American Association of Plastic Surgeons

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Socioeconomic Disparities in Extended Research Experience Participation: Bias in the Integrated Plastic Surgery Residency Match
Lawrence O Lin, MD1, Allyson Huttinger, MD2, Paris Butler, MD, MPH3, Amanda A Gosman, MD4, Jeffrey E Janis, MD1
1The Ohio State University, Columbus, OH, USA, 2Virginia Commonwealth University, Richmond, VA, USA, 3Yale University School of Medicine, New Haven, CT, USA, 4University of California San Diego Health, San Diego, CA, USA

PURPOSE: Integrated plastic surgery residency applicants have increased at a rate disproportionate to available positions. Research productivity has become a surrogate marker for competitiveness, and many applicants pursue extended research experiences (ERE) to distinguish themselves. To date, no study has investigated socioeconomic inequality in ERE participation.
METHODS: The authors distributed a 35-question cross-sectional survey to applicants to United States-based integrated plastic surgery residency programs from the 2019-2022 application cycles. The authors utilized summary tables, studentís t-test, and chi-square tests.
RESULTS: The authors recorded one-hundred sixty-one responses (response rate: 20.9%). Fifty-nine (40.7%) respondents participated in an ERE. The most common reason for ERE participation was strengthening oneís application. The most common reason against participation was avoiding delays in career progression. A greater percentage of respondents from Northeastern medical schools participated in EREs (p = 0.019). There were no significant differences in debt burden between those who did or did not participate in an ERE. A greater percentage of applicants whose parents had advanced degrees participated in EREs (p = 0.053).
CONCLUSION: There are likely geographic and socioeconomic biases present in access to and participation in extended research experiences for students interested in plastic surgery. While EREs can be beneficial for the appropriate candidate pursuing an academic career, their promotion and growth in the current match environment should be carefully measured. As most plastic surgeons ultimately practice in non-academic settings, the financial hardships and suspected socioeconomic inequities in access to research opportunities make them difficult to recommend for most plastic surgery candidates.


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