Plastic Surgery Match Research Articles

Evaluation of National Resident Matching Program and Electronic Residency Application Service Data in the Integrated Plastic Surgery Match.

The National Resident Matching Program and Electronic Residency Application Service provide data for tracking trends among applicants in each specialty over the past 5 years. The purpose of this study was to examine this information and determine sex and race/ethnicity distribution over the past 5 years. The National Resident Matching Program and Electronic Residency Application Service databases were surveyed for trends in the following categories: number of positions, number of applicants, percent of applicants per position, and number of applicants by sex and self-identified race/ethnicity. This information was analyzed graphically for visual representation of the changes in the field. While there has been a steady increase in number of positions offered, there has also been a significant decrease in number of applicants, resulting in an increase in number of positions offered per applicant. While female and Asian applicants have increased in number, rates of applications from other diverse groups have remained stagnant. The number of plastic surgery positions offered has increased, whereas the number of applicants has decreased, resulting in a reduction in the number of applicants per position. Lack of racial diversity remains a significant issue in the applicant pool.

The Association between Away Rotations and Rank Order in the Integrated Plastic Surgery Match.

Given the competition in the integrated plastic surgery Match, away rotations are ubiquitous among plastic surgery applicants to differentiate their applications. This study aimed to characterize how performing an away rotation affects rank order and Match outcomes for integrated plastic surgery programs. An online survey was designed and distributed to the top 25 integrated plastic surgery programs in the United States as determined by Doximity. Programs were polled about away rotation structure, position of rotators on their 2018 to 2019 rank list, and composition of current resident classes. Twenty-five programs completed the survey (response rate, 100 percent). On average, programs interviewed 34.9 applicants (range, 22 to 50 applicants) and ranked 32.8 applicants (range, 10 to 50 applicants). Most "ranked-to-match" positions were occupied by home students or away rotators (60.9 percent). Rank order of home students, away rotators, and nonrotators varied significantly (p < 0.001), with median rank order of home students [5 (interquartile range, 1 to 9)] and rotators [14 (interquartile range, 6 to 27)] higher than nonrotators [17 (interquartile range, 10 to 29)]. Rank orders of away rotators tended to follow a bimodal distribution. Furthermore, 64.4 percent of integrated residents were either a home student or away rotator at their matched integrated program, with 20 percent of residency programs composed of greater than 70 percent of away rotators/home students across postgraduate years 1 through 6 classes. For integrated plastic surgery programs, the majority of ranked-to-match students on rank lists and current residents were either home students or away rotators at their respective program. Performing well on an away rotation appears to confer significant benefit to the applicant applying in the integrated plastic surgery Match.

Location, Location, Location: The Geographic Impact of Medical School on the Plastic Surgery Match.

Background:This resident application cycle posed academic leadership and applicants with an unprecedented challenge: how to virtually match applicants to mutually beneficial programs. The authors sought to refer to previous years' data, specifically geographic trends, to better inform both program directors and applicants. The authors hypothesized that geography, as it pertains to the transition from medical school to residency, impacts match patterns.Methods:The study was designed as a cross-sectional analysis including all current integrated plastic surgery residents. The independent websites of all accredited integrated plastic surgery programs were then queried for the desired demographic resident information. Additionally, as an illustrative endpoint, geospatial heat maps were generated to better understand geographic trends.Results:All (n = 78) integrated plastic surgery programs and 953 residents were included in the study. Nearly half (47.2%) of current residents remain in the same geographic region in which they obtained their medical degree, with 26% and 17% remaining in the same state and institution, respectively. Students within all regions (North, South, Midwest, West) were more likely to stay within that region for residency (OR 2.59, 2.39, 2.09, 3.80, respectively). Students attending medical schools with affiliated integrated plastic surgery residencies have matched to programs with significantly higher Doximity rankings (p < 0.0001).Conclusions:Matched integrated plastic surgery applicants are more likely to continue their training at institutions in closer geographic proximity to their medical schools. Students graduating from medical schools without affiliated integrated plastic surgery programs appear to be at a disadvantage during the match process.

24. Location, Location, Location: The Geographic Impact of Medical School on the Plastic Surgery Match

24. Location, Location, Location: The Geographic Impact of Medical School on the Plastic Surgery Match

Virtual Interviews for the Independent Plastic Surgery Match: A Modern Convenience or a Modern Misrepresentation?

