akhter HM, Weis LE, Samson KK, Hon HH. Independent Plastic Surgery Match Regional Trends Comparing In-person and Virtual Interview Cycles. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5691. [PMID: 38528845 PMCID: PMC10962897 DOI: 10.1097/gox.0000000000005691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/02/2024] [Indexed: 03/27/2024]
Abstract
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.
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Affiliation(s)
- Sarah A. Mullen
- From University of Nebraska Medical Center, College of Medicine, Omaha, Neb
| | - Haris M. Akhter
- From University of Nebraska Medical Center, College of Medicine, Omaha, Neb
| | - Lauren E. Weis
- From University of Nebraska Medical Center, College of Medicine, Omaha, Neb
| | - Kaeli K. Samson
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, Neb
| | - Heidi H. Hon
- Division of Plastic and Reconstructive Surgery, University of Nebraska Medical Center, Omaha, Neb
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Lin LO, Huttinger AL, Butler P, Gosman AA, Janis JE. Socioeconomic Disparities in Research Participation: Bias in Plastic Surgery Residency Match. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5565. [PMID: 38313590 PMCID: PMC10836880 DOI: 10.1097/gox.0000000000005565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/11/2023] [Indexed: 02/06/2024]
Abstract
Background Integrated plastic surgery residency applicants have increased at a rate disproportionate to available positions. Research productivity has become a surrogate marker for competitiveness, and many applicants pursue it to distinguish themselves. To date, no study has investigated socioeconomic disparities in extended research experience (ERE) participation. Methods A 35-question cross-sectional survey was distributed to applicants to United States-based integrated plastic surgery residency programs during the 2019-2022 application cycles. Summary tables, student t test, and chi-square tests were used for statistical analysis. Results A total of 161 responses (response rate: 20.9%) were recorded. Fifty-nine (40.7%) respondents participated in an ERE. The most common reason for ERE participation was strengthening one's application. The most common reason against participation was avoiding delays in career progression. A greater percentage of respondents from Northeastern medical schools participated in EREs (P = 0.019). There were no significant differences in debt burden between those who did or did not participate in an ERE. A greater percentage of applicants whose parents had advanced degrees participated in EREs (P = 0.053). Conclusions There may be geographic and socioeconomic biases present in access to ERE for students interested in plastic surgery. The growing popularity of EREs may have unintended consequences for applicant diversity. As most plastic surgeons ultimately practice in nonacademic settings, applicants and plastic surgeons may consider the financial hardships and possible socioeconomic disparities in research opportunities before participating in or recommending them.
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Affiliation(s)
- Lawrence O. Lin
- From the Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Allyson L. Huttinger
- Department of Plastic and Reconstructive Surgery, Virginia Tech Carilion School of Medicine, Roanoke, Va
| | - Paris Butler
- Division of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn
| | - Amanda A. Gosman
- Division of Plastic Surgery, Department of Surgery, University of California San Diego Health, La Jolla, Calif
| | - Jeffrey E. Janis
- From the Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
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12
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Hauc SC, Rivera JC, Seiger K, Hanrahan GB, Ihnat J, Rivera GP, Alperovich M. Evaluating the Impact of Residency Research Productivity on Craniofacial Surgeons' Career Trajectory. J Craniofac Surg 2024; 35:72-74. [PMID: 37830796 DOI: 10.1097/scs.0000000000009776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/21/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVE To elucidate trends in publication productivity over the past 50 years and how they correlate with the stage of training as well as the competitiveness of residency and fellowship programs. The authors hypothesize that research qualifications play an important role in obtaining a competitively ranked craniofacial surgery fellowship and that over the past 50 years, there has been an upward shift in the research qualifications held by applicants at the time of application. DESIGN A cross-sectional study was performed involving all 121 academic craniofacial surgeons in the United States for whom sex, years since fellowship, current institution rank, current academic position, and years since graduation were available. MAIN OUTCOME MEASURES The relationship between research qualifications, as determined by the overall number of publications, number of first authorship publications, H-index scores, and years since fellowship completion, was examined. The study also analyzed the placement of surgeons at programs ranked in the top 25 versus the lower 25. RESULTS As the number of decades since beginning craniofacial fellowship decreased, the average number of first authorship publications and average H-index increased. Those who attended higher-ranking residency and fellowship programs had a higher average number of publications, number of first authorship publications, and H-index. CONCLUSIONS Over the past 5 decades, research productivity at all stages of medical training has surged, potentially fueled by the trend toward pass/fail grading in medical school evaluations and standardized exams and the need to differentiate oneself in an increasingly competitive field.
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Affiliation(s)
- Sacha C Hauc
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT
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13
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Sendek G, Blum JD, Reghunathan M, Chen S, Luong TT, Gosman AA, Butler PD. Deconstructing the Excellent Plastic Surgeon: A Survey of Key Attributes. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5460. [PMID: 38098952 PMCID: PMC10721122 DOI: 10.1097/gox.0000000000005460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/17/2023] [Indexed: 12/17/2023]
Abstract
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.
