American Council of Academic Plastic Surgeons
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The Microsurgery Fellowship Match: What's the cost?
Mariam Al-Hamad Daubs, MD; Dafhney Ferrer, BS; Paris Collier, BA/BS; John P Brosious, MD; Richard C Baynosa, MD; Joshua J Goldman, MD
Kirk Kerkorian School of Medicine at UNLV, NV, USA

Background: Near the end of residency, in addition to fellowship application, imminent moving costs, new state licensing fees, and the cost of board certification strains the finances of trainees. The question arises as to the effect financial strain has on fellowship application and if a new model for interviewing applicants would be preferable. More specifically, whether divorcing the interview process from the current match process can lessen cost and work-loss burden and be executed in a practical manner that maintains the integrity of the interview process
Methods: An adaptation of the seven-step process recommended for developing questionnaires for educational research found in AMEE Guide No. 87 was utilized to build a validated 35 question survey using Qualtrics. The survey was sent to a cohort of MFM applicants
Results: Forty surveys were initiated. 14 of the 40 surveys (35%) were completed. On average, applicants submitted 8.3 applications, were offered 6.5 interviews, and attended 5.5 interviews. Applicants missed about a week of work for interviews, costing applicants $2891, with average accumulated debt of $714 per applicant. Costs were mostly covered by applicants’ savings and credit cards. More than half of the applicants (8/14) were required to take vacation for missed time, and more than half stated that 75-100% of their interviews required air transportation and at least a one night hotel stay. Applicants rated faculty interviews (6.8) and current fellow interactions (5.4) as factors most likely to affect rank list order. Applicants rated social events (3.2) and institution tours (3.4) lower. Other factors impacting rank list were also assessed (e.g. institution prestige, case numbers, microsurgical case load, call, etc). The results of this validated survey indicate that approximately half the participants are content with the current system (5/14), while 6/14 opted for video conference interviews
Conclusion: The current MFM process is burdensome, to both applicants and programs, a common theme among many subspecialty fellowship selection processes. Particularly germane to pandemic times, where video platforms have become the mainstay, an opportunity exists to reassess the microsurgery fellowship application process and beyond.

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