Integrated Plastic Surgery Residency Research Articles

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

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. 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. 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. 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.

Are We Speaking the Same "Language" Regarding Underrepresented Groups in Plastic Surgery and Increasing Diversity Within Our Field?

Plastic Surgery is one of the fields that lags behind the rest when it comes to surgeons from backgrounds underrepresented in medicine (URiM). Extensive research has shown that diversity in health care not only fosters inclusivity but also saves lives. The study aim is to quantify how many integrated plastic surgery residency programs have outlined criteria defining diversity goals and/or groups of people they consider to be URiM. All American Council for Graduate Medical Education-accredited integrated plastic surgery program Web sites were reviewed for diversity missions/statements and explicit mentions of the racial and ethnic groups. Web sites were deemed "up-to-date" if they were last updated within 6 months before the initial data collection period. The data collection period was from November 20 to 29, 2022. A total of 86 program were reviewed. Only 8 programs (9%) had clear URiM criteria listed on their Web sites, whereas 26 (30%) relied on institution/department-wide criteria, 1 (1%) listed that they were adhering to American Association of Medical Colleges definition of URiM, and 51 programs (60%) had no form of definition for what is considered URiM. When looking at the programs that have some form of criteria for URiM (n = 35 [40%]), all programs (100%) considered African American/Black, Native American/Alaskan Native, Hispanic/Latinx, and Pacific Islander/Native Hawaiian as groups URiM. Assessing the same subset of programs that have a form of criteria listed (n = 35 [40%]), 19 (58%) had listed other groups outside of race/ethnicity considered to be URiM for their program, and 14 (42%) programs did not. Fourteen programs (74%) considered LGBTQIA+ as a URiM group. There still is a great deal of heterogeneity among residency programs when it comes to identifying which medical students are URiM. Numerous plastic surgery organizations have placed diversity and inclusive excellence at the forefront of their agendas; however, it is critical that residency programs also actively align their efforts in an equitable and intentional way. This study serves to encourage residency programs to evaluate their mission toward diversity, equity, and inclusion and to spark discussion toward creating a clearer URiM definition to be consistent among all programs.

Socioeconomic Disparities in Research Participation: Bias in Plastic Surgery Residency Match.

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. 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. 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). 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.

Exploring Trends in Immediate Postresidency Career Paths: A Multi-year Analysis of Plastic Surgery Resident Graduates Across the United States.

Plastic surgery is one of the most diverse specialties in medicine. Because of the competitiveness of plastic surgery residency, applicants are entering the field with increased experience and more developed interests in specific specialties. Programs and prospective applicants may find it beneficial to know trends in the career paths of recent graduates. To identify trends in postresidency career paths for plastic surgery graduates. Data from all integrated plastic surgery residency programs were analyzed from 2013 to 2022. Eighty-eight residency programs were analyzed for review. Residency websites were the primary source of data. Postresidency career paths were categorized into subspecialty fellowships, academic practice, or private practice. Secondary data included program rank, size of the program, associated fellowship program, associated independent program, and program location. Seventy-three programs met the inclusion criteria. Private practice was the most common immediate postgraduation path. Microvascular and aesthetic fellowships demonstrated maximum growth in the last 10 years, followed by hand fellowships. Programs ranked in the top 25 by Doximity reputation were significantly associated with graduates going into craniofacial (P = .05) and microvascular fellowship (P = .021), and immediate academic practice (P = .011). Lower-ranked programs were correlated with higher levels of graduates entering directly into private/community hospital practice (ρ = 0.327). Life after residency is a necessary consideration for training physicians. Understanding trends in postresidency career paths could help programs and prospective applicants make more informed decisions on what programs may offer the best opportunities to pursue their desired career path.

Evaluating Diversity Promotion on Integrated Plastic Surgery Residency Program Websites and Instagram Accounts.

