Orphan Applicants in Plastic Surgery: Where Do Medical Students Without an Affiliated Residency Program Match?

Area of Science:

• Medical Education
• Surgical Residency Matching
• Plastic Surgery Training

Background:

• Integrated plastic surgery residency positions are limited and highly competitive.
• Medical students often apply broadly to maximize their chances of matching into these sought-after programs.
• Previous research indicates that prior exposure to a specialty in medical school improves residency match success.

Purpose of the Study:

• To analyze trends in successful applicants to integrated plastic surgery residencies from 2016-2021.
• To identify characteristics of medical students who successfully match, particularly those from institutions without affiliated plastic surgery residency programs ('orphans').
• To correlate applicant demographics with medical school type, presence of affiliated residency programs, and geographic region of programs.

Main Methods:

• Evaluation of applicant data from 2016-2021 for integrated plastic surgery residencies.
• Analysis of medical school type, affiliation with a plastic surgery residency, and geographic region.
• Correlation of national quality rankings of medical schools with applicant demographics.
• Statistical analysis using chi-square tests.

Main Results:

• 'Orphan' applicants (no affiliated program) constituted 24.4% of matched residents, compared to 72.2% from schools with affiliated programs.
• At top-quartile prestige-rated programs, 'orphan' applicants represented only 17.4% of residents.
• 18.2% of all applicants matched into a program affiliated with their medical school (P = 0.04).
• Osteopathic and international medical graduates had low match rates (<1% and <4% respectively) with no significant change over 6 years.

Conclusions:

• A modest number of integrated plastic surgery residents graduate from medical schools without affiliated programs, but they are underrepresented in top-tier institutions.
• The match rates for osteopathic and international medical graduates remain very low and have not improved.
• Strategies may be needed to support 'orphan' applicants in matching into competitive plastic surgery residency programs.