American Council of Academic Plastic Surgeons
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Plastic Surgery as an Alternate Career Choice
Chloe C Krasnoff MD; Breanna Jedrzejewski MD MPH; Zbigniew Sikora BS; Lori K Howell MD FAAP

Background: Plastic surgery (PRS) remains one of the most competitive specialties to successfully match for an applicant. While there are studies on the intersection of PRS and medical students, there is limited insight into why students with interest in the specialty ultimately choose not to pursue it. This study characterizes the cohort of medical trainees who chose not to apply to PRS, investigates the reasons for ‘Why not PRS,’ and explores the nature of their attrition
Methods: An IRB exempt survey was emailed to all active residents at a single academic institution. Responses were recorded and descriptive statistics were performed in Qualtrics. All residents who identified as having an interest in PRS in medical school but did not apply to the PRS match were included in the study
Results: 45 residents from 35 different medical schools responded to the survey. Of these, 80% scored ?230 on Step 1, 29% had >5 manuscript publications, and 44% were members of Alpha Omega Alpha. The top specialties among this cohort were general surgery (24%), anesthesiology (11%), internal medicine (11%), dermatology (9%), and radiology (9%). With regards to specialty exposure, 29% shadowed an academic plastic surgeon, 13% participated in PRS research, and 53% completed a PRS rotation (40% MS3, 13% MS4). 9% eliminated PRS as a career choice prior to MS3 surgery rotation, 53% after MS3 surgery rotation, and 29% during MS4 year. The most common reasons cited for PS interest attrition were the following personal perspectives: poor work life balance (36%), noncompetitive USMLE score (29%), patient population not appealing (29%), noncompetitive research CV (27%), personality not a good fit (27%)
Conclusions: Residents who considered PRS ultimately committed to a broad range of both surgical and medical specialties, often made their decision in their clinical years of medical school, and frequently cited personal perception-based reasons rather than objective factors when choosing not to pursue PRS. Earlier and more standardized exposure to PRS within medical school curriculums, including its wide scope of practice and its members’ varied lifestyles, may help better retain quality applicants.


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