Summary: Plastic and reconstructive surgery is among the most competitive specialties in the residency match. Applicants seeking to maximize their chances of a successful match often submit numerous applications to the National Residency Matching Program. It is not uncommon for those applying to plastic and reconstructive surgery to apply to every program. The high application volume imparts significant time and financial burden for applicants and programs alike. Furthermore, it makes distinguishing between applicants with a genuine interest in a specific program and those who are merely hoping to improve their chances vastly more difficult. The authors sought to characterize trends in the match rate, as the number of integrated plastic and reconstructive surgery programs continues to increase. Furthermore, they reviewed the literature on game theory for possible solutions to residency application congestion. The authors propose the use of the game theory model to explain the observed results and show why an application limit is the most reasonable approach to address this issue.

The authors found aesthetic chief resident clinics to differ greatly in their structure. Yet the variety of procedures and services offered makes participation in these clinics an effective training method for the development of both aesthetic surgical technique and resident autonomy.

IntroductionThe process of applying to residency can be expensive for medical students, and the approach to financing this expense varies considerably from student to student. The process may become more burdensome as the match becomes increasingly competitive with recent advising strategies focusing on application to an increasing number of programs or on parallel application to alternative programs. The role of finances in students' decision-making during the residency application process is unclear though of critical interest due to the implications it has for our community. In addition to medical student debt burden, a financially driven application process may have implications on specialty demographics and diversity in medicine. In order for us to begin to understand and ultimately proactively address these long-term implications, the Organization of Student Representatives (OSR) has initiated periodic distribution of a questionnaire to assess and track the financial burden that applying to residency has on medical students and how students defray these costs. ImplementationIn March 2015, the OSR distributed a questionnaire concerning the cost of applying to residency in the 2014-2015 application cycle through the OSR listserve, requesting that OSR representatives disseminate it to fourth year students at their institutions. There were 959 partial or complete responses to the questionnaire. It is important to note that the questionnaire assessed expense related to interviewing (lodging and travel); the figures discussed throughout do not represent total cost to applicants over the interview season (e.g., additional costs associated with ERAS fees), but rather a key portion of the costs that are not usually traceable by other means. The results of the questionnaire presented in this report represent a small sample of medical students from institutions across the country. The self-reported and unverified data represent crude estimates and we are unable to assess the sampling bias associated with this questionnaire. The results should be interpreted with these limitations in mind. DemographicsDemographic information about the respondent's institution and specialty choices were collected. Figure 1. Out of 953 responses, 431 (45%) respondents identified their institution as private and 522 (55%) as public.Figure 2. Out of 953 responses, 670 (70%) of respondents identified attending medical school in an urban environment, 227 (24%) in a suburban environment, and 56 (6%) in a rural environment. Private 45% Public 55% n = 953 Rural 6% Suburban 24% Urban 70% n = 953 Figure 3. Out of 953 responses, 313 (33%) of respondents identified attending medical school in the Central Region, 287 (30%) in the Southern Region, 238 (25%) in the Northeast Region, and 115 (12%) in the Western Region.Figure 4.Out of 958 responses, 814 respondents (85%) applied to one specialty (inclusive of applicants who additionally applied to preliminary positions in medicine, surgery, or transitional programs), 68 (7%) applied to two distinct spe...

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