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Affiliation(s)
- Gabriela Sendek
- From the Division of Plastic Surgery, Department of Surgery, University of California, San Diego, San Diego, Calif
| | - Jessica D Blum
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin, Madison, Wis
| | - Meera Reghunathan
- From the Division of Plastic Surgery, Department of Surgery, University of California, San Diego, San Diego, Calif
| | - Shirley Chen
- Department of Plastic Surgery, Vanderbilt University, Nashville, Tenn
| | - Thanh T Luong
- From the Division of Plastic Surgery, Department of Surgery, University of California, San Diego, San Diego, Calif
| | - Amanda A Gosman
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin, Madison, Wis
| | - Paris D Butler
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn
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14
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Blum JD, Reghunathan M, Bradford PS, Camacho J, Sendek G, Jeffers L, Cash C, Mackay D, Butler PD, Gosman AA. Strength in Numbers: A SWOT Analysis of Plastic Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5462. [PMID: 38098947 PMCID: PMC10721123 DOI: 10.1097/gox.0000000000005462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/17/2023] [Indexed: 12/17/2023]
Abstract
Background Plastic surgeons comprise the minority of practicing surgeons, with an even smaller minority practicing in an academic setting. As the practice of medicine and the systems in which we operate continue to evolve, it is essential that plastic surgeons have a say in the changing landscape. This study conducted a strengths, weaknesses, opportunities, and threats (SWOT) analysis of plastic surgery to identify unifying strengths and common threats. Methods An electronic survey was distributed to American Council of Academic Plastic Surgeons' Winter Meeting attendees on three separate occasions preceding the meeting. Respondents were asked to provide demographic information and to identify the top three strengths, weaknesses, opportunities, and threats (SWOT analysis) for the specialty. Subgroup analyses were performed based on demographic characteristics. Results A total of 187 responses were received from meeting attendees, representing an 89.0% response rate. Most respondents were non-Hispanic (78.6%), White (66.8%), women (59.5%), and faculty/independent physicians (65.8%). The most identified strength in plastic surgery was our problem-solving abilities (62.0%). The most identified weakness was poor public perception of plastic surgery (54.0%). The most identified opportunity was demonstration of value to health systems (67.9%), and the most identified threat was scope of practice creep by other specialties (78.1%). The SWOT analysis identified lack of surgeon diversity as a key weakness, improvement of surgeon diversity as a key opportunity, and lack of diversity among plastic surgeons as a key threat to the specialty. Conclusion Only through a diverse but united front can we effectively use our strengths to face our threats and employ opportunities to overcome our weaknesses.
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Affiliation(s)
- Jessica D. Blum
- From the Division of Plastic Surgery, University of Wisconsin, Madison, Wis
| | - Meera Reghunathan
- Division of Plastic Surgery, Department of Surgery, University of California San Diego, San Diego, Calif
| | - Perry S. Bradford
- Department of Plastic and Maxillofacial Surgery, University of Virginia Health, Charlottesville, Va
| | - Justin Camacho
- Department of Medicine, Drexel University College of Medicine, Philadelphia, Pa
| | - Gabriela Sendek
- Division of Plastic Surgery, Department of Surgery, University of California San Diego, San Diego, Calif
| | - Lynn Jeffers
- St. John’s Pleasant Valley Hospital, Camarillo, Calif
| | - Camille Cash
- Camile Cash MD Aesthetic Plastic Surgery, Houston, Tex
| | - Donald Mackay
- Department of Surgery, Penn State Health, Hershey, Pa
| | - Paris D. Butler
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn
| | - Amanda A. Gosman
- Division of Plastic Surgery, Department of Surgery, University of California San Diego, San Diego, Calif
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15
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Reghunathan M, Thompson N, Sendek G, Butler PD, Reid CM, Gosman AA. A Practical Guide to Implementing Holistic Review during Surgery Resident Selection. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5459. [PMID: 38098951 PMCID: PMC10721126 DOI: 10.1097/gox.0000000000005459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/05/2023] [Indexed: 12/17/2023]
Abstract
Provider workforce diversity is a key component of improving healthcare quality and addressing healthcare disparities. Furthermore, the traditional approach of "score-centered" application metrics do not consistently correlate with meeting milestones in surgery, nor do they adequately predict a surgical resident's clinical strength and operative abilities. We present here an adaptable process by which surgical residency programs can identify their values and incorporate holistic review into their resident selection process to improve resident selection and physician workforce diversity.
