key: cord-0947728-hdx5bc21 authors: Egan, Katie G.; Nauta, Allison; Butterworth, James A. title: COVID-19 Effects on 2021 Home Program Match Rates at Integrated Plastic Surgery Programs date: 2021-12-27 journal: Plast Reconstr Surg DOI: 10.1097/prs.0000000000008746 sha: ae2f7212546f55beb71116e4dfd2cfc3be854d5d doc_id: 947728 cord_uid: hdx5bc21 nan the 2021 match were adapted by the American Council of Academic Plastic Surgeons. In an effort to eliminate disparities, visiting subinternship opportunities were eliminated. Likewise, in-person interviews were universally replaced with virtual interviews and visits. We hypothesized that changes to the 2020/2021 match year would have an impact on match patterns. Due to decreased in-person interactions, we anticipated that home institution match rates would be increased compared to previous years. Program match data were obtained from Instagram accounts of integrated plastic surgery residencies following the release of 2021 match results on March 19, 2021. Applicant medical schools were recorded. Medical schools were classified as either home program or non-home program match. A total of 181 applicants (96.8 percent) were identified of 187 integrated plastic surgery residency positions from the 2021 match. The majority of matched candidates came from schools with an affiliated integrated plastic surgery program (135 of 181, 76.7 percent). Medical students matched at the integrated residency program affiliated with their home medical school in 44 instances (24.3 percent). When compared to historical data, 2021 applicants were statistically more likely to match at their home program (p = 0.004). 4 The number of applicants matching from programs that did not have an affiliated plastic surgery program was also statistically lower than previously published data (p = 0.004). 1 The 2021 integrated plastic surgery match cycle presented unique challenges due to the ongoing public health crisis. With changes to interview structures and eliminating away subinternships for those with access to a home plastic surgery program, rates of medical students matching at home institutions were significantly higher. Although medical students from schools without plastic surgery programs may have had the opportunity to complete an away subinternship, a significant decrease in the match rate for students from schools without a plastic surgery program was seen. There were likely significant cost savings to applicants of the 2020/2021 match cycle. Drolet and colleagues estimated that the average cost of away subinternships is $3951. 3 An additional cost of $2500 to upward of $10,000 may be accrued related to interviews. 5 However, the value of in-person interactions sustained through these instruments should not be overlooked. The majority of applicants reported feeling that an away subinternship makes them more competitive at the program at which they are rotating. 3 In addition, applicants have rated interactions with faculty and residents as the most important aspect in evaluating a program interview, and this may be diminished in the virtual setting. Increasing diversity in trainee backgrounds through outside and away student matches may allow for shared experiences to benefit both residency programs and trainee education. Although short-term costs may be substantial to precedence over complimentary phrases in the absence of a discussion of the candidate's research. In summary, the present analysis underscores the importance of the unstructured letter when compared with standardized elements of the recommendation, emphasizing that efforts to standardize the letter of recommendation may offer little differentiation among candidates. O ver the past 10 years, the proportion of applicants matching at home and visiting subinternship institutions has been consistent. Home institution matches represent about 15 percent of successful matches and visiting subinternship matches represent a higher proportion at 27 percent to 30 percent. [1] [2] [3] [4] Due to the coronavirus disease of 2019 pandemic, guidelines regarding Volume 149, Number 2 • Viewpoints 369e A survey questionnaire was designed using Research Electronic Data Capture software (REDCap; developer, Vanderbilt University). The survey included questions about participant and program demographics and detailed questions regarding social media use. The survey was emailed to 135 program directors and division chiefs, as well as 88 program coordinators. The program coordinators were asked to distribute the survey to residents at their respective programs. Completed responses were recorded and analyzed. Forty-five faculty responded, resulting in a 33 percent response rate for the faculty group. An additional 30 responses were received from the trainee group. Sixty-seven percent of the faculty responses were from program directors and 33 percent were from division chiefs. Eighty percent of the trainee responses were from integrated residents and the remaining 20 percent were from independent residents. Seventy-six percent of programs reported having an official social media account, similar to results obtained by Azoury et al. 3 Instagram appeared to be the most popular platform in our study, with 85 percent of programs using it (Fig. 1) . The most common reasons for social media use were branding (77 percent), education (74 percent), and residency recruitment (66 percent). Our study found that the majority of social media accounts were managed by residents (65 percent) (Fig. 2) . Sixty-nine percent of faculty reported social media increased the reach of the program to potential applicants. This is likely due to increasing number of applicants using online resources to find information about training programs before submitting applications. 4, 5 Only 22 percent of programs reported using social media as a screening tool during the residency interview process. Of those programs that did, 70 percent reported it affected whether an applicant received an interview. Almost all plastic surgery trainees had at least one personal social media account (97 percent). Preferred platforms are shown in Figure 1 . Only 19 percent of trainees currently had a separate professional account. However, 52 percent of trainees planned to have a professional social media account after completing training. Sixty-nine percent of faculty reported having guidelines for social media use at their university. Fifty-one percent reported not having formal training for residents and faculty. Breach of patient privacy was reported by 11 percent of programs and 31 percent had professionalism concerns. Only 58 percent of programs had reprimands in place for inappropriate use. Overall, our data suggest that social media use is common among plastic surgery training programs. The most popular social media platform appears to be Instagram. While many universities have guidelines to govern institutional social media use, the majority do not provide residents with formal training in this arena. Further studies should focus on the development of proper training modules for social media use medical students, long-term benefits of resumed away subinternships likely warrant safe resumption of away subinternships as allowed. States over the past 15 years. Despite its widespread use in plastic surgery, the role of social media within plastic surgery training programs has yet to be well defined. 1,2 Therefore, the purpose of our study was to determine the prevalence, purpose, and ethical principles guiding social media use in plastic surgery training programs within the United States. Factors determining the ultimate fate of a plastic surgery applicant Integrated plastic surgery applicant review: Important factors and selection criteria A closer look at the 2013 to 2014 integrated plastic surgery match An updated view of the integrated plastic surgery match A closer look at the 2013 to 2014 integrated plastic surgery match Outcome analysis of factors impacting the plastic surgery match Away rotations and matching in integrated plastic surgery residency: Applicant and program director perspectives Geographic trends in the plastic surgery match The residency application process: Burden and consequences The authors have no financial interest to disclose. No funding was received for this study.