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Preference Signals and Away Rotations Greatly Influence Application Success in the Integrated Plastic Surgery Match
Jacob L Kotlier1, Angela P Mihalic2, Christopher Homsy1
1Department of Surgery, Tufts University School Of Medicine, Boston, Massachusetts.
Journal of Surgical Education
|February 26, 2025
Summary
The new preference signaling program in plastic surgery residency increased applications but decreased interview offers. Away rotations and preference signals significantly improve interview and match success.
Area of Science:
- Medical Education
- Surgical Residency Admissions
- Application Process Optimization
Background:
- Integrated plastic surgery implemented a preference signaling program (PSP) in the 2022-2023 cycle.
- The PSP allowed applicants to signal top 5 preferred programs via the Plastic Surgery Central Application (PSCA).
Purpose of the Study:
- To evaluate the impact of the new PSP on plastic surgery residency applicants and programs.
- To analyze changes in application metrics and interview offer distribution post-PSP implementation.
Main Methods:
- Cross-sectional study utilizing self-reported survey data (2019-2024) from the Texas STAR database.
- Statistical analysis included t-tests, Chi-squared tests, variance ratio testing, and ROC analysis.
Main Results:
- 2023-2024 applicants submitted more applications (85.1 vs 67.3) and received fewer interviews (12.5 vs 15.7) compared to 2017-2022.
- Interview offers were more evenly distributed in 2023-2024 (SD: 8.25 vs 10.5).
- Preference signals (OR: 5.72) and away rotations (OR: 30.2) significantly increased interview and match likelihood.
Conclusions:
- Preference signaling correlated with increased applications, fewer interviews, and more equitable distribution.
- Away rotations, preference signals, and geographic connections are key predictors of successful residency matches.
- No significant difference in application numbers, Step 2 CK scores, or clerkships for matched vs. unmatched applicants in 2023-2024.