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Affiliation(s)
- Meera Reghunathan
- From the Department of Surgery, Division of Plastic Surgery, UC San Diego, San Diego, Calif
| | - Noelle Thompson
- University of Toledo College of Medicine and Life Science, Toledo, Ohio
| | - Gabriela Sendek
- From the Department of Surgery, Division of Plastic Surgery, UC San Diego, San Diego, Calif
| | - Paris D Butler
- Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn
| | - Chris M Reid
- From the Department of Surgery, Division of Plastic Surgery, UC San Diego, San Diego, Calif
| | - Amanda A Gosman
- From the Department of Surgery, Division of Plastic Surgery, UC San Diego, San Diego, Calif
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16
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Gordon AM, Pulford C. Assessing the Finances of Applying to Surgical Residency in 2019-2020: A US Nationwide Surgical Specialties Comparison. J Grad Med Educ 2023; 15:558-563. [PMID: 37781430 PMCID: PMC10539139 DOI: 10.4300/jgme-d-23-00274.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 10/03/2023] Open
Abstract
Background The costs of applying to residency programs may affect which students choose to apply to a specialty, yet few studies have compared expenses of applying to different surgical specialties. Objective To compare individual and total expenses for applicants applying to 5 US surgical specialties during an in-person interview and recruitment period. Methods Post-match survey data from 2019-2020, from senior applicants of 123 of 141 (87.2%) US medical schools, to orthopaedic surgery (OS), neurological surgery (NS), urology (UR), plastic surgery (PS), otolaryngology (OTO) programs, was analyzed for applicant characteristics and mean application, away rotation, interview, and total expenses. Kruskal-Wallis H tests compared differences in costs between specialties. P values <.05 were significant. Results The survey data included 1136 applicants, representing a response rate of 27%, with 459 applicants to OS, 121 to NS, 191 to UR, 117 to PS, and 248 to OTO. Mean application costs were different among the specialties: OS, $1,990; NS, $1,711; UR, $1,570; PS, $1,638; and OTO, $1,612 (P≤.003). Mean interview expenses also differed: OS, $3,129; NS, $6,400; UR, $3,915; PS, $5,486; and OTO, $3,540 (P≤.001) as well as away rotation expenses: OS, $3,182; NS, $3,840; UR, $2,640; PS, $4,074; and OTO, $2,437 (P≤.029). Mean total costs were high and differed among specialties: OS, $8,205; NS, $11,882; UR, $8,207; PS, $10,845; and OTO, $7,516 (P≤.029). Conclusions Applying to surgical residencies in the pre-pandemic era was expensive, with mean costs over $10,000 for NS and PS. The largest contribution to total costs were interview expenses.
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Affiliation(s)
- Adam M Gordon
- is Master of Business Administration Student, Questrom School of Business, Boston University, and Orthopedic Surgery Resident, Department of Orthopaedic Surgery, Maimonides Medical Center; and
| | - Christopher Pulford
- is Urological Surgery Resident, Department of Urology, University of Michigan Health
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17
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Dzubara B, Bajestani N, Paras S, Min E, Sharma S, Katta J, Ueno C. A Systematic Review of the State of Preclinical Mentorship Programs in Plastic and Reconstructive Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5322. [PMID: 37817925 PMCID: PMC10561798 DOI: 10.1097/gox.0000000000005322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/24/2023] [Indexed: 10/12/2023]
Abstract
Background Plastic and reconstructive surgery is consistently one of the most competitive medical specialties in the match. The recent United States Medical Licensing Examination score reporting switch to pass-fail led to a change in metrics by which applicants are evaluated by plastic surgery programs. Applicant research productivity and the demand for plastic surgery mentorship will continue to rise. Given the competitive nature of the residency match and shift in metrics emphasis after the change in STEP 1 scoring, early exposure to plastic surgery and mentoring relationships are paramount to applicant success. However, most medical students are not exposed to plastic surgery until they begin clinical rotations. Methods A literature review of plastic surgery mentorship programs available during preclinical years was conducted to identify preclinical mentorship opportunities in plastic surgery. Sixty-eight references were identified, but only two studies met the inclusion criteria of addressing mentorship programs in preclinical years. Results Examination of the included studies indicated that preclinical medical students achieve self-identified goals and generate longitudinal benefits in plastic surgery by participating in early and focused mentorship programs. Conclusions The limited number of studies in this review highlights a lack of available, studied preclinical mentorship programs in plastic surgery and reveals a knowledge gap concerning the creation of successful preclinical mentorship programs. Early exposure to plastic surgery, combined with the development of structured preclinical mentorship programs, can potentially replicate successful outcomes seen in other surgical subspecialties' mentorship programs while addressing the lack of formalized mentorship opportunities for preclinical students in plastic surgery.
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Affiliation(s)
- Bryce Dzubara
- From The Ohio State University College of Medicine, Columbus, Ohio
| | - Nojan Bajestani
- From The Ohio State University College of Medicine, Columbus, Ohio
| | - Stephanie Paras
- From The Ohio State University College of Medicine, Columbus, Ohio
| | - Eric Min
- From The Ohio State University College of Medicine, Columbus, Ohio
| | - Shuchi Sharma
- From The Ohio State University College of Medicine, Columbus, Ohio
| | - Juhi Katta
- From The Ohio State University College of Medicine, Columbus, Ohio
| | - Cristiane Ueno
- Department of Plastic and Reconstructive Surgery, The Ohio State University, Columbus, Ohio
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18
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Wickenheisser VA, Biswas S, Marks C, Geng Y, Phillips BT. Defining Predictors of Future Academic Productivity in Plastic Surgery Residency. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5358. [PMID: 37850201 PMCID: PMC10578684 DOI: 10.1097/gox.0000000000005358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/11/2023] [Indexed: 10/19/2023]
Abstract
Background Research is a valued component of applications to plastic surgery residency. No prior studies have explored factors associated with increased resident research productivity. This study aims to compare the academic productivity levels of plastic surgery residency graduates based on their pre- and postresidency experiences. Methods Residents graduating in 2019 and 2020 were identified from integrated programs. Metrics collected included the number of publications in medical school and residency. Descriptive statistics were completed along with linear regressions to evaluate the impact of these on academic productivity. Results A total of 221 residents from the classes of 2019 and 2020 were included. Most residents completed fellowship (75.9%) although less than half went on to academic practice (42.3%). Approximately one in five residents obtained secondary degrees (17.4%). Subjects averaged 3.15 (N = 208, SD = 4.51) publications while in medical school and 8.1 publications during residency (N = 209, SD = 10.0). For h-index calculated at the end of residency, having dedicated medical school research time was the only statistically significant factor (coefficient = 2.96, P = 0.002). Conclusions Plastic surgery residents published more often as first authors and overall during residency than medical school, indicating increased research involvement and leadership. The present study builds upon prior studies by confirming the importance of dedicated medical school research time and its lasting impact. Understanding the associations of academic factors with increased research productivity in residency is relevant for both applicants and programs evaluating residency candidates.
