Plastic Surgery Research: A Means to an End?

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

Plastic and reconstructive surgery remains one of the most competitive career paths in medicine.1 Currently, there are two pathways to become a plastic surgeon. Graduating medical students either directly match into an integrated plastic surgery residency or they pursue an independent plastic surgery fellowship after completing general surgery, ear-nose-throat surgery, oral and maxillofacial surgery, or orthopedic surgery residency.2 Medical students applying for plastic surgery are among the most highly ranked and accomplished in their medical school classes, earn high scores on U.S. Medical Licensing Examination board examinations,1 and are actively involved in research and scholarly activities.1,3,4 According to the data from the National Resident Matching Program, the mean number of abstracts, presentations, and publications among matched and unmatched integrated plastic and reconstructive surgery applications nearly doubled from 2011 to 2018 (Table 1). Table 1. - Mean Number of Abstracts, Presentations, and Publications NRMP Year Matched Unmatched 2018 14.2 (n = 146) 14.9 (n = 24) 2016 11.9 (n = 124) 6.5 (n = 39) 2014 12.5 (n = 126) 6.4 (n = 52) 2011 8.1 (n = 74) 6.1 (n = 94) NRMP, National Resident Matching Program. Given this trend of increased competitiveness, a growing number of applicants elect for dual degrees, such as an M.D./Ph.D., or dedicated research time before applying for plastic and reconstructive surgery training programs, at either their own institution or in structured extramural research programs (Table 2). Similarly, surgical residents who intend to apply for the independent plastic surgery match often elect to take time off for dedicated research, which may be a protected period built into academic surgical training programs with opportunities for advanced degrees during this time. Table 2. - Research Programs for Medical Students Type of Research Research Program Offered Informal research experience Most training programs with a Department or Division of Plastic and Reconstructive Surgery Formal research programs Doris Duke Clinical Research Fellowship Howard Hughes Medical Institute Medical Research Fellows Program National Institutes of Health Medical Research Scholars Program Institute-specific research programs (i.e., clinical research fellowship in the Division of Plastic Surgery at the University of Pennsylvania) Dual-degree programs Medical scientist training program M.D./Ph.D. D.O./Ph.D. M.D./M.S. M.D./M.P.H. While these research experiences provide an opportunity to learn important skills and train the next generation of surgeon-scientists, potential applicants are often focused on the opportunity to publish and improve their chances of matching. This mentality has prevailed over recent decades, and has likely contributed to the vast decline of the surgeon-scientist in practice. While productivity and an increased competitiveness in applying for residency are important, research should not solely be perceived as a means to this end. A dedicated period of research can contribute to the personal and professional development of trainees, providing exposure beyond the scope of standardized medical school curricula and clinical training. This period of cognitive independence allows students and trainees to mature their interest in plastic surgery, meet mentors, and begin building a professional network, identifying a scientific niche to pursue in their own careers.5 Most importantly, research is a critical part of the continued growth and advancement of the field. Basic and translational investigations improve our understanding of disease processes and have the potential to expand the therapeutic options available to patients. Moreover, clinical research provides the opportunity to evaluate novel therapies and ultimately define and improve patient outcomes. There is great potential for academic plastic surgery training programs to sponsor the rebirth of surgeon-scientists entering the next generation as innovative thought leaders and true academicians. Ultimately, as more trainees elect to take dedicated research time, it is important for them to understand that the value of additional training extends beyond increasing their likelihood of matching into residency. Meaningful and productive involvement in plastic surgery research offers trainees of all stages the opportunity to sow the seeds of their career success and ensure the continued advancement of the field of plastic and reconstructive surgery. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article.