Proposed Solutions for Improving the Plastic Surgery Residency Application Process.

Abstract

Integrated plastic surgery residency programs have historically utilized a combination of objective measures, such as United States Medical Licensing Examination scores and research experience, and subjective measures, including performance on away rotations and letters of recommendation, to select applicants to interview.1 The 2019 National Resident Matching Program applicant survey reported applicants from U.S. allopathic medical schools who matched applied to a median of 76 programs, received 21 interview offers, and attended 15 interviews.2 Due to the coronavirus disease of 2019 pandemic, in-person away rotations were canceled and interviews became virtual. These changes occurred across all specialties, and the consequences of these necessary changes are becoming apparent as we move through this interview season. The American College of Surgeons recently described the potential for a crisis in the surgery match this year secondary to the low number of virtual interview cancellations.3 The Association of American Medical Colleges also issued a letter voicing concern over the distribution of interview invitations, suggesting that students with a surplus of interviews release invites and program directors rank more applicants than prior years to successfully fill spots.4 We fear this pattern may also be occurring in the integrated plastic surgery application cycle. Due to these changes, we anticipate a select number of applicants with exceptional objective statistics will receive the majority of interview invites, while qualified applicants without a home plastic surgery program, applicants without optimal curriculum vitae, or applicants who decided on plastics later in medical school are forced to scramble for interview spots. In addition, applicants are more likely to schedule and attend more interviews due to minimal geographical or financial limitations, fewer time constraints, and increased uncertainty associated with this application cycle.5 Applicants who believe they need a higher number of interviews to successfully match this year are unlikely to cancel interviews to programs they are not interested in, preventing others from interviewing. Programs may not have students from moderately ranked schools or students without well-known plastic surgery programs on their radar, disincentivizing them to offer interviews to applicants from these schools.3 A higher than anticipated number of applications may increase the difficulty of holistically reviewing all applicants without utilizing common objective cutoffs. We will not be able to determine the effects of the changes to the application season until after the match. However, this match crisis only highlights longstanding structural defects in the application cycle, and we see this as an opportunity for change. As the 2021/2022 season may also be virtual, we recommend implementing several changes to ensure that program positions do not go unfilled: Limiting the number of programs to which applicants can apply. Limiting the number of interviews applicants can attend. Using the Electronic Residency Application Service scheduling platform to ensure that applicants and programs are following guidelines. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article. No funding was received for this article.