• Nikki Super, Joshua Tieman, Kenneth Boucher, William Bradford Rockwell, and Jayant P Agarwal.
• From the *Division of Plastic and Reconstructive Surgery, School of Medicine, and †Biostatistics Core, University of Utah, Salt Lake City, UT.
• Ann Plast Surg. 2013 Oct 1; 71 (4): 406-9.

BackgroundMatching into a plastic surgery (PS) residency program is a highly competitive process. Selection criteria are very stringent and may influence an applicant's candidacy and application strategy. The purpose of this study was to evaluate recent trends of applicants matching into integrated PS programs using published National Resident Match Program data.MethodsResidency match data were gathered for application years 2002 to 2011 using the National Resident Match Program/Association of American Medical Colleges databases. Analyses were limited to the US senior group and excluded the non-US senior group because of the small numbers in the latter group. For all data sets, a logistic regression was performed to analyze the statistical significance of the data.ResultsThe overall match rate continues to approximately 50%. United States senior applicants were more likely to rank PS only versus PS and others (PS + other) over time (P < 0.0001) with an odds ratio of 1.2 per year (P < 0.0001). For any given year, US senior applicants ranking PS only were more likely to match versus US senior applicants ranking PS + other (odds ratio, 1.71; P < 0.0001). If this trend continues, it is expected that by 2022, 90% of US senior applicants will rank PS only.ConclusionsThe proportion of applicants ranking PS only is steadily rising. The ranking strategy used by US senior applicants is self-selecting into a more competitive (PS only) and less competitive (PS + other) applicant pool. If this continues, nearly 50% of applicants will not match and could be left scrambling for an alternative residency position. These findings therefore suggest that all candidates, regardless of their perceived application strength, should consider having a "backup plan."

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