Medical students applying to residency, including those from underrepresented groups, strongly value cultural fit and program diversity. Program websites and social media are thus an influential information source for prospective applicants and recruitment tool for residencies. We evaluated whether and how integrated plastic surgery residency program websites and social media display commitments to diversity online. We evaluated program websites for 8 predetermined diversity elements, (1) nondiscrimination and (2) diversity statements, (3) community resources, (4) faculty and (5) resident biographies, (6) faculty and (7) resident photographs, and (8) resident resources, and assessed Instagram accounts for diversity-related images, captions, and hashtags. Our analysis used Mann-Whitney U, chi-squared, and t tests; significance level was P < 0.05. We reviewed 82 program websites with a mean of 3.4 ± 1.4 diversity elements. Resident (n = 76, 92.7%) and faculty photographs (n = 65, 79.3%) and resident biographies (n = 43, 52.4%) were the most common. Seventy programs (85.4%) had Instagram accounts, the majority of which (n = 41, 58.6%) shared content related to diversity in race, ethnicity, gender, and/or sexual orientation. Programs located in smaller cities were more likely to have ≥4 website diversity elements (P = 0.014) and mention diversity on Instagram (P = 0.0037). Programs with women chairs/chiefs were more likely to mention diversity on Instagram (P = 0.007). In the age of virtual recruitment, program websites and social media should provide sufficient information, described in our diversity element checklist, to help prospective applicants determine fit from a diversity perspective. Residents, who often contribute to program social media, and women chairs/chiefs may be critical to driving diversity promotion.

A Review of Medical Student First-Author Publications in Plastic Surgery.

The integrated plastic surgery residency match is a highly competitive process.If performed wisely, medical research is an opportunity to differentiate applications from peers, and productivity is closely evaluated by residency programs.In this study, the authors aimed to characterize medical student research productivity for integrated plastic surgery residency programs and their respective medical schools. To this end, the authors performed a retrospective review of senior author publications from the 81 integrated plastic surgery programs from January 1, 2016, to December 31, 2020. The primary outcome was a publication with a medical student as the first author.Secondary outcomes included the number of faculty from each program, the geographic region of the program, and the ranking of associated medical schools. It was found that the average number of medical student first-author publications and faculty members per institution were 14.0 and 11.0, respectively.There was a positive correlation between the number of faculty members and several medical student first-author publications for a program (R = 0.54, P < 0.0001). The average number of medical student first-author publications was higher in the top 25 programs than for the remaining programs (P < 0.001), and most medical student first-author publications in the United States were produced by 10 plastic surgery programs. From these findings, it was concluded that these programs associated with higher-ranking medical schools produce greater numbers of medical student first-author publications.These analyses of medical student academic productivity should be a highly useful guide for current and future medical students as they strategize their successful match into plastic surgery.

Rise Above the Competition: How Do Plastic Surgery Residency Applicants with NCAA Experience Fare in the Residency Match?

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. This study aimed to evaluate the impact of participation in collegiate athletics on applicant anticipated rank and academic success. 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. After reviewing 885 applications, 61 applicants (6.89%) were former NCAA athletes. Former NCAA involvement was associated with the highest effect on anticipatedranking (- 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). 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 .

A 5-point framework for students evaluating plastic surgery research fellowship opportunities

