To analyze trends in applications to plastic surgery residency programs, Dr. Zins and colleagues analyzed data from 2010 to 2018 from the San Francisco Matching and the National Resident Matching Program. go through six years of study directly out of medical school.
From 2010 to 2018, the number of integrated plastic surgery residencies increased by 142%. However, applications to these programs increased by only 14.5%. Overall, the number of applicants for the existing integrated training area has almost halved: from 2.9 applicants per post in 2010 to 1.4 in 2018. “Therefore, the probability of being accepted into an integrated program has increased from about 35% in 2010 to almost 73%. in 2018,” Dr. Zins and colleagues write.
Meanwhile, positions in traditional independent programs, where plastic surgery applicants must complete training in general surgery or a surgical subspecialty before entering a three-year plastic surgery residency, have dwindled dramatically. The total number of plastic surgery residencies, including both integrated and independent positions, increased by 45% during the study period, while the number of applicants decreased by approximately 9%.
Increasing Plastic Surgery Applications to Non-Surgical Residency Programs
Trends in plastic surgery applications were consistent with other surgical specialties. General surgery, neurosurgery, orthopedic surgery, and otorhinolaryngology decreased from 12.5% to 22.5%. At the same time, applications to internal medicine and specialty non-surgical residency programs have increased significantly. The biggest increase was in internal medicine, 17%; emergency medical care, 37%; and family medicine, 44%.
According to the authors, “Historically, plastic surgery has been considered a highly desirable residency and has anecdotally attracted some of the best and brightest talent.” So why aren’t application numbers tracking the increase in residency spots? Although the reasons are “multifactorial”, Dr. Zins and coauthors write that “students have relatively little exposure to this field during medical school. In addition, some medical schools do not have plastic surgery residency programs. Finally, medical students’ perceptions of the competitiveness of the match. and stressors may be a significant barrier.”
Based on the growing popularity of non-surgical residency positions, “It is possible that lifestyle issues are driving students away from surgical subspecialties and toward less time-consuming specialties,” the researchers add. Recent measures to promote primary care may also be a contributing factor.
Dr. Zins and colleagues write that the future of plastic surgery “will depend heavily on the talent pool.” They suggest steps to ensure the visibility of plastic surgery in medical school curricula and create opportunities for future plastic surgeons. “Approaching medical students and emphasizing the wide range of opportunities offered by plastic surgery is perhaps the best approach,” the researchers conclude.