Analysis of Reapplications to Integrated and Independent Plastic Surgery Residency

BACKGROUND: Plastic surgery is one of the most competitive specialties to match, with integrated plastic surgery having the highest rate of unmatched applicants in all categorical specialties. Unmatched applicants face difficult challenges, especially because there is a lack of data to help inform and guide both reapplicants and their advisors. METHOD: A national survey targeting plastic surgery applicants to both integrated and independent tracks from 2014 to 2020 was conducted in August 2020 to identify reapplicants, their application characteristics, and their outcomes. RESULTS: Eighteen of the 54 (33.3%) integrated reapplicants responded to the survey, as well as 7 of the 42 (16.7%) independent reapplicants. Fifty percent of integrated reapplicants and 43% of independent reapplicants successfully eventually matched. For integrated reapplicants, the mean (SD) number of first cycle invites was the greatest predictor of eventual match success, 9.00 (5.93) invites for reapplicants that eventually successfully matched compared with 2.89 (2.89) for those that remained unmatched, P = 0.025. Integrated reapplicants obtained on average 2.47 less invites during the reapplicant cycle compared with the initial cycle, P = 0.046. A Fisher exact test revealed no differences in match outcomes of those integrated reapplicants who spent time in between cycles pursuing research compared with a preliminary surgical year, P = 0.99. CONCLUSIONS: Reapplication to both integrated and independent plastic surgery may result in worse matching outcomes compared with the initial match. Applicants should attempt to preemptively address potential initial application weaknesses as reapplication after a failed initial attempt may carry disadvantages.