From Contributors to First Authors: Medical Student Authorship in Plastic Surgery, 2010–2025

Background: Medical student research productivity has become an increasingly visible signal in plastic surgery residency selection, yet the extent to which students have transitioned from contributors to first authors within the specialty literature remains unclear. We evaluated temporal trends, authorship structure, and institutional concentration of medical student authorship in plastic surgery publications. Methods: We performed a cross-sectional analysis of U.S.-affiliated articles published in Plastic and Reconstructive Surgery , PRS Global Open , and Annals of Plastic Surgery from 2010 through 2025. An AI-enabled extraction pipeline identified author credentials, authorship position, institutional affiliation, publication year, and team size. Medical students were classified by bachelor-level credentials without concurrent doctoral-level degrees. Temporal trends in medical student first authorship were evaluated using segmented regression with a prespecified 2018 breakpoint. Results: Among 13,723 eligible publications, 4227 (30.8%) included at least one medical student author and 2135 (15.6%) were first-authored by a medical student. Medical student first authorship increased from 58 publications in 2010 (9.5%) to 209 in 2025 (20.9%), peaking at 24.3% in 2022. Mean annual first-author output increased by 143% between the early and late eras (77.8 versus 189.1 publications/year). Segmented regression demonstrated significant post-2018 slope acceleration ( P <0.001). Publications with medical student authors had larger teams than those without student involvement (mean, 6.14 versus 4.01 authors; P <0.001). The top 20 institutions accounted for 53.0% of identifiable student first-author publications. Conclusions: Medical student authorship in plastic surgery has undergone marked temporal acceleration, with increasing first-author leadership embedded within larger collaborative teams. Student first authorship may signal merit, but also reflects access to mentorship, infrastructure, and institutional research opportunity.