Saturday, February 16, 2013


It is a truth universally acknowledged that plastic surgery is the most elusive residency in the United States. Unlike most other major surgical subspecialties, there are two well-defined routes to becoming a plastic surgeon—the independent and integrated pathways.1 The integrated pathway consists of 6-year training programs that accept graduating medical students, whereas the independent pathway consists of 3-year training programs that accept graduates of general surgery, neurological surgery, orthopedic surgery, oral and maxillofacial surgery, otolaryngology, and urology residency programs. Both pathways are very competitive—in 2011, only 44 percent of U.S. seniors applying to integrated plastic surgery programs matched into the specialty.2 For comparison, the next lowest match rate belonged to orthopedic surgery, at 77 percent. The competitiveness of the independent pathway has diminished slightly since the training program was lengthened from 2 years to 3 years, but it remains in high demand, with the match rate ranging between 39 and 82 percent over the past 5 years.3,4 Clearly, plastic surgery program directors enjoy a buyer's market.