ObjectiveThe virtual interview for residency and fellowship applicants has previously been utilized preliminarily in their respective processes. The COVID-19 pandemic forced many programs to switch to a virtual interview process on short notice. In the independent plastic surgery process, which was underway when the pandemic started, applicants had a heterogeneous experience of in-person and virtual interviews. The purpose of this study was to assess if applicants prefer a virtual interview experience to an in-person interview as well as determine if virtual interview applicants had a different opinion of a program compared to the in-person interview applicants.Design/Setting/ParticipantsThe 2019 to 2020 applicants who interviewed at the Indiana University Independent Plastic Surgery program were administered an anonymous online survey about their interview experience at our program.ResultsOur survey response was 60% (18/30). The in-person interview group (n = 10) rated their overall interview experience higher than the virtual interview group (n = 8) 8.8 vs 7.5 (p = 0.0314). The in-person interview group felt they became more acquainted with the program, the faculty, and the residents more than the virtual group (4.7 vs 3.25, p < 0.0001) (4.3 vs 3.25, p = 0.0194) (4.3 vs 2.75, p < 0.0001). The majority of applicants favored in-person interviews (16/18, 88.9%). The in-person interview group spent significantly more money on their interview at our program compared to the virtual interview group ($587 vs $0, p < 0.0001).ConclusionOur study demonstrated that the virtual interview process was an efficient process for applicants from both a financial and time perspective. However, the virtual interview process left applicants less satisfied with their interview experience. The applicants felt they did not become as acquainted with the program as their in-person counterparts. The virtual interview process may play a large role in residency and fellowship applications in the future, and programs should spend time on how to improve the process.

Implications of United States Medical Licensing Examination Step 1 Becoming Pass/Fail on the Integrated Plastic Surgery Match.

There has been much conversation surrounding the United States Medical Licensing Examination’s recent decision to transition Step 1 score reporting from a three-digit numeric score to a pass/fail outcome.1 Integrated plastic surgery is one of the most competitive matches for medical students.2 To be successful in the plastic surgery match, applicants must have strong board scores, extensive research experience, and numerous volunteer opportunities.2,3 Historically, Step 1 scores have provided an estimate for competitiveness for students.4 This change in scoring will effectively remove this means for self-selection. With a pass/fail system, students will have one less component with which to differentiate themselves from their peers. This may generate disadvantages to students attending U.S. medical schools outside of the top 40 in National Institutes of Health funding who previously had the opportunity to demonstrate their academic potential with an achievement-based standardized examination. With no numeric score for Step 1, naturally programs will have to seek other ways to differentiate students. At this point, Step 2 Clinical Knowledge will remain a numeric score, and consequently programs may use this to replace the importance of Step 1. However, Step 2 Clinical Knowledge is usually taken after the completion of the third year of medical school. Given the time delay for grading national board examinations, many students may not receive their scores until just before applications are due, which could leave students without enough time to estimate their competitiveness. Currently, many students delay taking Step 2 Clinical Knowledge until after applications are submitted to complete several away rotations as is expected in this specialty. Subsequently, the timing of these rotations could also be affected. The United States Medical Licensing Examination upholds that, across specialties, Step 1 scores positively correlate with specialty board pass rates.1 This is important for programs to consider, as board pass rates can have an impact on accreditation and program reputation. With the absence of Step 1 scores, programs may choose to put more weight into research experiences and productivity. Many students currently elect to take a year or more of dedicated research time within medical school.5 If programs were to place a higher emphasis on research, students completing their medical education in 4 years with no time off would be at an inherent disadvantage, not given the opportunity to equalize their applications with a strong performance on Step 1. A new form of applicant self-selection may occur based on research experience, similar to what has occurred in Canada after the implementation of a pass/fail scoring system.4 Similarly, without the standardized comparison of applicants provided by a uniform examination, equal comparisons of students between medical schools will be more difficult to achieve. This may lead to significant disadvantage for students coming from medical schools deemed to be less prestigious and limit these students’ opportunity for upward mobility. Although the termination of numeric Step 1 scores is a recent decision, it is important for programs to be proactive when considering factors for assessing future applicants and the effects that this change may have on the applicant pool at large. DISCLOSURE Neither of the authors has a financial interest to declare in relation to the content of this article. No funding was received for this work.