An increasing number of medical students pursue research fellowships to enhance their odds of matching into an integrated plastic surgery residency program. 1 Keane C.A. Akhter M.F. Sarac B.A. Janis J.E. Characteristics of Successful Integrated Plastic Surgery Applicants from US Allopathic Medical Schools without a Home Integrated Program. J Surg Educ. 2022; 79: 551-557https://doi.org/10.1016/j.jsurg.2021.11.002 Crossref Scopus (11) Google Scholar , 2 Pathipati A.S. Taleghani N. Research in Medical School: A Survey Evaluating Why Medical Students Take Research Years. Cureus. 2016; 8e741https://doi.org/10.7759/cureus.741 Crossref Google Scholar , 3 Mehta K. Sinno S. Thanik V. Weichman K. Janis J.E. Patel A. Matching into Integrated Plastic Surgery: The Value of Research Fellowships. Plast Reconstr Surg. 2019; 143: 640-645https://doi.org/10.1097/PRS.0000000000005212 Crossref PubMed Scopus (56) Google Scholar The American Council of Academic Plastic Surgeons (ACAPS) Job Board lists research fellowship positions for the following academic year from November to March annually. 4 American Council of Academic Plastic Surgeons . Job Board. Available at 〈https://acaplasticsurgeons.org/jobs/〉. Accessed January 16, 2023 Google Scholar Zimmerman et al. also developed a database of plastic surgery research fellowships and their requirements. 5 Zimmerman C.E. Humphries L.S. Taylor J.A. Equitable Access to Research Opportunities in Plastic Surgery: Development of a Research Fellowship Database. Plast Reconstr Surg. 2021; 148: 1087e-1088ehttps://doi.org/10.1097/PRS.0000000000008535 Crossref Scopus (1) Google Scholar As students select amongst these positions it may be difficult to identify one that matches their goals and interests. The following viewpoint describes a five-part framework of important concerns research year candidates should consider when seeking placement to ensure a high-yielding experience (Figure 1). This framework includes expressing interest to a specific program, attaining funding, maximizing research productivity, creating meaningful mentorship connections and improving skills as a future resident through clinical opportunities.

Recent Trends and Future Directions for the Integrated Plastic Surgery Match.

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

The Relationship between Plastic Surgery Residency Instagram Characteristics and Doximity Rank

Background: Social media provides unique insight into the facilities, personnel, and culture of plastic surgery residency programs. Applicants can gain a more holistic view of programs based on their social media accounts. This study aims to evaluate the relationship between the popularity of a program's Instagram account and the program's Doximity ranking and to investigate the factors which contribute to greater viewership, with a special focus on diversity. Methods: Using Doximity's 2021-2022 Residency Navigator, a list of all integrated plastic surgery residency programs was obtained, and their social media accounts were documented. Instagram accounts were analyzed for metrics, post content, and website links. A 15-month period of posts was analyzed, then grouped into eight categories. Diversity was assessed using average Fitzpatrick skin type for each post containing photographs of people. Results: Of the 88 programs, 85 (96.6%) had an Instagram account at the time of analysis. Analysis of Instagram post content found that personnel and social function posts had significantly more likes than other categories. Posts with average Fitzpatrick type greater than or equal to III also had significantly more likes. Linear regression demonstrated a positive relationship between higher Doximity rank and number of followers; however, there was no clear relationship between rank and posts per week or engagement score. Conclusions: Plastic surgery social media accounts may make a positive impact on followers. It is important to understand the factors that can increase engagement and broaden viewership. Tailoring posts based on content popularity and highlighting diversity may help to accomplish these goals.

30. Rise Above the Competition: How Do Plastic Surgery Residency Applicants with NCAA Experience Fare in the Residency Match?

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. 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 exam 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 (-0.22, p= 0.001) rank. Former NCAA involvement demonstrated the highest odds of receiving an anticipated ranking in the top 5 (OR 2.05, p=0.01). 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%) athlete applicants identifying as Caucasian, while 430 (56.5%) 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.

Impact of ACAPS Coordinated Interview Release Policy: Applicant and Program Attitudes, Adherence, and Interview Trends.

