COVID-19 Effects on 2021 Home Program Match Rates at Integrated Plastic Surgery Programs.

Over the past 10 years, the proportion of applicants matching at home and visiting subinternship institutions has been consistent. Home institution matches represent about 15 percent of successful matches and visiting subinternship matches represent a higher proportion at 27 percent to 30 percent.[1-4] Due to the coronavirus disease of 2019 pandemic, guidelines regarding the 2021 match were adapted by the American Council of Academic Plastic Surgeons. In an effort to eliminate disparities, visiting subinternship opportunities were eliminated. Likewise, in-person interviews were universally replaced with virtual interviews and visits. We hypothesized that changes to the 2020/2021 match year would have an impact on match patterns. Due to decreased in-person interactions, we anticipated that home institution match rates would be increased compared to previous years.

Program match data were obtained from Instagram accounts of integrated plastic surgery residencies following the release of 2021 match results on March 19, 2021. Applicant medical schools were recorded. Medical schools were classified as either home program or non–home program match.

A total of 181 applicants (96.8 percent) were identified of 187 integrated plastic surgery residency positions from the 2021 match. The majority of matched candidates came from schools with an affiliated integrated plastic surgery program (135 of 181, 76.7 percent). Medical students matched at the integrated residency program affiliated with their home medical school in 44 instances (24.3 percent). When compared to historical data, 2021 applicants were statistically more likely to match at their home program (p = 0.004).[4] The number of applicants matching from programs that did not have an affiliated plastic surgery program was also statistically lower than previously published data (p = 0.004).[1]

The 2021 integrated plastic surgery match cycle presented unique challenges due to the ongoing public health crisis. With changes to interview structures and eliminating away subinternships for those with access to a home plastic surgery program, rates of medical students matching at home institutions were significantly higher. Although medical students from schools without plastic surgery programs may have had the opportunity to complete an away subinternship, a significant decrease in the match rate for students from schools without a plastic surgery program was seen.

There were likely significant cost savings to applicants of the 2020/2021 match cycle. Drolet and colleagues estimated that the average cost of away subinternships is $3951.[3] An additional cost of $2500 to upward of $10,000 may be accrued related to interviews.[5] However, the value of in-person interactions sustained through these instruments should not be overlooked. The majority of applicants reported feeling that an away subinternship makes them more competitive at the program at which they are rotating.[3] In addition, applicants have rated interactions with faculty and residents as the most important aspect in evaluating a program interview, and this may be diminished in the virtual setting. Increasing diversity in trainee backgrounds through outside and away student matches may allow for shared experiences to benefit both residency programs and trainee education. Although short-term costs may be substantial to medical students, long-term benefits of resumed away subinternships likely warrant safe resumption of away subinternships as allowed.

DISCLOSURE

The authors have no financial interest to disclose. No funding was received for this study.