Identifying Barriers Faced by Applicants without a Home Residency Program when Matching into Plastic Surgery

Abstract

Background Applying into plastic surgery (PS) is competitive. Lacking a home residency program (HRP) is another barrier. Our goal is to characterize challenges faced by PS applicants without HRPs and identify solutions. Methods Surveys were designed for current integrated PS residents and applicants in the 2022 Match without HRPs. Surveys were distributed electronically. Only U.S. allopathic graduate responses were included. Results Of 182 individuals surveyed, 74 responded (39%, 33 residents, 41 applicants). Sixty-six percent reported feeling disadvantaged due to lack of an HRP. Seventy-six percent of applicants successfully matched. Of these, 48% felt they required academic time off (research year) versus 10% of unmatched applicants. Ninety-seven percent of matched applicants identified a mentor versus 40% of unmatched applicants ( p < 0.05). Matched applicants identified mentors through research (29%) and cold calling/emailing (25%). Matched versus unmatched applicants utilized the following resources: senior students (74 vs. 10%, p < 0.05) and social media (52 vs. 10%, p < 0.05). Among residents, 16 had PS divisions (48%). Thirty-six percent with divisions felt they had opportunities to explore PS, compared with 12% without divisions. Residents without divisions felt disadvantaged in finding research (94 vs. 65%, p < 0.05), delayed in deciding on PS (50 vs. 28%), and obtaining mentors (44 vs. 35%) and letters of recommendation (31 vs. 24%). Conclusion PS residents and applicants without HRPs reported feeling disadvantaged when matching. The data suggest that access to departments or divisions assists in matching. We identified that external outreach and research were successful strategies to obtain mentorship. To increase awareness for unaffiliated applicants, we should increase networking opportunities during local, regional, and national meetings.

Keywords: diversity; plastic surgery; residency match.

Fig. 1

Total responses from applicants and residents (PGY1–5s) to the following question: “Do you feel that as a medical student without a home plastic surgery department that you were at a significant disadvantage matching in a plastic surgery program?”

Fig. 2

( A ) (Upper left) Percent of matched (97%) versus unmatched (40%) applicants showing if they had obtained a plastic surgery mentor ( p  < 0.05). ( B ) (Bottom) Percent responses of resources used by matched applicants to identify a plastic surgery mentor. ( C ) (Upper right) Percent responses from matched versus unmatched applicants showing resources used while applying to residency. * indicates p  < 0.05.

Fig. 3

Percent responses from applicants with and without plastic surgery divisions, demonstrating their feeling delayed in their decision (28 vs. 73%, p  = 0.022), not having opportunities to explore the field (28 vs. 76%, p  = 0.013), and difficulty in finding research opportunities (29 vs. 82%, p  = 0.003). * indicates p  < 0.05.