Underrepresented in Medicine Applicants are Less Likely to Successfully Match into Plastic Surgery

The lack of underrepresented in medicine physicians in academic plastic surgery has been a topic of interest for many years, and accordingly outreach has been undertaken to address the pipeline from medical school to residency and beyond.

This study aims to assess and identify the characteristics associated with plastic surgery match success for underrepresented in medicine applicants.

Residency application data for first time, US allopathic medical school seniors from the 2017-2018 to 2021-2022 applicant cycles were abstracted from Electronic Residency Application Service applications, and match results were determined using the National Residency Matching Program database and online public sources. Data included self-reported race, and multiple application characteristics. Multivariable logistic regression of application characteristics were used to assess the relationship between underrepresented in medicine status and successfully matching. Binary logistic regression was used in subgroup analyses of each application characteristic, and interactions regression was used to evaluate the relative weight of each characteristic on successfully matching.

Underrepresented in medicine applicants were 57% less likely to match than non-underrepresented in medicine applicants (OR 0.43, p = 0.001), though they were 60% less likely to match (OR_adj 0.4, p = 0.216) when adjusted. Subgroup analysis revealed that odds of matching as an underrepresented in medicine applicant were significantly increased if the applicant had a home program, took a research year, and had an increased number of published research and presentations (ORs 0.43-0.48, all p < 0.05). Odds of matching as an underrepresented in medicine applicant were significantly decreased if the applicant went to a medical school ranked in the highest or lowest third (ORs 0.41-0.42, all p < 0.01); however, on interaction regression the odds of matching from a highly ranked medical school was increased (OR 3.5, 95% CI 0.98-12.55, p = 0.05).

The likelihood of matching as an underrepresented in medicine applicant is lower than the rest of the applicant population, and there are no individual applicant characteristics that can increase these odds to equal that of the general applicant population.