How to get into a Plastics Residency?

[lackey]

I'm a first year student, and I think I might be interested in plastic and reconstructive surgery for residency. Basically, what are some things that are highly recommended to land a seat in a competitive specialty like plastic/reconstructive surgery? I know grades and step 1 scores are important, so I've been working on grades. Unfortunately, I'm hovering more on the B+ side than the A side, so I don't expect to be in AOA since statistically, like a third of my class is scoring better than me. I did manage to land a research position with my school's plastics department for the summer, so I'm excited for that. What other things could I do to improve my app in general from the get go?


I know I have a ways to go to finalize this decision and I shouldn't worry, but I figure it would be smart to prepare as if I wanted to go into that field just in case I actually choose it. I don't think a great step 1 will be improbable since I scored really well on my MCAT (yes they're not comparable, but maybe good scores are correlated), and I have been doing okay in my classes as well, but ultimately, I know that step will decide my options for me.I just want to set my self up for success in the long run, and I feel like if I prepare myself to be competitive for a residency like that, then I'll be better off for many other choices that I might have in the future.

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[BurghStudent]

Focusing on grades, USMLE (eventually), and research is the best approach, and you're already taking it.

You're probably right that preparing for a plastics residency, probably the most competitive match would de facto make you a competitive applicant. Off the cuff, it would look great for general surg, ortho, ENT et. However, it might not be optimal for other competitive fields if you decide to change your mind. Just a thought. You're fine.

 

[neusu]

It sounds like you're an average student. If you can score well on Step 1, that make a difference. Try not to get too involved in your research endeavors so as to blow off classes or the Steps. This is a common fatal flaw. Certainly, there will be someone in your class who scores >265 who says "Hey, I want to to PRS." He'll show up and your department will fawn over him and you'll be last weeks news with your average score.

 

[lackey]

Is it possible to land a competitive residency of this caliber without making all As or being in AOA? I hear AOA thrown around a lot, and everyone in my class makes it seem like you have to be flawless in your preclinical years and cure cancer in your time off to land something this competitive. Does anyone else have any other legitimate input?

 

[surgok]

I think the recipe is pretty obvious. Do well in classes, step 1, rotations, and publish as many papers as possible in plastics or related fields. Also LORs and network..
Still 50:50 even with a perfect application.

 

[BurghStudent]

Is it possible to land a competitive residency of this caliber without making all As or being in AOA? I hear AOA thrown around a lot, and everyone in my class makes it seem like you have to be flawless in your preclinical years and cure cancer in your time off to land something this competitive. Does anyone else have any other legitimate input?

In a word, yes. AOA is by no means a prerequisite. That being said, it never hurts to make sure you always perform to your fullest capacity. Then, you just have to roll the dice. Really, what is the other alternative- taking it a little easy because you know AOA etc is not required? No. You want to be an excellent doctor either way.

Also, realize that there are other ways to get what you want. Let's say you want an integrated plastics residency, but by application time you know you don't have the stats. Do you give up? No, if you want to do plastic surgery, do a general surgery residency and then a two year plastics fellowship. If you want to focus on facial plastic surgery, try competing for ENT instead. If you really want to focus on one area, you could do oculoplastics as an ophthalmologist. Point is, there are many roads to the same destination, and many destinations with the same road.

 

[DermViser]

In a word, yes. AOA is by no means a prerequisite. That being said, it never hurts to make sure you always perform to your fullest capacity. Then, you just have to roll the dice. Really, what is the other alternative- taking it a little easy because you know AOA etc is not required? No. You want to be an excellent doctor either way.

Also, realize that there are other ways to get what you want. Let's say you want an integrated plastics residency, but by application time you know you don't have the stats. Do you give up? No, if you want to do plastic surgery, do a general surgery residency and then a two year plastics fellowship. If you want to focus on facial plastic surgery, try competing for ENT instead. If you really want to focus on one area, you could do oculoplastics as an ophthalmologist. Point is, there are many roads to the same destination, and many destinations with the same road.

With doing a general surgery residency, you are no way assured of getting a plastic surgery fellowship afterwards. Plastic surgery applicants in general surgery, tend to be top of their residency class with top scores on their ABSITE exam. So be wary, that if you do the general surgery route, you need to be ok with the possibility of being "stuck" possibly doing general surgery, if you don't match.

 

[alpinism]

Agreed.

Don't go into general surgery expecting to do plastics afterwards.

If you really want plastics, you're on the right track. Do some research over the summer (I'd also try get a few case reports published) and study your ass off during M2. Hopefully you can pull a 250+ step 1.

