Unmatched. What’s Next? Is A Preliminary Year Of Residency Or Research Fellowship Better For Reapplicants To Plastic Surgery?

PURPOSE: Matching into a plastic and reconstructive surgery residency remains challenging. Match rates have declined since 2018, with a match rate of ~55% in 2022. Two common options before reapplying are a preliminary year of residency (PY) or a research fellowship (RF). This study investigated which option is more likely to lead to a successful match for reapplicants. METHODS: This retrospective study included all applicants to an integrated plastic surgery residency from 2015-2023. Two cohorts based on reapplication strategy (RF or PY) were created. Demographic, applicant, and match data were collected. Pearson's Chi-squared, Fisher's exact, and Wilcoxon rank sum testing was performed. RESULTS: 125 reapplicants were included. 71 (57%) and 29 (23%) pursued a PY or RF, respectively. Compared to PY reapplicants, RF reapplicants had a greater mean number of first author publications (8.8 vs 3.2, p<0.001), non-first author publications (11.0 vs 6.0, p=0.021), poster presentations (9.7 vs 6.0, p=0.028), and oral presentations (12 vs 6, p<0.001). RF reapplicants were more likely to match into plastic surgery than PY reapplicants, with 21 (72%) RF reapplicants matching into plastic surgery vs 28 (39%) PY reapplicants (p=0.003). When comparing only RF and PY reapplicants who matched into any specialty, RF reapplicants were again more likely to match into plastic surgery compared to PY reapplicants (84% vs 54%, p=0.010). CONCLUSION: RF reapplicants demonstrated greater research productivity than PY reapplicants. The rate of RF reapplicants matching into a plastic surgery residency was almost double the rate of PY applicants.