Strategies to Reduce Congestion in the Resident Match: What Can Plastic Surgery Learn from Other Specialties?

Many medical specialties are experiencing congestion in the residency match process because of increasing competition amongst applicants to secure a training position. With rising application numbers for a stable number of positions, the result is an inefficient use of time and financial resources on behalf of both the residency applicants and programs. Solutions to address congestion in the match process have been proposed in the literature, and other specialties have implemented specialty-wide reforms. Methods: The Pubmed and Web of Science databases were queried using keywords related to the residency match and resident selection. The initial search yielded 372 results. Titles and abstracts were evaluated for inclusion and 93 articles met criteria for full-text evaluation. The bibliographies of these publications were reviewed for additional references. Results: Numerous strategies to reduce congestion in the match were identified across specialties. Implemented reforms include a centralized preference signaling system, an interview cap, a staged or consortia match, and publication of transparent program-specific resident selection criteria. We discuss pros and cons of different strategies to reduce congestion in the match and summarize the effects that recent reforms have had on other specialties. Conclusions: Plastic surgery as a field is at a distinct advantage to be a leader in transforming the residency match process, as we are a small and historically innovative group. We hope to spark discussion amongst students, residents, and program faculty with the goal of creating a more efficient match process.