 

[lackey]

The reason why I say I won't get AOA is because I'm just preparing for the worst, in case it happens. I am not going to expect anything to be handed to me, so I wanna make sure I cover all my bases if I can. I'll definitely try and work harder this year and try and do some productive research this summer while trying to network. I wont start worrying about step till a year from now, but hopefully I'll be able to do well on that too. I just wanted to know how the whole volunteering and involvement in various organizations and mission trips etc, how all that other stuff aside from academics figured into the equation. I was trying to look up some match stats and stats of the average accepted/applied applicant, but for some reason, the NRMP site said the pages I wanted to look at were taken down.

I think I would like to do something surgical in the future so I do feel fortunate that things like ENT and general surgery and the like can overlap with plastics, assuming I still would like to do it when I apply for residencies.

 

[ulikedaggers]

The reason why I say I won't get AOA is because I'm just preparing for the worst, in case it happens. I am not going to expect anything to be handed to me, so I wanna make sure I cover all my bases if I can. I'll definitely try and work harder this year and try and do some productive research this summer while trying to network. I wont start worrying about step till a year from now, but hopefully I'll be able to do well on that too. I just wanted to know how the whole volunteering and involvement in various organizations and mission trips etc, how all that other stuff aside from academics figured into the equation. I was trying to look up some match stats and stats of the average accepted/applied applicant, but for some reason, the NRMP site said the pages I wanted to look at were taken down.

I think I would like to do something surgical in the future so I do feel fortunate that things like ENT and general surgery and the like can overlap with plastics, assuming I still would like to do it when I apply for residencies.

ENT is almost up there with Plastics in terms of competitiveness afaik.

 

[evilbooyaa]

ENT is almost up there with Plastics in terms of competitiveness afaik.

No way. 2011 NRMP Charting the Outcomes puts an average step score at 250 for Plastics, 240 for ENT.

Of U.S. Seniors, 74 matched into plastics (94 didn't). 267 matched ENT (45 didn't).

ENT is competitive for sure, but integrated plastics is just a diffferent beast.

 

[member1000765]

No way. 2011 NRMP Charting the Outcomes puts an average step score at 250 for Plastics, 240 for ENT.

Of U.S. Seniors, 74 matched into plastics (94 didn't). 267 matched ENT (45 didn't).

ENT is competitive for sure, but integrated plastics is just a diffferent beast.

You're referring to data that is 3 years old now. Most ENT applicants receiving interviews nowadays have STEP 1 scores in the 250s-260s. Integrated plastics will always be the most competitive specialty to match into because there are so few spots. If all PRS programs nationwide go integrated, which will probably never happen, it would probably drop behind in competitiveness. You don't have to do general surgery to match into a plastics fellowship. You can also match into a PRS fellowship if you've completed an ENT, OMFS, or Urology (and maybe ortho, too?) residency, and frankly you're much better prepared for plastics if you come out of ENT or OMFS, because you have much more extensive soft tissue and craniofacial reconstructive training during your residency.

To the original poster, if plastic surgery is what you want to do, and you feel like you would be happiest in your career as a plastic surgeon, then go for it. Be realistic when it comes to your chances of matching and have a viable alternative in case you don't match into the integrated route, but remember that there are multiple routes to becoming a plastic surgeon in the end as long as you're committed to reaching that goal. If it doesn't work out, then it doesn't work out, but at least you tried, and by aiming for something really competitive you'll probably increase your performance status for the rest of your medical school career.

 

[evilbooyaa]

You're referring to data that is 3 years old now. Most ENT applicants receiving interviews nowadays have STEP 1 scores in the 250s-260s. Integrated plastics will always be the most competitive specialty to match into because there are so few spots. If all PRS programs nationwide go integrated, which will probably never happen, it would probably drop behind in competitiveness.

Your anecdotes about average step scores doesn't mean a whole lot IMO. Even if you are an ENT resident and play a role in the application process, you are saying that the AVERAGE Step 1 is 250+ for ENT? Maybe at your instituion (if you were a rock-star med student).

I don't disagree with what you said about PRS dropping in competitiveness if all the fellowship spots became residency spots.

But when you have over 50% of US seniors (even if it is 3 years ago) not matching into their desired specialty (even though most of those people likely have very good back-up plans), it's hard to think that it is not more competitive than ENT.

 

[KinasePro]

lol @ ENT step 1 average being 250-260. That dude's FOS.

 

[ulikedaggers]

No way. 2011 NRMP Charting the Outcomes puts an average step score at 250 for Plastics, 240 for ENT.