The authors studied the impact of a new, coordinated interview release date for integrated plastic surgery residencies. A cross-sectional study of all 2020 integrated plastic surgery residencies and applicants was performed. Voluntary, anonymous surveys were administered following implementation of the interview policy. Program response rates were 55.6% for the initial survey and 57.1% for the follow-up survey. Programs released an average of 2.1 (95% CI, 1.8 to 2.4) rounds of interview invitations and invited 39.0 (95% CI, 35.3 to 42.6) applicants to interview. Policy adherence was high (91.1%). Most programs believed the interview policy was an improvement for applicants (46.5% yes; 9.1% no) and programs (41.9% yes; 27.0% no). Median rank of matched candidates was 13, and 55.1% of programs matched candidates within the top quartile of their rank list. The average candidate applied to 72 programs, attended 11 interviews, and ranked 12 programs. Interview distribution was bimodal, with peaks at six and 15 total interview invitations. Applicants within the top fifth, tenth, and fifteenth percentile for total interview invites disproportionately accounted for 15.3%, 26.6%, and 36.5%, respectively, of all invitations received. Survey data suggested applicant satisfaction with travel planning, improved scheduling, and cost savings following implementation of the interview policy. Applicants were somewhat dissatisfied with interview distribution. A coordinated interview release date is facile to adopt and does not adversely impact program interview trends or match rates. Applicants benefit from improved scheduling, travel planning, and cost savings; however, interview distribution continues to favor top-tier candidates.

Master's Degrees Among Academic Plastic Surgeons and Plastic Surgery Residents: What Are the Trends?

As more plastic surgery clinicians pursue advanced degrees and strive to become stronger physician-scientists, an objective understanding of how such degrees influence careers becomes important. We hypothesized that having a master's degree is associated with higher scholarly activity, research funding, academic progression, and leadership appointments. Accreditation Council for Graduate Medical Education-accredited integrated plastic surgery residency program Web sites were queried to create a data set of current academic plastic surgeons (APSs) and plastic surgery residents (PSRs). Scholarly metrics such as publications, citations, and H-indices were extracted from the Scopus database. National Institutes of Health and Plastic Surgery Foundation funding information was collected through their respective Web sites. Our cohort comprised 799 APSs and 922 PSRs, of whom 8% and 7.4%, respectively, had at least one master's degree. Academic plastic surgeons with master's of public health degrees had a significantly higher median number of publications and citations than APSs without a master's of public health. There was no association between any master's degree and academic rank or being a department chairman or program director. Academic plastic surgeons with master of science degrees were more likely to receive National Institutes of Health grants. Among PSRs, master's of science graduates had a higher median number of publications. Other master's degrees did not significantly influence scholarly productivity or funding. Certain master's degrees had an impact on scholarly productivity, with no significant effect on academic rank or leadership positions. The value of master's degrees in programs focusing on healthcare management, leadership skills, and business acumen likely extends beyond the scope of this study.

Research Productivity of Integrated Plastic Surgery Residents: Does Reputation Matter?

It is unknown whether the ranking of plastic surgery residency programs influences resident research output. This study aims to determine whether program reputation and other factors are associated with integrated plastic surgery resident academic productivity. Programs were divided into four tiers based on Doximity reputation rankings. Residents from 2019 to 2020 were found through program websites and social media accounts. Works published during residency were identified through PubMed and Scopus from July 1 of each resident's intern year to August 10, 2020. Variables included resident demographics and medical school, residency reputation ranking, geographic region, and medical school affiliation. 'High research output' was defined as having ≥75th percentile of publications adjusted by training year. In total, 921 residents in 80 programs were identified. The median (IQR) number of total publications and original articles was 3 (1-6) and 2 (0-4), respectively. On multivariable analysis, residents in top-20 ranked programs (OR=2.31, 95% CI [1.55; 3.43], P<0.001) or from programs associated with top-20 medical schools (OR=1.61, 95% CI [1.08; 2.41], P=0.020) were more likely to have higher research output. On the other hand, coming from a top-50 in research medical school (OR=1.80, 95% CI [1.31; 2.47], P<0.001) or being in a program affiliated with a top-20 medical school (OR=2.52, 95% CI [1.69; 3.78], P<0.001) were associated with higher original article output. Gender and geographic location were not associated with higher research output. Program reputation and affiliated medical school research rankings are associated with research productivity during integrated plastic surgery residency. Applicants with a particular interest in research careers may consider this as they apply to residency.

