The Comprehensive Cost of Applying to Plastic Surgery: Unveiling Financial Burdens Along the Pipeline

This is the authors' abstract. We don't add key points for this paper.

Introduction: For those pursuing a career in plastic surgery (PS), preparation often begins long before applying to residency programs as a fourth-year medical student. With the historically challenging nature of matching into PS, it is no surprise that the expectations for competitive PS applicants, like publishing research frequently and networking year-round at conferences, commonly incur significant expenses upon students. Though a few studies have explored the financial implications of the PS application process, our study is the first to detail the comprehensive costs of pursuing PS throughout the entire pipeline. Methods: A branched logic survey was created to inquire about respondents' demographics, personal finances, expenses related to education and research, and opinions on the comprehensive costs of pursuing PS. The survey was distributed internally among 30 senior medical student members of a virtually-based PS research group. Data was collected over a one-week period and results were analyzed using descriptive statistics. Results: The survey achieved an 83.3% response rate. The majority of respondents were third-year students (40.0%), followed by students in a dedicated research year (32.0%). Most attended a school without a home integrated residency program (44%). Of students who pursued a research year, 40.0% did not receive any funding and 60.0% reported a cost of living that exceeded their income. Most respondents have attended >5 PS conferences (52.0%) with a median total cost of $2,000 - $3,000. Most fourth-year students participated in three away rotations with a median total cost of $6,000 - $9,000. The comprehensive financial burden of pursuing a career in PS, including tuition debt, PS-related extracurricular activities, and application-associated costs is estimated to be $212,000 - $217,300. Table 1 provides a detailed summary. When asked if financial security, work-life balance, and length of training are barriers to pursuing PS, 72.0% reported "yes, more than in other specialties." All respondents believed that the cost of becoming a plastic surgeon was either too high or excessively high. When asked if the overall costs were worth becoming a plastic surgeon, 48.0% reported "probably yes," 40.0% reported "definitely yes," and 12.0% reported "maybe." Conclusions: In considering the length of PS residency, often an additional research year, and the emphasis on attending conferences and publishing research, students pursuing PS face a substantial opportunity cost compared to other specialties. The financial investment required to pursue PS is not sustainable for most. In light of this burden, additional efforts should be made to reduce financial barriers for PS applicants. Ensuring funding to all students pursuing a research year, increasing funding for conference attendance and away rotations, opportunities for loan forgiveness, and decreasing length of training are a few potential solutions to offset the cost of applying to PS.