Mentorship is Critical: An Analysis of the 2022 Plastic Surgery Match
Christopher D. Lopez1, Kimberly H. Khoo1, Alisa O. Girard1, Cynthia Yusuf1, Isabel V. Lake1, Richard J. Redett1, Robin Yang1
1Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
Background: Plastic surgery residency remains one of the most competitive specialties participating in the National Resident Matching Program Match. However, changes in both medical education and healthcare (e.g. change of USMLE Step 1 to P/F, COVID-19 restriction on visiting sub internship opportunities) have limited the ability to utilize traditional tools to assess candidates, thereby providing the impetus to elicit new, evidence-based approaches to applicant assessment.
Methods: An IRB-approved survey was electronically administered to medical students applying to a single institutional plastic and reconstructive surgery (PRS) residency program. The survey was comprised of questions inquiring about patient demographic information, statistics relevant to their residency applications, mentorship experience, and Match outcomes. Bivariate and multivariable logistic regression models were created to assess for odds of matching into plastic surgery overall, matching into an applicant's top ranked program, matching at an institution where a participant completed a sub-internship, and overall Match outcomes.
Results: A total of 151 responses were collected for a 49.8% response rate. Most participants were female (52.3%), White (68.9%), and not Hispanic or Latino (84.8%). The largest percentage of respondents (22.5%) were raised in households where the median household income was more than $300,000. Regarding mentorship, the largest percentage of respondents had a faculty mentor only from their home institution (55.0%) and a resident mentor from only their home institution (32.3%). Participants who had a faculty mentor from both a home institution and outside institution had 7.4 times the odds of matching into PRS (p =.02) than students with no faculty mentorship, and students with resident mentors from both a home and outside institution had a 18.5 times higher odds of matching into PRS compared to students with no resident mentorship (p<.001). Students in the lower MHI brackets (below $100,000) had statistically significantly lower odds of scoring above a 240 on Step 1, scoring above a 240 on Step 2 CK, and matching into PRS at all, as well as significantly lower numbers of interview offers and completed interviews.
Conclusions: Subjective metrics, rather than objective scores, had the most influence on success in matching into plastic and reconstructive surgery. Both faculty and resident mentorship seem to be critical for match success. As medical education and the residency application processes continue to evolve, it behooves programs to provide equitable access to resources like faculty and resident mentorship to students who may be disenfranchised and/or have less access to mentorship opportunities.
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