Plastic and reconstructive surgery (PRS) is among the most competitive specialties, with up to 45% going unmatched each year. While extensive research exists on first-time PRS applicants, data on reapplicants remain limited. This study examines PRS Program Directors’ (PDs) perceptions of reapplicants, preferred pathways, and key factors influencing reapplication success.

The 12-item survey included questions regarding perceived stigma toward reapplicants, recommended reapplication strategies, and barriers to matching.

Multi-institutional

The survey was distributed via email to PRS PDs through American Council of Academic Plastic Surgeons from November 2024 to February 2025.

Twenty-five (28.5%) PDs completed the survey. Of these, 21 (84.0%) acknowledged stigma toward reapplicants, while 20 (80.0%) reported offering interviews at least "sometimes." PDs who recognized stigma were not significantly more likely to offer interviews than those who did not (45.5% vs. 33.3%; p = 0.593). The most favored pathways were a preliminary surgical internship (n = 17, 54%) and research fellowship (n = 11, 22%). Key factors for reapplicant success included excelling in clinical rotations (n = 11, 22.0%), conducting new research (n = 9, 18.0%), and rotating in the target department (n = 7, 14.0%). The greatest barriers were lack of resume improvement (n = 11, 22.0%), poor interview performance (n = 8, 16.0%), and weak letters of recommendation (n = 8, 16.0%).

While stigma exists, most PRS programs still consider reapplicants. The most recommended pathway for reapplicants was a preliminary surgical internship, followed by a research fellowship. Additionally, PDs emphasized clinical excellence, research productivity, and mentorship as key factors for success. Ultimately, reapplicants must take a critical, personalized approach to their deficiencies.