Evaluating the Importance of Sub-Internships on the 2022 Integrated Plastic Surgery Match During Continued COVID-19 Regulations

ObjectiveFollowing the 2021 integrated plastic surgery match, we found a significant increase in home match rates and decrease in match rate for students without a home plastic surgery program with the elimination of visiting sub-internships and the initiation of virtual interviewing. With the return of visiting sub-internships in the 2022 match cycle, we hypothesize that these rates will approach values more consistent with historical controls.DesignProgram match data was obtained from posts to residency program Instagram pages and posts associated with the hashtag #PRSMatch2022. Data on visiting sub-internship matches was obtained from a publicly available Google Sheet with applicant contributors. The Chi square test was used to assess for differences.SettingMedical schools and plastic surgery programs were categorized into west, midwest, south, and northeast regions.ParticipantsMatched applicants to integrated plastic surgery residency programs.ResultsIn total, 192 of 194 (99%) of applicants matched to integrated plastic surgery residency positions were identified. The match rate for applicants without an affiliated plastic surgery program (31.3%) increased from 2021 (p = 0.03) and returned to a level consistent with historical controls (p = 0.38). Similarly, the home program match rate (15.1%) and match rate for applicants from Top 40 medical schools (34.2%) decreased from 2021, returning to pre-pandemic levels (p = 0.63, p = 0.12). Finally, regional match preferences remained generally consistent with historical controls, apart from a higher proportion of northeast applicants matching to programs in the northeast (72.5%, p = 0.04), and a lower proportion of west applicants matching to programs in the west (26.3%, p = 0.002).ConclusionsThe 2022 integrated plastic surgery match cycle saw a reversal of many of the changes to match rates seen in the 2021 cycle. These changes may be due to the reintroduction of visiting sub-internships following updates in COVID-19 policies.

QS36. A Comprehensive Review of Medical Student First Author Publications in Plastic Surgery

Purpose: The integrated plastic surgery residency match is a highly competitive process. If performed wisely, medical research is an opportunity to differentiate application from peers, and productivity is closely evaluated by residency programs. In this study, we aimed to characterize medical student research productivity for integrated plastic surgery residency programs and their respective medical schools. Methods: A retrospective review of senior author publications from the 81 integrated plastic surgery programs from January 1, 2016 to December 31, 2020 was performed. The primary outcome was publication with a medical student as the first author. Secondary outcomes included number of faculty from each program, geographic region of program, and ranking of associated medical school. Results: The average number of medical student first author publications and faculty members per institution were 14.0 and 11.0, respectively. There was a positive correlation between number of faculty members and number of medical student first author publications for a program (R = 0.54, p < 0.0001). The average number of medical student first author publications was higher at top 25 programs than for the remaining programs (p < 0.001). Conclusions: Most medical student first author publications in the United States are produced by 10 plastic surgery programs. Programs associated with higher ranking medical schools produce greater numbers of medical student first author publications. These analyses of medical student academic productivity should be a highly useful guide for current and future medical students as they strategize their successful match into plastic surgery.

A Descriptive Analysis of Integrated Plastic Surgery Residency Program Directors in the United States.