An In-Depth Analysis of Research Output in Successful Integrated Plastic Surgery Match Applicants and Factors Associated With Matching at Top-Ranked Programs

With USMLE Step I score reports becoming pass/fail, research output may become a more important factor for applicants in the integrated plastic surgery match. The authors aim to assess the research output of successful applicants and bibliometric variables associated with matching at higher tier programs. A search of peer-reviewed publications up to or during September before the matriculant's match year was performed using PubMed, Google Scholar, and Scopus for each resident. Bibliometric variables were analyzed including those associated with matching at higher tier Doximity reputation/research programs. University of Pennsylvania (Philadelphia, Pennsylvania). Integrated plastic surgery interns for the 2019 to 2020 and 2020 to 2021 academic years (n = 301). Three hundred one matriculants at 73 programs produced a total of 731 manuscripts. The mean number of publications and H-index per applicant was 2.43 ± 3.84 and 1.01 ± 1.30, respectively. The average and maximum journal impact factor was 2.8 ± 1.81 and 4.66 ± 5.59, respectively. H-index, total publications, plastic surgery-related and unrelated publications, and first-author studies were all associated with matching into both a higher ranked reputation and research tier program, respectively (p < 0.05). Highest impact factor publications were associated with matching at top tier research programs only (p < 0.05). Among students from US News Top 40 and non-Top 40 medical schools, total publications and first-author publications remained associated with matching at a higher tier reputation and research program (p < 0.05). However, plastic surgery-related publications were significantly linked to matching into a higher tier program for matriculants from non-Top 40 medical schools only (p < 0.05). Research productivity, particularly total publications and first-author publications, is associated with an increased likelihood of matching at a higher tier integrated plastic surgery residency. Regardless of their medical school's US News rank, students may gain a competitive edge in the match with increased research output.

Implementation of a Secondary Application to Increase Efficiency in the Plastic Surgery Match.

Implementation of a Secondary Application to Increase Efficiency in the Plastic Surgery Match.

Abstract 10: How Many Manuscripts: An Analysis of Medical Student Publications in the Integrated Plastic Surgery Match

Abstract 10: How Many Manuscripts: An Analysis of Medical Student Publications in the Integrated Plastic Surgery Match

Integrated Plastic Surgery Match: Trends in Research Productivity of Successful Candidates.

Plastic surgery continues to be one of the most competitive specialties in the residency match. Research productivity is a key component of the selection process. Nevertheless, potential applicants have a poor understanding of the strength of their research credentials in comparison to other applicants. The authors identified successful applicants from the 2012 to 2017 integrated plastic surgery residency application cycles. The authors performed a bibliometric analysis of these residents using Scopus, PubMed, and Google Scholar to identify published articles at the time of application. The authors then calculated the h-index of each applicant at the time of application. The authors included 829 integrated residents. The median h-index was 0 (interquartile range, 0 to 3) and the median number of publications was 2 (interquartile range, 0 to 5) for all applicants. The proportion of applicants with at least one publication at the point of application increased significantly over time (60 percent in 2012 versus 76 percent in 2017; p = 0.0072). In addition, the number of publications per applicant increased over time (one in 2012 versus two in 2017; p = 0.0005), as did h-index (0 in 2012 versus 1 in 2017; p = 0.0015). Strikingly, the number and percentage of review articles among applicants increased significantly over this time frame (9 percent versus 14 percent; p = 0.0299). The increasing level of academic productivity among applicants may reflect the increasing competitiveness of the integrated plastic surgery residency application process. As the pressure to compete for a training position increases, students may seek faster-to-publish articles to gain an edge.

