The Popularity and Productivity of Research Years among Matched Plastic and Reconstructive Surgery Residents from 2022-2025

Background: Plastic surgery remains one of the most competitive specialties in medicine. The transition of the USMLE Step 1 exam to pass/fail removed a long-standing quantitative metric, prompting students to seek alternative ways to distinguish themselves—most notably through dedicated research years (RY). Prior studies (Janis et al., Hinchcliff et al.) show that exceeding 15 publications does not significantly improve match outcomes, yet RY participation continues to rise. The 2024 cohort was the first to match under the new Step 1 format. This study analyzes trends in RY participation and productivity among matched applicants from 2022–2025, stratified by degree type. Methods: Two cohorts were analyzed: pre–Step 1 pass/fail (2022–2023) and post–Step 1 pass/fail (2024–2025). A master list of matched integrated plastic surgery residents was compiled using publicly available sources (Google Sheets, residency websites, LinkedIn, ResearchGate), recording program, degree type (MD, DO, US-IMG, non-US IMG), and RY participation. Chi-square tests compared RY incidence across degree types. Cohort matching created equal groups of MD and non-MD residents with and without RYs. Each resident’s research output prior to March 15 of their match year was scored using: (1*all publications + 1.5*first author + 1.5*PRS-related). A two-way ANOVA examined differences in productivity scores by cohort, degree type, and RY status. Results: From 2022–2025, applicants to integrated plastic surgery increased annually by an average of 15, while residency positions increased by only 8.5 per year. RY participation rose significantly post–Step 1 pass/fail (χ2 p < 0.001), driven disproportionately by non-MD residents (χ2 p < 0.001). Despite this, a two-way ANOVA showed a significant cohort effect on productivity scores (F = 5.09, p = 0.028), with the 2024–2025 cohort showing lower mean productivity than 2022–2023. Degree type trended toward significance (p = 0.081), while RY participation alone did not predict productivity. Discussion: Despite increased RY participation—especially among DO and IMG residents—overall research productivity declined. This suggests a growing emphasis on RYs as a compensatory strategy for perceived disadvantage in a post–Step 1 numeric environment, yet it is not mirrored in returns in scholarly output. The disconnect between RY participation and output raises concerns about efficiency, equity, and opportunity cost. RYs may now serve more as strategic pauses than scholarly pursuits, offering time to build networks, secure mentorship, and navigate structural barriers, particularly for non-traditional applicants. While AOA membership and strong letters remain key predictors of match success, the added value of RYs—independent of publication metrics—is unclear. As research years increasingly substitute for a high Step 1 score, they risk becoming another checkbox in an overly metric-driven application process.