The role sex plays in surgical leadership positions is heavily discussed in the literature; however, there is an absence of research looking at plastic surgery program director (PD) demographics and the differences between male and female PDs. A cross sectional study of publicly available online resources of all integrated plastic surgery residency programs was performed. Demographic and academic data of integrated plastic surgery PDs was analyzed focusing on the differences in PDs based on sex. Eighty-two integrated plastic surgery residencies were analyzed. Fifteen PDs (18.3%) were female. Fifty-six (68%) PDs completed general surgery residencies, whereas 24 (29%) completed an integrated plastics residency. All female PDs were fellowship trained, whereas only 46 (68%) male PDs pursued additional training after residency ( P = 0.02). Research output among male PDs was greater with 49.9 publications and a higher average H-index, at 13.3, compared with women with an average of 27.5 publications ( P = 0.008) and an H-index of 8.7 ( P = 0.02). When comparing male to female PDs, there was no difference between age at PD appointment ( P = 0.15), or in the amount of time between completion of plastic surgery training to PD appointment ( P = 0.29). Male PDs were older (52.2) compared with female PDs (46.5) ( P = 0.02). Male PDs served longer terms (4.98 years) than female PDs (2.87 years) ( P = 0.003). The majority of integrated plastic surgery PDs are men with a Doctor of Medicine degree who completed a general surgery residency and a plastic surgery fellowship. Most PDs also completed fellowship in a plastic subspecialty. Male PDs had higher research output, which may be attributed to their older age on average. Although women make up only 18.3% of plastic surgery PDs, this percentage is similar to the 17.2% of active female plastic surgeons in the United States. As more women train in plastic surgery, it is possible that the percentage of women serving academic leadership roles will increase. By gaining a better understanding of the demographics and diversity in plastic surgery residency program leadership, efforts can be made to increase the representation of minority groups in academic leadership roles.

2. A Descriptive Analysis of Integrated Plastic Surgery Program Directors

Background: The role gender plays in surgical leadership positions is heavily discussed in the literature, however there is an absence of research looking at plastic surgery program director (PD) demographics and the differences between male and female PDs. Methods: A cross sectional study of publicly available online resources of all integrated plastic surgery residency programs was performed. Demographic and academic data of integrated plastic surgery PDs was analyzed focusing on the differences in PDs based on gender. Results: 82 integrated plastic surgery residencies were analyzed. 15 PDs (18.3%) were female. 56 (68%) PDs completed general surgery residencies, while 24 (29%) completed an integrated plastics residency. All female PDs were fellowship trained while only 46 (68%) male PDs pursued additional training after residency (p=0.02). Research output amongst male PDs was greater with 49.9 publications and a higher average H-index, at 13.3, compared to women with an average of 27.5 publications (p=0.008) and an H-index of 8.7(p=0.02). When comparing male to female PDs, there was no difference between age at PD appointment (p=0.15), or in the amount of time between completion of plastic surgery training to PD appointment (p=0.29). Male PDs were older (52.2) compared to female PDs (46.5) (p=0.02). Male PDs served longer terms (4.98 years) than females (2.87 years) (p=0.003). Conclusion: The majority of integrated plastic surgery PDs are male with an M.D. who completed a general surgery residency and a plastic surgery fellowship. Most PDs also completed fellowship in a plastic subspecialty. Male PDs had higher research output, which may be attributed to their older age on average. Although females make up only 18.3 % of plastic surgery PDs, this percentage is similar to the 17.2% of active female plastic surgeons in the U.S. As more women train in plastic surgery, it is possible that the percentage of females serving academic leadership roles, will increase. By gaining a better understanding of the demographics and diversity in plastic surgery residency program leadership, efforts can be made to increase the representation of minority groups in academic leadership roles.

Cancellation of the United States Medical Licensing Examination Step 2 Clinical Skills: How Will This Affect International Medical Graduates Applying to Integrated Plastic Surgery Residency Programs?

Cancellation of the United States Medical Licensing Examination Step 2 Clinical Skills: How Will This Affect International Medical Graduates Applying to Integrated Plastic Surgery Residency Programs?

Changing Dynamics in Medical Education during COVID-19 Pandemic: Are Integrated Plastic Surgery Programs Adapting for Residency Applicants?