Solving Congestion in the Plastic Surgery Match: A Game Theory Analysis

Solving Congestion in the Plastic Surgery Match: A Game Theory Analysis

The Independent Plastic Surgery Match (2010-2018): Applicant and Program Trends, Predictors of a Successful Match, and Future Directions

Changes were made to the independent plastic surgery residency in 2009 to 2010 that included full prerequisite training and increased from 2 to 3 years of independent residency. The authors sought to determine subsequent match trends and predictors of a successful match. With American Council of Academic Plastic Surgeons approval, the San Francisco Match provided data for the independent match (2010-2018). Trends in the independent plastic surgery were reviewed. Applicant variables were analyzed to determine correlation with a successful match and a match at top-ranked programs using Doximity Residency Navigator. Total independent applicants per cycle decreased 18% while foreign medical school applicants increased from 19.4% to 27%. Available positions decreased from 97 to 66 (32%) and match rate decreased from 82% to 78%. Applicants who matched were from US medical schools, had higher USMLE Step 1 scores, were from University and top General surgery residencies, and averaged more interviews (p < 0.05). By multivariate regression, number of interviews completed (odds ratio [OR] 15.35 95% confidence interval [CI] 7.7-30.6, p < 0.001) and having completed prerequisite training at a university based program in addition to having graduated from an allopathic medical school (OR 1.78 95% CI 1.1-2.97, p = 0.027) were predictive of a successful match. Step 1 score ≥ 240 (OR 3.2, 95% CI 1.0-10.2, p = 0.046), Alpha Omega Alpha membership (OR 2.2, 95% CI 1.1-4.9, p = 0.048), and having completed prerequisite training at the same institution (7.6, 95% CI 2.2-25.7, p < 0.001) were predictive of matching at top-ranked programs. Since 2010, independent plastic surgery applicant and program participation have decreased. Greater number of interviews, university-based prerequisite training, and allopathic medical school background are variables that correlate with a successful match. Factors predictive of a match at top-ranked Doximity Residency Navigator plastic surgery programs include high Step 1 scores, Alpha Omega Alpha membership, and prerequisite training at the same institution.

Abstract 7: The Independent Plastic Surgery Match (2010 to 2018): Applicant and Program Trends, Successful Match Predictors, and Future Directions

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.

Solving Congestion in the Plastic Surgery Match: A Game Theory Analysis.

Plastic and reconstructive surgery is among the most competitive specialties in the residency match. Applicants seeking to maximize their chances of a successful match often submit numerous applications to the National Residency Matching Program. It is not uncommon for those applying to plastic and reconstructive surgery to apply to every program. The high application volume imparts significant time and financial burden for applicants and programs alike. Furthermore, it makes distinguishing between applicants with a genuine interest in a specific program and those who are merely hoping to improve their chances vastly more difficult. The authors sought to characterize trends in the match rate, as the number of integrated plastic and reconstructive surgery programs continues to increase. Furthermore, they reviewed the literature on game theory for possible solutions to residency application congestion. The authors propose the use of the game theory model to explain the observed results and show why an application limit is the most reasonable approach to address this issue.

Solving Congestion in The Plastic Surgery Match

Solving Congestion in The Plastic Surgery Match

How Competitive Is Plastic Surgery? An Analysis of the Canadian and American Residency Match

Plastic surgery (PS) is considered to be one of the most competitive specialties. As a result, some students are discouraged from applying, reducing the overall number of PS candidates. Still, much of what we know of the match is based in conjecture. To examine the Canadian PS match data from 1997 to 2016. To our knowledge, this is the first long-term analysis of the Canadian PS residency match. We examined the Canadian Residency Matching Service reports from 1997 to 2016, extracting key match statistics, including available positions, number of applicants, positions filled, positions unfilled, and gender-specific match results. To examine competitiveness, the ratio of total applicants per quota per year (CR) and the ratio of applicants who chose PS as their first-choice specialty per quota per year were calculated (FC-CR). The National Residency Matching Program data were used to assess the American integrated PS match over the past decade and served as a comparison. The CR of Canadian PS programs declined over the last 20 years (P < .001), indicating fewer applicants applied to the program per available position. Similarly, the FC-CR also declined over the last 20 years (P < .001). The number of females matching to their first-choice discipline of PS increased from 1997 (P < .001). There was no significant change in the number of males matching to their first-choice discipline of PS (P = .15). There was no significant change in the competitiveness (CR) of the American integrated PS match over the last decade (P = 0.087). Encouragingly, today PS has more training positions and more female residents; yet, the overall number of applicants has remained relatively static over the past 20 years. This analysis serves as a valuable reference for PS programs and should assist in developing strategies to encourage the best applicants to apply.

The Plastic Surgery Match: A Quantitative Analysis of Applicant Impressions From the Interview Visit.

