More Than a Home Program: Institutional Deficits Hindering Medical Student Engagement in Plastic Surgery

Objective: Choosing a specialty is a challenging, multifactorial decision for medical students, especially when considering competitive residencies like plastic and reconstructive surgery (PRS). This study examines students’ exposure to the field as well as influential factors when considering a PRS career. Methods: A cross-sectional survey was distributed to U.S. and Canadian medical students interested in PRS to investigate attitudes, demographics, influential factors, and exposures. Results: Eighty-seven submissions were analyzed. Of those, 47.1% report being hesitant to fully pursue PRS—58.5% of whom cite a lack of resources to feel confident in matching. Between students with and without a home program, there were notable differences in resource availability. Considering positive factors of PRS, 80.5% highlighted patient impact, with 64.4% ranking it as a top motivator. Conversely, 70.1% identified the competitive nature as a deterrent, followed by residency duration and perception of the general public. Among PRS subspecialties, cosmetic and breast surgery had the highest levels of exposure. Overall, the most cited sources of exposure were self-research (45.5%) and shadowing (43.6%)—many times experienced before medical school. There were no significant differences between students with and without home programs in their interest in, exposure to, or knowledge of the included subspecialties. Conclusion: Given new heights for a successful match into PRS, early interest is crucial to begin research, foster supportive networks, and engage with PRS communities. This data can guide institutions and PRS organizations to enhance early exposures and targeted resources, ultimately making this field more equitable and accessible for all applicants.