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Affiliation(s)
- Victoria A. Wickenheisser
- From the Division of Plastic, Maxillofacial, and Oral Surgery, Duke University Hospital, Durham, N.C
| | - Sonali Biswas
- From the Division of Plastic, Maxillofacial, and Oral Surgery, Duke University Hospital, Durham, N.C
| | - Caitlin Marks
- From the Division of Plastic, Maxillofacial, and Oral Surgery, Duke University Hospital, Durham, N.C
| | - Yisong Geng
- From the Division of Plastic, Maxillofacial, and Oral Surgery, Duke University Hospital, Durham, N.C
| | - Brett T. Phillips
- From the Division of Plastic, Maxillofacial, and Oral Surgery, Duke University Hospital, Durham, N.C
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19
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Porras Fimbres DC, Zeng S, Phillips BT. Prevalence of International Medical Graduates in Integrated Plastic Surgery Programs. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5140. [PMID: 37577252 PMCID: PMC10419534 DOI: 10.1097/gox.0000000000005140] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/12/2023] [Indexed: 08/15/2023]
Abstract
International medical graduates (IMGs) are physicians who did not attend medical school in the USA or Canada. IMGs comprise nearly one-quarter of the physician workforce and play a vital role in health care. Here, we aimed to identify the prevalence of IMGs in integrated programs and evaluate factors that influence their success in the residency match. Methods The annual match reports from 2010 to 2020 were retrieved and summarized. Electronic surveys for program directors and program coordinators were distributed to US integrated plastic surgery programs. Each program's website was appraised for information regarding the eligibility of IMGs. Websites were also used to identify the number of IMG residents. Results The number of applicants who matched into integrated programs ranged from 69 to 180 per year, of which US applicants comprised 61-165. US IMGs filled one to three positions per year, whereas non-US IMGs filled two to seven. Although 48% of programs have matched non-citizen IMGs and 79% have not encountered difficulties during the visa process, 67% of coordinators reported that the onboarding process is more challenging for IMGs. There are no IMGs in 52% of programs, and most institutions offer information on their website regarding visa sponsorship. Conclusion IMGs make up less than 10% of filled positions per cycle. Although most programs accept IMGs, a small number matriculate. This may be explained by the competitiveness of integrated programs and the volume of IMG applications. Further research is needed to identify contributing factors of low IMG representation in plastic surgery programs.
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Affiliation(s)
| | - Steven Zeng
- From the Department of Medicine, Duke University School of Medicine, Durham, N.C
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20
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Nguyen M, Kaminaka A, Brutus NN, Gonzalez LA, Ratanpal A, Alperovich M, Jeffe DB, Ata A, Mason HRC, Butler PD. Changing Faces: Factors Associated with the Intention to Pursue Plastic Surgery and Practice in Underserved Areas. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5177. [PMID: 37577250 PMCID: PMC10419697 DOI: 10.1097/gox.0000000000005177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/22/2023] [Indexed: 08/15/2023]
Abstract
Improving the number of plastic and reconstructive surgeons who provide care to patients in underserved communities is critical to achieving health equity. We aimed to identify factors associated with graduating medical students' intentions to pursue plastic surgery and practice in underserved areas. Methods De-identified data for US medical school graduates were obtained from the Association of American Medical Colleges for students who matriculated in academic years 2007-2008 and 2011-2012. Data collected included self-reported demographic and future practice intentions. Multivariate analysis was conducted to determine indicators of students' interest in plastic surgery, and their intention to practice in underserved areas. Results Of the 57,307 graduating US medical students in our cohort who completed the Graduation Questionnaire, 532 (0.9%) reported an intention to pursue plastic surgery. Hispanic [adjusted odds ratio (aOR): 1.45; 95% confidence interval (95% CI), 1.07-1.98] and multiracial (aOR: 1.59; 95% CI, 1.03-2.45) students were more likely to pursue plastic surgery compared with other surgical specialties. Among students interested in plastic surgery, compared with non-Hispanic White students, Black (aOR: 6.15; 95% CI, 1.96-19.26) students were more likely to report intention to practice in underserved areas. Students with community-engagement experiences were more likely to report intention to practice in underserved areas. Conclusions Diversity among medical trainees pursuing plastic and reconstructive surgery is critical for maintaining and expanding plastic surgery services rendered in underserved areas. These findings suggest that student demographics and experiences with community-engagement experiences are positive indicators of practicing in underserved communities.
