American Association of Plastic Surgeons

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The Plastic Surgery Prisoner's Dilemma: The Inverse Relationship Between Number Of Residency Applications And Match Rate
Felipe Molina Burbano, BA, Amy Yao, BS, Jeffrey Stock, MD, Peter J. Taub, MD.
Icahn School of Medicine at Mount Sinai, New York, NY, USA.

PURPOSE
Plastic surgery is one of the most competitive residency matches. The mean number of applications per applicant is correspondingly high, creating significant time and financial strains. In this study we examine whether an increased number of applications confers an application benefit by correlating the number of applications with the match rate.
Methods
The authors analyzed annual data from the NRMP and ERAS for integrated plastic surgery programs since 2010 to assess the association between mean number of submitted applications and the match rate for that year, adjusted for the number of available positions.
Results
An inverse relationship between mean number of applications submitted and the adjusted match rate approached significance at p=0.09 (Figure 1). There was no significant relationship between the mean number of submitted applications and the unadjusted match rate (p=0.516) or the mean number of spots ranked by each applicant (p=0.345).
Conclusion
Our study suggests that applying to a greater number of programs does not correlate with increased chances of matching. This may be explained by the prisoner's dilemma paradox of game theory. If each applicant acts in their own self-interest and applies to a large number of programs, all individuals have a reduced chance of matching. An application limit may benefit the applicant by saving time and resources, without decreasing their chances of a successful match.


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