by Gloria R. Sue, MD and Raj Sawh-Martinez, MD
Plastic and reconstructive surgery is a highly desired specialty among medical students and surgery trainees. It is a thriving specialty with a broad scope, encompassing operations on all parts of the body and on patients of all ages. Plastic surgery is also a technically demanding field that is characterized by a continuous drive for innovation.
There are two established pathways to complete the requisite training to become a plastic surgeon.1 They are the independent and integrated pathways. The independent pathway is the traditional method of entering this specialty, and involves training in plastic surgery following completion of residency training in general surgery, otolaryngology, neurosurgery, orthopedic, or oral maxillofacial surgery. The independent pathway is a 3-year long training program. More recently, a couple of decades ago, the integrated pathway for plastic surgery training was established.2
The integrated pathway is a 6-year training program that accepts students directly upon graduation from medical school. The integrated pathway has since become the increasingly popular method of entering the plastic surgery specialty, with more positions offered each year in the integrated residency match, inversely correlated with fewer independent pathway positions offered each year. In 2015, there were 148 positions offered in the integrated pathway, compared to only 70 positions offered in the independent pathway.
Integrated plastic surgery residency ranks among the most competitive residencies to match into in the United States. The match rate into this specialty was approximately 50% throughout the 2000s.3 Alpha Omega Alpha (AOA) honor society membership and attendance at a top medical school are independent predictors of matching into integrated plastic surgery residency.4 High class rank and authorship on research publications are also associated with a successful match.5 Data from the 2014 main residency match published by the National Resident Matching Program show that among medical students applying integrated plastic surgery, including those who matched and those who did not match, the mean Step 1 score was greater than 240, and the mean number of research abstracts and publications was greater than 10.6
Matching successfully into integrated plastic surgery residency requires more than superb academic credentials. Plastic surgery is a small and well-connected community. Getting to know the plastic surgery community is critical for any medical student interested in entering this specialty. This can help the student decide whether this specialty is the right fit for him or her. Simultaneously, this allows for established plastic surgeons to evaluate the student for the desired qualities of a future plastic surgeon: strong work ethic, integrity, creativity, empathy, and a commitment to advancing the profession. Recommendations from established members of this community play a major role in obtaining a residency position and are critical to a successful match.7
Medical students are encouraged to start the process of engagement with local plastic surgery programs and leaders as early as possible. This will allow time to develop scientific projects, attain mentorship relationships and develop an in-depth understanding of multi-faceted aspects of plastic and reconstructive surgery. As a senior medical student, on-the-job performance as a sub-intern becomes a critical component of the application process. In this context, the student’s dedication, work ethic, personality, knowledge base, and patient care skills will all be put to the test. This month-long, intensive interview can often make or break a candidacy based on the student’s dedication and resiliency. Although no measureable metric exists for this performance, letters of recommendation are often obtained upon the completion of the sub-internship, which will undoubtedly reference the student’s clinical performance.
Although achieving all these specific metrics may seem daunting, a select 148 medical students, and 70 residents will enter specialty training in Plastic Surgery annually. The high bar of entry should be approached as an exciting challenge to prove oneself, and demonstrate one’s penchant for innovation, hard work and desire for elite surgical training.
We wish you the best of luck on your journey! Please be sure to use all the resources at www.prsjournal.com and feel free to reach out to us, or any of the PRS Resident Bloggers with any questions you might have along the way!
- Nagarkar P, Pulikkottil B, Patel A, Rohrich RJ. So you want to become a plastic surgeon? What you need to do and know to get into a plastic surgery residency. Plastic and Reconstructive Surgery 2013;131:2 pgs 419-22.
- Luce EA. A survival plan. Plastic and reconstructive surgery 2001;108:776-82.
- Super N, Tieman J, Boucher K, Rockwell WB, Agarwal JP. Recent trends in applicants and the matching process for the integrated plastic surgery match. Annals of Plastic Surgery 2013;71:406-9.
- Sue GR, Narayan D. Generation Y and the Integrated Plastic Surgery Residency Match: A Cross-sectional Study of the 2011 Match Outcomes. Plastic and Reconstructive Surgery Global Open 2013;1:e33.
- Rogers CR, Gutowski KA, Munoz-Del Rio A, et al. Integrated plastic surgery residency applicant survey: characteristics of successful applicants and feedback about the interview process. Plastic and reconstructive surgery 2009;123:1607-17.
- Charting Outcomes in the Match, 5th edition. In. Washington, DC: National Resident Matching Program; 2014.
- Janis JE, Hatef DA. Resident selection protocols in plastic surgery: a national survey of plastic surgery program directors. Plastic and reconstructive surgery 2008;122:1929-39; discussion 40-1.