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Affiliation(s)
- Mytien Nguyen
- From the School of Medicine, Yale University, New Haven, Conn
| | | | | | | | | | - Michael Alperovich
- Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn
| | - Donna B. Jeffe
- Department of Medicine, Washington University School of Medicine, St. Louis, Mo
| | | | | | - Paris D. Butler
- Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn
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21
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Galbraith LG, Avasarala VS, Jinka SKA, Collar J, Prassinos A. Plastic Surgery Research Year: An Equalizer or Disparity? PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5102. [PMID: 37534109 PMCID: PMC10393079 DOI: 10.1097/gox.0000000000005102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/15/2023] [Indexed: 08/04/2023]
Affiliation(s)
- Logan G. Galbraith
- From the Northeast Ohio Medical University College of Medicine, Rootstown, Ohio
| | | | - Sanjay K. A. Jinka
- From the Northeast Ohio Medical University College of Medicine, Rootstown, Ohio
| | - John Collar
- Department of Plastic Surgery, Yale School of Medicine, New Haven, Conn
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22
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Weidman AA, Hernandez Alvarez A, Valentine L, Manstein SM, Comer C, Foppiani J, Sarac BA, Janis JE, Lin SJ. Workplace Bias Affecting Applicants to Independent Plastic Surgery Residencies. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5220. [PMID: 37744674 PMCID: PMC10516385 DOI: 10.1097/gox.0000000000005220] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/12/2023] [Indexed: 09/26/2023]
Abstract
Background This study explores factors that encourage residents to apply to independent plastic surgery residencies to gain insight into whether they faced bias as a result of this decision. Methods Resident applicants who applied to two academic independent plastic surgery residencies in 2021 and 2022 were emailed a survey consisting of 25 questions. Responses were collected anonymously and analyzed. Descriptive statistics were performed, and subgroup analyses were conducted with Fisher exact and Pearson χ2 testing. Results Thirty-nine complete responses were included for analysis (response rate 22.7%). Participants were asked what encouraged them to go into plastic surgery during residency. The most common reasons were scrubbing in on plastic surgery cases and interactions with plastic surgery faculty/residents, with each reason cited by 30 respondents (76.8%). Further, 20.5% of residents agreed or strongly agreed that they felt unsupported by their program director in their decision to apply into plastic surgery. Likewise, 64.1% of respondents agreed or strongly agreed to having experienced demeaning comments or jokes by faculty about their choice of plastic surgery. Consequently, 17.9% agreed or strongly agreed that they developed stress or anxiety due to how co-residents and/or faculty treated them regarding their decision to pursue plastic surgery. Conclusions General surgery residents planning to apply to independent plastic surgery residency may experience workplace biases related to their career decision. An important opportunity exists to support independent applicants and to provide mentorship.
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Affiliation(s)
- Allan A. Weidman
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass
| | - Angelica Hernandez Alvarez
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass
| | - Lauren Valentine
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass
| | - Samuel M. Manstein
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass
| | - Carly Comer
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass
| | - Jose Foppiani
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass
| | - Benjamin A. Sarac
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jeffrey E. Janis
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Samuel J. Lin
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass
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23
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Thomas HC, Chen S, Narisetti L, Janis JE, Perdikis G, Drolet BC. The Utility of the Plastic Surgery Standardized Letter of Recommendation Form in Predicting Residency Match Outcomes. JOURNAL OF SURGICAL EDUCATION 2023; 80:948-956. [PMID: 37150702 DOI: 10.1016/j.jsurg.2023.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/15/2023] [Indexed: 05/09/2023]
Abstract
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.
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Affiliation(s)
| | - Shirley Chen
- School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Lipika Narisetti
- College of Arts & Science, Vanderbilt University, Nashville, Tennessee
| | - Jeffrey E Janis
- Department of Plastic Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Galen Perdikis
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Brian C Drolet
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
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Rogers AE, Mantilla-Rivas E, Duarte-Bateman D, Manrique M, McGrath JL, Sohel Rana M, Oh AK, David LR, Janis JE, Rogers GF. Prevalence of Prohibited Questions during Plastic Surgery Residency Interviews. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5018. [PMID: 37325372 PMCID: PMC10263253 DOI: 10.1097/gox.0000000000005018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/03/2023] [Indexed: 06/17/2023]
Abstract
Despite rules set forth by the National Resident Matching Program and American Association of Medical Colleges (AAMC), prohibited questions during the residency interview process are well documented. This study describes the prevalence of these encounters by surveying residency applicants to integrated plastic and reconstructive surgery (PRS) programs for the 2022 match cycle. Methods An anonymous 16-question REDCap survey was distributed to 2022 cycle applicants of a single PRS program. The applicants were queried about demographic information, interview experience, and questions deemed illegal by the AAMC/NRMP guidelines. Results One hundred survey responses were attained for a 33.1% response rate. The majority of respondents were aged 26-30 (76%), women (53%), and white (53%); 33% received 15+ interviews for the application cycle. Seventy-eight percent of respondents reported being asked a prohibited question during at least one interview, with the most common "illegal" question categories being number/ranking of interviews (42%), marital status (33%), career balance (25%), and race/ethnicity (22%). Only 25.6% of applicants considered the subject matter inappropriate, whereas 42.3% were unsure. Although no applicant took action to report the potentially illegal scenarios, 30% said that their experiences influenced their rank list. Conclusions Our survey study revealed that prohibited interview questions in PRS residency interviews are common. Permissible lines of questioning and discussion between programs and applicants during residency interviews have been defined by AAMC. Institutions should provide guidance and training to all participants. Applicants should be made aware of and empowered to utilize available anonymous reporting tools.
