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.