The coronavirus disease of 2019 (COVID-19) pandemic drastically changed the 2020 to 2021 residency application process.1 The American Association of Medical Colleges released recommendations against visiting rotations and in-person interviews. Traditionally competitive fields, including plastic surgery, strongly encouraged students to participate in visiting rotations, which offer students an opportunity to network broadly, experience the specialty outside their own school’s department, and learn about different residency training programs.1,2 Loss of in-person evaluations may impact programs’ assessments of applicants and applicants’ impressions of programs. In this article, we describe how integrated plastic surgery programs adapted for the 2021 application cycle by developing a social media presence and implementing virtual opportunities. An official list of accredited integrated plastic surgery residency programs was obtained from the Electronic Residency Application Service, identifying 82 programs. All programs were included and reviewed for the presence of departmental and residency Twitter, Instagram, and Facebook accounts. Platforms, program websites, and the American Council of Academic Plastic Surgeons website were reviewed for posts regarding virtual subinternship and open house opportunities. The Visiting Student Application Service website was reviewed for virtual subinternship opportunities. All data were collected on September 9, 2020. Social media presence and virtual opportunities are profiled in Tables 1 and 2. In total, 138 social media accounts were identified, 65 programs (80 percent) had an online presence on either Twitter, Instagram, or Facebook, and 12 (15 percent) had a presence on all three platforms. Table 1. - Social Media Characteristics of Integrated Plastic Surgery Programs: Ownership and Creation Date of Program Social Media Accounts Program Characteristics No. of Accounts (%) No. Established before 2020 (%) No. Established after 2020 (%) Twitter Departmental Twitter 27 (33%) 23 (85%) 4 (15%) Residency Twitter 4 (4%) 4 (100%) 0 (0%) Instagram Departmental Instagram 22 (27%) 21 (96%) 1 (4%) Residency Instagram 49 (60%) 38 (78%) 11 (22%) Facebook Departmental Facebook 30 (37%) 28 (93%) 2 (7%) Residency Facebook 6 (7%) 5 (83%) 1 (17%) Table 2. - Social Media Characteristics of Integrated Plastic Surgery Programs: Number of Programs with Open House and Subinternship Opportunities Program Characteristics Twitter Instagram Facebook Programs with open house opportunities on social media, no. 10 (12%) 36 (44%) 6 (7%) Programs with virtual subinternship opportunities on social media, no. 2 (2%) 8 (10%) 1 (1%) Open houses were listed by 50 programs (61 percent) on American Council of Academic Plastic Surgeons and four program websites (5 percent). Instagram offered 88 total open house opportunities, and 17 programs (21 percent) posted more than one offering. Three virtual subinternships (4 percent) were identified through the Visiting Student Application Service website and none through American Council of Academic Plastic Surgeons or program websites. Two virtual subinternships listed on the Visiting Student Application Service website were not advertised on social media, and six virtual subinternships available on social media were not listed on the Visiting Student Application Service website. Hosting of virtual open houses appears to be the preferred method of outreach to applicants this year, adhering to COVID-19 social distancing recommendations and travel limitations. Open houses hosted by residency training programs may have increased impact over virtual subinternships, creating program diversity for applicants. The apparent lack of virtual subinternship standardization through an official American Association of Medical Colleges platform is novel, and we recommend exploration of program social media to elucidate opportunities. We anticipate that letters of recommendation from students’ home institutions and program director communication will play an enhanced role in the 2021–2022 residency application year. Almost all integrated plastic surgery residency social media accounts were made before 2020 (Fig. 1). Instagram is the preferred social media platform of integrated programs, supported by 2020 studies.3,4Fig. 1.: Date of social media account foundation.This article has limitations, including its retrospective nature. Data may be skewed due to the constantly changing social media platforms. In addition, the opening of departmental grand rounds, didactic conferences, and the like were not captured. Integrated plastic surgery residency programs adapted to the novel COVID-19 pandemic by creation of virtual open houses for applicants. Programs demonstrated minimal virtual subinternship opportunities. Instagram is the preferred social media outlet for integrated plastic surgery residencies. DISCLOSURE None of the authors has a financial interest in any of the products mentioned in this article. No funding was received for this article.