Abstract
BACKGROUND: Significant changes were made to the independent plastic surgery residency model in 2009–2010 that included full prerequisite training and increased from two to three years of independent residency. The authors sought to determine the subsequent impact on the match and predictors of a successful match at a highly regarded program METHODS: With American Council of Academic Plastic Surgeons (ACAPS) approval, the San Francisco Match provided data for the independent match (2010–2018). Applicant variables were analyzed to determine possible correlation with a successful match at a highly ranked program. RESULTS: Total independent applicants per cycle decreased 18% while foreign medical school applicants increased from 8% to 27%. Available positions decreased from 97 to 66 (32%) and match rate decreased to 78% from 82%. In 2010, 37% matched their top choice and 69% within their top 3; those numbers decreased to 32% and 62% in 2018, respectively. Matched applicants averaged more interviews (11.9 vs. 3.6, p<0.0001). By multivariate regression analysis, Step 1 scores 220–239 (OR 2.3, p=0.004), ≥ 240 (OR 3.9, p<0.0001), and Alpha Omega Alpha (AOA) membership (OR 2.2, 95% CI 1.1–4.4, p=0.03) were predictive of matching at a highly-ranked program. CONCLUSION: Since 2010, independent plastic surgery training has become less popular. Fewer applicants are matching at the top of their rank list. Factors predictive of a successful match at a highly ranked program include high Step 1 scores and AOA membership. Without changes to the independent curriculum, participation will continue to trend towards the integrated pathway.
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