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Affiliation(s)
- Ashley E. Rogers
- From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C
| | - Esperanza Mantilla-Rivas
- From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C
| | - Daniela Duarte-Bateman
- From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C
| | - Monica Manrique
- From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C
| | - Jennifer L. McGrath
- From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C
| | - Md Sohel Rana
- Joseph E. Roberts, Jr. Center for Surgical Care, Children’s National Hospital, Washington, D.C
| | - Albert K. Oh
- From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C
| | - Lisa R. David
- Department of Plastic and Reconstructive Surgery Wake Forest Baptist Medical Center Winston Salem, N.C
| | - Jeffrey E. Janis
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Gary F. Rogers
- From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C
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25
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Fijany AJ, Zago I, Olsson SE, Troia T, Givechian KB, Boctor MJ, Pekarev M. Recent Trends and Future Directions for the Integrated Plastic Surgery Match. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5053. [PMID: 37342307 PMCID: PMC10278693 DOI: 10.1097/gox.0000000000005053] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/13/2023] [Indexed: 06/22/2023]
Abstract
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.
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Affiliation(s)
- Arman J. Fijany
- From the Anne Burnett Marion School of Medicine, Texas Christian University, Fort Worth, Tex
| | - Ilana Zago
- From the Anne Burnett Marion School of Medicine, Texas Christian University, Fort Worth, Tex
| | - Sofia E. Olsson
- From the Anne Burnett Marion School of Medicine, Texas Christian University, Fort Worth, Tex
| | - Thomas Troia
- From the Anne Burnett Marion School of Medicine, Texas Christian University, Fort Worth, Tex
| | | | | | - Maxim Pekarev
- From the Anne Burnett Marion School of Medicine, Texas Christian University, Fort Worth, Tex
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Shaffrey EC, Moura SP, Wirth PJ, Attaluri PK, Schappe A, Edalatpour A, Bentz ML, Rao VK. Objective Residency Applicant Assessment Using a Linear Rank Model. JOURNAL OF SURGICAL EDUCATION 2023; 80:776-785. [PMID: 37012141 DOI: 10.1016/j.jsurg.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES Residency applicant assessment is imperfect, with little objectivity built into the process, which, unfortunately, impacts recruitment diversity. Linear rank modeling (LRM) is an algorithm that standardizes applicant assessment to model expert judgment. Over the last 5 years, we have used LRM to assist with screening and ranking integrated plastic surgery (PRS) residency applicants. This study's primary objective was to determine if LRM scores are predictive of match success and, secondarily, to compare LRM scores between gender and self-identified race categories. DESIGN Data was collected on applicant demographics, traditional application metrics, global intuition rank, and match success. LRM scores were calculated for screened and interviewed applicants, and scores were compared by demographic groups. Univariate logistic regression was used to evaluate the association of LRM scores and traditional application metrics with match success. SETTING University of Wisconsin, Division of Plastic and Reconstructive Surgery. Academic institution. PARTICIPANTS Six hundred seventeen candidates who applied to a single institution over 4 application cycles (2019-2022). RESULTS Using area under the curve modeling, LRM score was the most predictive indicator for match success. With every one-point increase in LRM score, there was an 11% and 8.3% increase in the likelihood of screened and interviewed applicant match success (p < 0.001). An algorithm was developed to estimate the probability of match success based on LRM score. No significant differences in LRM scores were appreciated for interviewed applicant gender or self-identified race groups. CONCLUSIONS LRM score is the most predictive indicator of match success for PRS applicants and can be used to estimate an applicant's probability of successfully matching into an integrated PRS residency. Furthermore, it provides a holistic evaluation of the applicant that can streamline the application process and improve recruitment diversity. In the future, this model could be applied to assist in the match process for other specialties.
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Affiliation(s)
- Ellen C Shaffrey
- Division of Plastic and Reconstructive Surgery, University of Wisconsin School of 11 Medicine and Public Health, Madison, Wisconsin
| | - Steven P Moura
- Division of Plastic and Reconstructive Surgery, University of Wisconsin School of 11 Medicine and Public Health, Madison, Wisconsin
| | - Peter J Wirth
- Division of Plastic and Reconstructive Surgery, University of Wisconsin School of 11 Medicine and Public Health, Madison, Wisconsin
| | - Pradeep K Attaluri
- Division of Plastic and Reconstructive Surgery, University of Wisconsin School of 11 Medicine and Public Health, Madison, Wisconsin
| | - Alyssa Schappe
- Division of Plastic and Reconstructive Surgery, University of Wisconsin School of 11 Medicine and Public Health, Madison, Wisconsin
| | - Armin Edalatpour
- Division of Plastic and Reconstructive Surgery, University of Wisconsin School of 11 Medicine and Public Health, Madison, Wisconsin
| | - Michael L Bentz
- Division of Plastic and Reconstructive Surgery, University of Wisconsin School of 11 Medicine and Public Health, Madison, Wisconsin
| | - Venkat K Rao
- Division of Plastic and Reconstructive Surgery, University of Wisconsin School of 11 Medicine and Public Health, Madison, Wisconsin.
