A Race with No End: Research Productivity Does Not Predict Residency Placement of Successful Plastic Surgery Applicants

Abstract

PURPOSE: Plastic surgery program directors heavily weigh research output when considering prospective applicants: 80% rate its importance as 4.2/5.0 on the Likert scale in determining whom to interview. According to the National Resident Matching Program student survey, U.S. allopathic seniors who matched into integrated plastic surgery programs in 2020 produced an average of 19.1 abstracts, presentations, and publications by the time of application submission. While many studies have explored the average number of publications for successful plastic surgery applicants, none have evaluated their predictive value in matching into highly ranked programs. Additionally, few studies have explored applicant qualities outside of research productivity that may predict residency placement. Therefore, the aim of this study is to identify factors that may provide predictive value for resident matriculation into reputable and research-focused plastic surgery programs. METHOD: Integrated plastic surgery interns between 2019-2021 were identified. Demographics such as attending a top 40 NIH-funded medical school, medical school affiliation with a top-quartile plastic surgery program (ranked by reputation), pre-residency publication count, and the quartile of their matriculating residency program rank were recorded. Univariate and multivariate logistic ordinal tests were used to identify the demographics that may predict matching into the top quartile of plastic surgery programs ranked by either program reputation or research output. These rankings were based on those provided by the Doximity Residency Navigator. RESULTS: A total of 509 interns across 78 programs were included. Despite an increasing yearly trend in the number of pre-residency manuscripts, multivariate analysis revealed that publication count did not significantly predict matching into a top plastic surgery program ranked by either reputation (OR 1.05 95% CI: 0.99 – 1.13; p=0.14) or research output (OR 1.01 95% CI 0.95 – 1.07; p=0.68). Attending a medical school affiliated with a top-quartile reputable plastic surgery program (OR 2.01 95% CI 1.21 – 3.34; p=0.007) and having top 40 NIH funding status (OR 2.16 95% CI 1.39 – 3.37; p<0.001) were significant predictors of placement into a top quartile reputable plastic surgery program. Attending a medical school within the top 40 NIH-funded institutions (OR 1.57 95% CI: 1.07 – 2.31; p=0.02) or one that is affiliated with a top-quartile reputable plastic surgery program (OR 2.50 95% CI: 1.56 – 4.03; p<0.001) also significantly predicted placement into a top quartile plastic surgery program based on research output. CONCLUSION: These findings suggest that applicants from lesser-funded medical schools are less likely to match into top quartile plastic surgery programs, and that pre-residency publication count may not be weighed as heavily as other factors. This is pertinent as students from lower-ranked medical schools may find it increasingly difficult to match into top programs now that USMLE Step 1 has transitioned to a pass/fail scoring system.