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Home Field Advantage: Assessing the Geographic Trends of the Plastic Surgery Residency Match during the COVID-19 Pandemic
Paul A. Asadourian, MEng; Alexander I. Murphy, BA, Andrew Marano, MD; Christine Rohde, MD, MPH; June K. Wu, MD
Division of Plastic and Reconstructive Surgery, Department of Surgery, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, NY, Fort Washington Ave, New York, NY

Introduction: In previous cycles of the plastic surgery match, in-person activities at other institutions, such as away rotations, have facilitated matches outside of an applicant’s home program or region. The COVID-19 pandemic, however, limited these in-person opportunities. Thus, in 2021, we hypothesized that applicants will have matched at higher rates at programs where they have existing geographic connections than in previous years.
Methods: Residency program websites and social media accounts (Facebook, Instagram, Twitter, and Doximity) were searched for resident names and educational information. Outcomes included rates of applicants matching at the program affiliated with their medical school (“home program”), or matching in the same state or US Census Map region (Northeast, South, Midwest, or West) as their medical school or undergraduate institution. Subgroup analyses were stratified by program region, size of incoming resident class, and Doximity residency reputation ranking.
Results: For the 2015-2020 residency cycles, 963 residents were identified from 78 (95.1%) programs. For 2021, 159 incoming interns were identified from 70 (82.3%) programs. In 2021, applicants matched into their home program at higher rates than in 2015-2020 (36.0% vs. 24.1%, P=0.019). This trend was similar regardless of region (Figure 1) or size of program. This increase was significant for programs ranked outside of the top 30 (41.5% vs 26.4%, P=0.032), but not for those in the top 30 (32.1% vs. 22.3%, P=0.128). Excluding those who matched at their home program, likelihood of matching in same state or region of medical school or undergraduate institution was similar for 2015-2020 and 2021 applicants (p>0.05 for all).
Conclusions: During the COVID-19 pandemic, plastic surgery residency programs matched more applicants from affiliated medical schools than in previous years. This may result from the lack of in-person opportunities for applicants at other programs. Rates of matching students from affiliated medical schools at higher ranked programs appeared to be less effected, which may be due to the wider adoption of virtual alternatives to in-person opportunities at these programs. These alternative relationship-building opportunities, such as webinars and virtual sub-internships, may be required to facilitate broader geographic connections in the 2022 match cycle.


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