The integrated plastic surgery match is a competitive process not only for applicants but also for programs vying for highly qualified candidates. Interactions between applicants and program constituents are limited to a single interview visit. The authors aimed to identify components of the interview visit that influence applicant decision making when determining a final program rank list. Thirty-six applicants who were interviewed (100% response) completed the survey. Applicants rated the importance of 20 elements of the interview visit regarding future ranking of the program on a 1 to 5 Likert scale. Data were analyzed using descriptive statistics, hierarchical cluster analysis, analysis of variance, and Pearson correlations. A literature review was performed regarding the plastic surgery integrated residency interview process. Survey questions were categorized into four groups based on mean survey responses:1. Interactions with faculty and residents (mean response > 4),2. Information about the program (3.5-4),3. Ancillaries (food, amenities, stipends) (3-3.5),4. Hospital tour, hotel (<3).Hierarchical item cluster analysis and analysis of variance testing validated these groupings. Average summary scores were calculated for the items representing Interactions, Information, and Ancillaries. Correlation analysis between clusters yielded no significant correlations. A review of the literature yielded a paucity of data on analysis of the interview visit. The interview visit consists of a discrete hierarchy of perceived importance by applicants. The strongest independent factor in determining future program ranking is the quality of interactions between applicants and program constituents on the interview visit. This calls for further investigation and optimization of the interview visit experience.

The “Independent” Plastic Surgery Match: Analysis of Changes in Recent Years and Applicant Preferences

The number of surgical applicants to "independent" plastic surgery programs has drastically decreased. However, the competitiveness of recent applicants relative to previous years has not been assessed. The purpose of this study was to analyze the characteristics of recent "independent" applicants and to obtain their preferences regarding the match. A 25-question survey was distributed to 97 applicants of the 2012 "independent" match. The survey consisted of questions regarding demographics, academic qualifications, interview results, match results, program characteristic preferences, interview preferences, and future career plans. A total of 62 applicants responded; 71% male, 82% US medical graduates, 94% general surgery residents, and 76% in university programs. Three-quarters had ≥2 publications and 29% in plastic surgery journals. Applicants most commonly attended 11 to 13 interviews, and 31% got their top choice. Mean rank list position matched was 2.7. Out of 10 program selection criteria, overall training quality and geographic location were most important to applicants. Difficulty of on-call responsibilities and research opportunities were least important. Applicants interested in university-based practice had a significantly higher interest in research (p = 0.003). Most prefer one-on-one interviews with 5 sessions being ideal. Two-thirds would prefer regional coordination of interviews. Half were undecided about fellowship, and most were undecided about subspecialty of greatest interest. University-affiliated (39%) and university-based (33%) were the most commonly envisioned future practices. The profile of "independent" plastic surgery applicants has not changed much in recent years. When selecting a program, applicants are looking for the best overall operative training above all else with little regard for difficulty of on-call responsibilities or ability to do research. Applicants are still very moldable in their preference of future career plans with the majority possessing an early interest in academic-related practices.

A Closer Look at the 2013 to 2014 Integrated Plastic Surgery Match: Correction

A Closer Look at the 2013 to 2014 Integrated Plastic Surgery Match: Correction

Geographic Trends in the Plastic Surgery Match

The integrated plastic surgery match is among the most competitive residency matches in recent years. Although previous studies have correlated applicant characteristics with successful match outcomes, none have comprehensively investigated the role of geography in the match. This study elucidates regional biases in the match. Plastic surgery residents who matched during 2011-2015 were eligible for study inclusion. Names of residents were obtained from official residency program websites and cross-referenced with data obtained from the Student Doctor Network. For each resident, region of residency program and medical school were compared. From 67 programs, 622 residents were identified. Most graduated from US medical schools (97.9%). A total of 94 residents matched at a home institution (15.1%). Half of the residents matched in the same region as their medical school (48.9%). Programs in the South matched the greatest number of residents from the same region (60.8%), whereas West programs matched the least (30.8%, p < 0.001). No regional differences existed regarding residents matching at their home institution (p = 0.268). More women matched at West programs (43.1%) versus East programs (30.6%, p < 0.05). A significant number of residents matched at their home institution. Roughly, half matched at a program in the same region as their medical school. Whether this regional phenomenon stems from applicant or program factors remains unknown. Yet, given the limited number of interviews and the high costs of interviewing, applicants and programs can use these data to help optimize the match process.