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McGraw JR, Amro C, Niu EF, Honig SE, Broach RB, Fischer JP, Kovach SJ, Azoury SC. The Role of Dedicated Research Training in Promoting Academic Success in Plastic Surgery: Analysis of 949 Faculty Career Outcomes. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4996. [PMID: 37207243 PMCID: PMC10191581 DOI: 10.1097/gox.0000000000004996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/23/2023] [Indexed: 05/21/2023]
Abstract
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.
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Affiliation(s)
- J. Reed McGraw
- From the Division of Plastic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
| | - Chris Amro
- From the Division of Plastic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
| | - Ellen F. Niu
- From the Division of Plastic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
| | - Stephanie E. Honig
- From the Division of Plastic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
| | - Robyn B. Broach
- From the Division of Plastic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
| | - John P. Fischer
- From the Division of Plastic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
| | - Stephen J. Kovach
- From the Division of Plastic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
- Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
| | - Saïd C. Azoury
- From the Division of Plastic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
- Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
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Seaward JR, Carter LR, Nagarkar P, Zhang AY. Rating the Rater: A Technique for Minimizing Leniency Bias in Residency Applications. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4892. [PMID: 37101610 PMCID: PMC10125539 DOI: 10.1097/gox.0000000000004892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 02/03/2023] [Indexed: 04/28/2023]
Abstract
Each program in the highly competitive match for a surgical residency needs a way to review applicants effectively. Often this task is undertaken by individual faculty members, reviewing an applicant's file and assigning a score. Despite being asked to rate on a standardized scale, our program found that ratings of the same applicants varied dramatically, with certain faculty consistently scoring higher or lower than others. This is termed leniency bias, or the Hawk-Dove effect, and can affect who is invited to interview depending on which faculty are assigned to review an applicant's file. Methods A technique to minimize leniency bias was developed and applied to this year's 222 applicants for our plastic surgery residency. The effect of the technique was evaluated by comparing variance between ratings of the same applicants by different faculty before and after our technique. Results The median variance of ratings of the same applicants reduced from 0.68 before correction to 0.18 after correction, demonstrating better agreement between raters of the applicants' scores after our technique had been applied. This year, applying our technique affected whether or not 16 applicants (36% of interviewees) were invited for interview, including one applicant who matched to our program but who otherwise would not have been offered an interview. Conclusions We present a simple but effective technique to minimize the leniency bias between raters of residency applicants. Our experience with this technique is presented together with instructions and Excel formulae for other programs to use.
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Affiliation(s)
- James R. Seaward
- From the Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Tex
| | - Lillian R. Carter
- From the Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Tex
| | - Purushottam Nagarkar
- From the Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Tex
| | - Andrew Y. Zhang
- From the Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Tex
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29
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Wells MW, Deleonibus A, Kotha VS, Chang IA, Rampazzo A. Defining the Role of Resident Mentorship for Senior Medical Students in Sub-internship Selection in Plastic Surgery. JOURNAL OF SURGICAL EDUCATION 2023; 80:490-491. [PMID: 36646620 DOI: 10.1016/j.jsurg.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Michael W Wells
- Case Western Reserve University School of Medicine, Cleveland, Ohio.
| | - Anthony Deleonibus
- Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Vikas S Kotha
- Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Irene A Chang
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Antonio Rampazzo
- Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
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30
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Ruffolo AM, Sommer NZ, Neumeister MW. Strategies to Reduce Congestion in the Resident Match: What Can Plastic Surgery Learn from Other Specialties? PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4830. [PMID: 36936461 PMCID: PMC10017395 DOI: 10.1097/gox.0000000000004830] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/04/2023] [Indexed: 03/17/2023]
Abstract
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.
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Affiliation(s)
- Alexis M. Ruffolo
- From the Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, Ill
| | - Nicole Z. Sommer
- From the Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, Ill
| | - Michael W. Neumeister
- From the Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, Ill
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31
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Evolution of a Plastic Surgery Summer Research Program: Lessons Learned from Programmatic Evaluation and Quality Enhancement. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4785. [PMID: 36817275 PMCID: PMC9937103 DOI: 10.1097/gox.0000000000004785] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 11/21/2022] [Indexed: 02/19/2023]
Abstract
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.
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Yoon J, Major M, Khoo K, Gosman AA, Liang F, Steinberg JP, Lifchez SD. Differences in Applicant Perceptions of Virtual Interviews Between Integrated Plastic Surgery and Subspecialty Fellowship Applicants. JOURNAL OF SURGICAL EDUCATION 2023; 80:143-156. [PMID: 36050268 DOI: 10.1016/j.jsurg.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/03/2022] [Accepted: 08/07/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE We aim to survey and compare integrated plastic surgery and plastic surgery subspecialty fellowship applicants on their experiences with virtual interviews and to determine if there are differences between them. DESIGN An IRB-approved survey study was conducted using the Qualtrics platform. SETTING The study was conducted at the Johns Hopkins University and the R Adams Cowley Shock Trauma Center in Baltimore Maryland. PARTICIPANTS Applicants that applied to 1) the Johns Hopkins/University of Maryland or the University of California San Diego integrated plastic surgery residency programs, 2) craniofacial surgery fellowship, and 3) microsurgery, hand surgery, or burn surgery fellowship at the Johns Hopkins University were selected to participate in the survey. RESULTS A total of 94 surveys were completed by residency applicants and 55 by fellowship applicants. After the interview season, 80% of fellowship applicants recommended virtual interviews compared to 61.7% of residency applicants (p = 0.03). Fellowship applicants reported significantly less issues with self-advocacy and did not view the virtual interview process as significant of a detriment when meeting program residents/staff, viewing the hospital/surrounding area, and learning about the program (p < 0.05). A higher percentage of fellowship applicants interviewed at multiple programs during a single day compared to residency applicants (56.4% vs 27.7%; p < 0.001). CONCLUSIONS A higher proportion of fellowship applicants prefer virtual interviews, which associated with key differences in perceptions, expectations, and priorities. Our data supports that fellowship programs may wish to continue virtual interviews even after COVID-related restrictions are lifted, because fellows are equally able to self-advocate in a virtual format while benefiting from cost and time savings; fellowship programs would also gain the cost and time savings from this model as well.