Of U.S. Seniors, 74 matched into plastics (94 didn't). 267 matched ENT (45 didn't).

ENT is competitive for sure, but integrated plastics is just a diffferent beast.

I agree. I just meant that ENT is not really an easy way into plastics.

 

[evilbooyaa]

I agree. I just meant that ENT is not really an easy way into plastics.

I mean, it's not an 'easy' way. No way is. If you want to do it as a fellowship (even after general surg) you have to have research (residents at my hospital's gen surg program generally take 1-2 years off for it) plus rock your ABSITEs.

 

[BurghStudent]

If I recall correctly, aren't AOA ENT programs that DOs can match into combined Otolaryngology/Head&Neck Surgery/Facial Plastics? So they don't have to complete a fellowship?

 

[VisionaryTics]

If I recall correctly, aren't AOA ENT programs that DOs can match into combined Otolaryngology/Head&Neck Surgery/Facial Plastics? So they don't have to complete a fellowship?

It's just semantics. You get training in facial plastics in both AOA and ACGME ENT residency, but it's really limited. No one does much facial plastics at all out of residency without a fellowship.

 

[evilbooyaa]

If I recall correctly, aren't AOA ENT programs that DOs can match into combined Otolaryngology/Head&Neck Surgery/Facial Plastics? So they don't have to complete a fellowship?

I imagine if an an AOA trained ENT wanted to do purely plastics he would still have to go through a fellowship. Not 100% sure if this is true, however.

 

[FIREitUP]

lol @ ENT step 1 average being 250-260. That dude's FOS.

sorry to bump this thread. average is 244 as per AAMC

 

[Kaputt]

sorry to bump this thread. average is 244 as per AAMC

244...
https://www.aamc.org/cim/specialty/list/us/336856/otolaryngology.html

 

[rocketbooster]

Yea 244 was ENT and 249 was plastics in 2011. That's not a huge difference. And I wonder how competitive those 50% who don't match plastics are. They all know there are alternative routes to plastics so there may be many with a low chance just applying for the heck of it in case they get lucky and can skip GS residency.

 

[Daodejing]

for anyone that cares, here is a user-generated PRS list:
https://docs.google.com/spreadsheet...bmFBMWktZnI0R2RNOTR6WjRTdUE&usp=sharing#gid=0

based on the culled data, ~250 Step 1, ~255 Step 2, with ~2/3 AOA

 

[rocketbooster]

for anyone that cares, here is a user-generated PRS list:
https://docs.google.com/spreadsheet...bmFBMWktZnI0R2RNOTR6WjRTdUE&usp=sharing#gid=0

based on the culled data, ~250 Step 1, ~255 Step 2, with ~2/3 AOA

Those lists are always way overestimated because only the ppl at the top report their Step 1s. The urology list is similar. On this list only 40/140 reported scores, so it's pretty meaningless. There's supposed to be a new Charting Outcomes coming out next year, so that'll be much better data.

 

[Daodejing]

Those lists are always way overestimated because only the ppl at the top report their Step 1s. The urology list is similar. On this list only 40/140 reported scores, so it's pretty meaningless. There's supposed to be a new Charting Outcomes coming out next year, so that'll be much better data.

I realized that, which is why I said user-generated. But more importantly, the AAMC and NRMP have finally settled their squabble? Now there's some good news.

 

[mdambitions]

I'm still excited about just getting accepted to medical school, so I have no idea what I want to specialize in yet... just wandering around the forums, saw this post and took a look at that document. Good god! How does one acquire 30 publications/posters/etc... in 4 years? PhD? I understand STEP I is the ultimate decider of futures, but is this level of research expected of the most competitive specialties? Is it luck + a good lab + awesome PI? I suddenly feel like I'm already behind. Any advice on how to you keep yourself open to all possibilities and generally "competitive" if you're not sure of your intended specialty?

 

[Slack3r]

Those lists are always way overestimated because only the ppl at the top report their Step 1s. The urology list is similar. On this list only 40/140 reported scores, so it's pretty meaningless. There's supposed to be a new Charting Outcomes coming out next year, so that'll be much better data.

The last Charting Outcomes pegged average Step 1 for successful PRS matches at 249. An increase in one point wouldn't be too surprising, especially since the average board score has increased quite a bit since 2011.

 

[Daodejing]

I'm still excited about just getting accepted to medical school, so I have no idea what I want to specialize in yet... just wandering around the forums, saw this post and took a look at that document. Good god! How does one acquire 30 publications/posters/etc... in 4 years? PhD? I understand STEP I is the ultimate decider of futures, but is this level of research expected of the most competitive specialties? Is it luck + a good lab + awesome PI? I suddenly feel like I'm already behind. Any advice on how to you keep yourself open to all possibilities and generally "competitive" if you're not sure of your intended specialty?

