Kotlier Jacob L, Mihalic Angela P, Homsy Christopher
Department of Surgery, Tufts University School Of Medicine, Boston, Massachusetts.
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas.
J Surg Educ. 2025 May;82(5):103467. doi: 10.1016/j.jsurg.2025.103467. Epub 2025 Feb 25.
Integrated plastic surgery implemented a preference signaling program (PSP) starting the 2022 to 2023 application cycle which allowed applicants to signal their top 5 preferred programs through the Plastic Surgery Central Application (PSCA). In this study, we aim to evaluate the effect on this new PSP at both the applicant and program level.
This cross-sectional study relies on self-reported survey data from 2019 to 2024 from the Texas Seeking Transparency in Application to Residency (STAR) database. Variables associated were analyzed using 2-sided t-tests, Chi-squared tests, variance ratio testing and receiver operating characteristic (ROC) analysis.
Plastic surgery applicants from 2023 to 2024 submitted more applications (85.1 vs 67.3, p < 0.001) and received fewer interview offers (12.5 vs 15.7, p = 0.003) than 2017 to 2022 applicants. 2023 to 2024 interview offers were more evenly distributed (SD: 8.25 vs 10.5, p = 0.001). Applications employing a signal were more likely to receive an interview (OR: 5.72, p < 0.001) and subsequently match (OR: 5.19, p < 0.001). Applications where students had done away rotations were significantly more likely to result in an interview offer (OR: 30.2, p < 0.001) and a match (OR: 27.4, p < 0.001). There was no significant difference in application number, Step 2 CK scores or honored clerkships between matched and unmatched 2023 to 2024 applicants.
The implementation of preference signaling in the integrated plastic surgery residency application process appears to have corresponded to an increase in average applications per student, decreased interview offers and more evenly distributed interviews among applicants. Away rotations, preference signals and geographic connections seem to most strongly predict whether an application results in a successful match.
整形外科学会从2022至2023年申请周期开始实施偏好信号程序（PSP），该程序允许申请人通过整形外科学中央申请系统（PSCA）表明其排名前5的首选项目。在本研究中，我们旨在评估这一新的PSP在申请人和项目层面的效果。
这项横断面研究依赖于2019至2024年来自德克萨斯州住院医师申请透明度查询（STAR）数据库的自我报告调查数据。使用双侧t检验、卡方检验、方差比检验和受试者工作特征（ROC）分析对相关变量进行分析。
与2017至2022年的申请人相比，2023至2024年的整形外科学申请人提交的申请更多（85.1份对67.3份，p<0.001），收到的面试邀请更少（12.5次对15.7次，p = 0.003）。2023至2024年的面试邀请分布更均匀（标准差：8.25对10.5，p = 0.001）。使用信号的申请更有可能获得面试机会（比值比：5.72，p<0.001），随后匹配成功（比值比：5.19，p<0.001）。学生进行过轮转实习所在医院的申请更有可能获得面试邀请（比值比：30.2，p<0.001）和匹配成功（比值比：27.4，p<0.001）。2023至2024年匹配和未匹配的申请人在申请数量、第二步临床知识（Step 2 CK）考试成绩或优秀实习方面没有显著差异。
在整形外科学住院医师申请过程中实施偏好信号似乎对应着每名学生平均申请数量的增加、面试邀请的减少以及申请人之间面试分布更加均匀。轮转实习、偏好信号和地域联系似乎最能有力预测一份申请是否能成功匹配。