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Affiliation(s)
- Joshua Yoon
- Division of Plastic, Reconstructive & Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, Maryland; Department of Surgery, George Washington University Hospital, Washington, District of Columbia
| | - Melanie Major
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Kimberly Khoo
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Amanda A Gosman
- Division of Plastic Surgery, University of California San Diego School of Medicine, San Diego, California
| | - Fan Liang
- Division of Plastic, Reconstructive & Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, Maryland
| | - Jordan P Steinberg
- Division of Plastic Surgery, Nicklaus Children's Hospital, Miami, Florida
| | - Scott D Lifchez
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland.
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The Virtual Interview Experience: Advantages, Disadvantages, and Trends in Applicant Behavior. Plast Reconstr Surg Glob Open 2022; 10:e4677. [PMID: 36438459 PMCID: PMC9681621 DOI: 10.1097/gox.0000000000004677] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/22/2022] [Indexed: 01/25/2023]
Abstract
UNLABELLED Residency programs and applicants were forced to hold virtual interviews during the 2020-2021 application cycle. Inability to evaluate a program and/or applicant in person has intangible drawbacks. However, there are obvious advantages: cost, convenience, and comfort. Do the advantages outweigh the disadvantages? How have applicant behaviors changed to learn about programs in a virtual-only interview process? METHODS A survey was distributed to 302 applicants to a single plastic surgery residency program during the 2020 application cycle. Demographics, social media presence and utilization, and experience with the virtual application and interview process were analyzed. A 2018 survey from our institution was compared with a subset of questions for longitudinal analysis. RESULTS Seventy-six respondents (25.2%) completed the survey. Most applicants (88.2%) spent less than $1000 during the interview and application cycle. Over half (56.6%) did not receive letters of recommendation from outside their home program. A significant minority (27.6%) of applicants attended more than one interview in a single day. Compared to 2018, applicants in 2021 were significantly more likely to access alternative digital resources (forums/discussion boards, social media, and podcasts) when learning about programs. Average number of interviews remains in the range of pre-COVID studies, but the percentage of interviews attended increased. CONCLUSIONS Applicants spent substantially less money on interviews and relied on alternative digital sources to learn about residency programs. This study objectively quantifies the advantages of virtual interviews. Disadvantages include inability to assess "fit" and lack of nonverbal communication.
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Kebede S, Marxen T, Om A, Bakayoko N, Losken A. COVID-19 and the Integrated Plastic Surgery Match: An Update on Match Trends by Applicant Location. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2022; 10:e4527. [PMID: 36172061 PMCID: PMC9512139 DOI: 10.1097/gox.0000000000004527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022]
Abstract
COVID-19 significantly impacted the residency match process. Away rotations and in-person interviews were canceled in 2021, resulting in a geographic shift in integrated plastic surgery match results. Although several of these limitations were lifted during the 2022 cycle, the resulting geographic outcomes have yet to be described. This study aims to determine whether the changes seen during the previous cycle persisted despite loosened restrictions. Methods Integrated plastic surgery match results and applicants' home institutions from the 2022 match cycle were determined using publicly available data. Geographic data from this cycle were then compared with pre-COVID-19 match cycles (2016-2020) and the COVID-19-affected 2021 match cycle. Results Eighty percent (n = 68) of US integrated plastic surgery programs were included in this study. In 2022, 18.42% of applicants matched at their home institution compared with 25.12% in 2021. There was no significant difference in home, state, or regional match rates between 2022 and the five cycles preceding the pandemic (2016-2020). Combining these data to reflect the non-COVID-19-affected cycles (2016-2020 and 2022) and comparing to the COVID-19-affected cycle (2021), a significant difference in rates of home matches (P = 0.0395) was identified. Conclusions A significant increase in home institution match rates was not noted during the 2022 cycle. This return to pre-COVID-19 rates is likely attributed to the loosening of restrictions and more opportunities for interaction between applicants and programs outside of their home institution.
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Affiliation(s)
- Sara Kebede
- From the Emory University School of Medicine, Division of Plastic and Reconstructive Surgery, Atlanta, Ga
| | - Troy Marxen
- From the Emory University School of Medicine, Division of Plastic and Reconstructive Surgery, Atlanta, Ga
| | - Anjali Om
- From the Emory University School of Medicine, Division of Plastic and Reconstructive Surgery, Atlanta, Ga
| | - Ngafla Bakayoko
- Morehouse School of Medicine, Department of Surgery, Atlanta, Ga. Atlanta, GA 30322
| | - Albert Losken
- From the Emory University School of Medicine, Division of Plastic and Reconstructive Surgery, Atlanta, Ga
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