30+ is definitely an outlier. According to the document, the avg was 13-14. Also, keep in mind that these are research experiences, not pubs. You'll be surprised at how "experiences" can accrue, especially if you show initiative. PhD can definitely help add onto your #, but there's no guarantee, and you will still have to be proactive. Step is not the ultimate decider but plays more of a role as a limiter. It is one of the most crucial components of your file but not the only one. It can only close doors.

There's no denying that you should always be open to all possibilities. If you want to be seen as competitive w/o knowing what you want to do in the first couple years, then it's the age-old mantra of studying efficiently, and thereby doing well in class. Research in the most competitive field you're interested in also doesn't hurt, but don't dabble and waste your time. It can be a huge time-sink if you don't know what you're doing.

Also, do yourself a favor and try not to be so neurotic and "feel behind" this early. Enjoy your recent success, and you'll be fine.

 

[FIREitUP]

while the average step 1 has increased i wonder what percent of those are 250+? i would guess the increase in 250+ scores are minimal at best.

 

[caffeinemia]

OP! I'm glad you are thinking about this early. It definitely requires some pre-planning and will save you a lot of headaches later on when you applied.

You dern screwed up son, cuz you went to a school with pre-clinical grades. Shoulda done that shiet P/F. I joke.

AOA is nice, but not prerequisite. Otherwise, get honors in med and surg, at least. Life is tough without those. Get Step 1 off the hook. Research CV off the hook like 10+ pubs/abstracts/presi, etc.

Don't forget the MOST IMPORTANT thing in plastics. FRIENDS/PATRONS/OVERLORDS. You need good friends in high places writing letters, making calls, etc. That's because academic plastics is a tiny field compared to other specialties... maybe 500-1000 people who really determine the residency/fellowship show and they all know each other via golf, dining clubs, conferences, wine tours in Europe, being rich clubs, or whatever. I would say if you're doing research this summer, your goal should be first and foremost to make some friends (ie grovel and be research biatch for senior residents/attendings), and secondary goal to get on board or complete some clinical projects to get the ball rolling on that CV. Let me just say that if you prove yourself an excellent research slave, you'll be looked upon very favorably. If you fail and fack up the project or create more headaches than help, you may get blacklisted permanently. Keep your head down and hustle! Goodluck!

 

[notbobtrustme]

you know that guy gunning for derm?

Work harder than that guy.

 

[Kahreek]

you know that guy gunning for derm?

Work harder than that guy.

I lolled at this, and lolled even harder when I saw the dermviser like 😀
Seems that plastics is pretty posh, like in the bad way.

 

[lackey]

OP! I'm glad you are thinking about this early. It definitely requires some pre-planning and will save you a lot of headaches later on when you applied.

You dern screwed up son, cuz you went to a school with pre-clinical grades. Shoulda done that shiet P/F. I joke.

AOA is nice, but not prerequisite. Otherwise, get honors in med and surg, at least. Life is tough without those. Get Step 1 off the hook. Research CV off the hook like 10+ pubs/abstracts/presi, etc.

Don't forget the MOST IMPORTANT thing in plastics. FRIENDS/PATRONS/OVERLORDS. You need good friends in high places writing letters, making calls, etc. That's because academic plastics is a tiny field compared to other specialties... maybe 500-1000 people who really determine the residency/fellowship show and they all know each other via golf, dining clubs, conferences, wine tours in Europe, being rich clubs, or whatever. I would say if you're doing research this summer, your goal should be first and foremost to make some friends (ie grovel and be research biatch for senior residents/attendings), and secondary goal to get on board or complete some clinical projects to get the ball rolling on that CV. Let me just say that if you prove yourself an excellent research slave, you'll be looked upon very favorably. If you fail and fack up the project or create more headaches than help, you may get blacklisted permanently. Keep your head down and hustle! Goodluck!

Thanks for the input! When I met with the research director a while ago, she mentioned that I should expect a few papers out of this research program and maybe even present at a national conference. Now I know that it isn't set in stone, it's nice to hear how she mentioned that she's been doing this with students for a while and they all end up getting at least 1 first author paper and maybe a few more and they have had 1 person go to a national conference for the past 2 years. Even if I don't wanna do plastics, I feel like getting in their good books and working hard this summer will be beneficial to me so I can learn and grow from the experience!