The Plastic Surgery Common Application: Improving Efficiency and Reducing Inequity in the Application Process

Abstract

Summary: The residency application process is expensive, costing an average of $2149 in application fees per applicant during the 2020–2021 cycle. Additionally, the number of applications per applicant continues to rise annually across all specialties. This considerable cost creates a financial barrier for students, particularly those from first-generation and underrepresented backgrounds. Moreover, the Electronic Residency Application Service (ERAS) application generates a lengthy, diluted output that hinders a holistic review. We developed the Plastic Surgery Common Application (PSCA), a focused, specialty-specific application external to ERAS with the goal of lessening the financial barrier for students and improving reviewer satisfaction. The PSCA was revised over a 5-month period after prepiloting with stakeholders. All integrated plastic surgery programs were invited to participate. Of the 86 plastic surgery programs, 20 agreed to participate in the pilot, accepting both ERAS and PSCA for direct comparison. A total of 181 completed applications were received through the PSCA. In a postparticipation survey, most applicants and reviewers felt that the PSCA offered a reasonable alternative to ERAS, despite minor technical difficulties. The PSCA pilot demonstrates that there is a reasonable alternative to applying to residency through ERAS and offers a template for developing a system that is not cost-prohibitive to applicants. The PSCA also demonstrates the benefit of a specialty-specific, customizable application for reviewer efficiency and satisfaction.

Comparative Evaluation of the Electronic Residency Application Service Versus the Plastic Surgery Common Application to a Single Institution in the 2022 Integrated Plastic Surgery Match

“…10 The PSCA was recently proposed as an alternative to ERAS that could help lessen the prohibitive financial costs for applicants who come from underrepresented backgrounds and are interested in plastic surgery. 1 While ERAS has been the traditional way to apply to integrated plastic surgery residency, there are numerous factors in both the PSCA and ERAS applications that can determine the fit of a candidate for a residency program. Several aspects of an application are considered when a residency program evaluates a candidate, including their transcript, letters of recommendation, volunteer experiences, medical school reputation, scholarly work, interviews, away rotations, and the US Medical Licensing Examination board scores.…”

“…Lastly, applicants could submit only 3 letters of recommendation in the PSCA application, whereas the ERAS application allowed 4 letters. 1 Limitations of this study include the single-institution nature, the fact that only interviewee applications were reviewed, and that the basis of evaluation was the 6-core components historically used for applicant review (Fig. 1).…”

“…4 Furthermore, the number of residency programs applied to per applicant continues to rise, as the number of candidates applying to each specialty increases. 1,5 As a result, residency programs are inundated with an increasing number of applications to review, which makes it more difficult to identify those candidates who are seriously interested in their program. 6 These challenges are heightened in plastic surgery, as it is a competitive specialty with a limited number of residency positions.…”

“…The Electronic Residency Application Service (ERAS) is a national application system used to evaluate prospective candidates for residency programs. However, the majority of medical specialties agree that the current application process through ERAS is protracted and associated with prohibitive costs 1 . The cost of applying to residency through the standard ERAS application is expensive, with each applicant spending an average of $2149 in application fees during the 2020–2021 cycle 2 .…”

Strategies to Reduce Congestion in the Resident Match: What Can Plastic Surgery Learn from Other Specialties?

“…The Plastic Surgery Common Application (PSCA) has been piloted over the last three years and represents another effort put forth to combat rising costs of applications for medical students applying to plastic surgery residency. 5 Inefficiency in the current match process is unlikely to resolve without intervention, prompting the discussion of potential changes to the plastic surgery match process. Other medical specialties are facing a similar dilemma, and strategies to improve the match have been successfully incorporated.…”