Saldana, Golddy M.

Objective Preparation for a career in plastic and reconstructive surgery (PRS) begins long before the residency application process. Given the challenging nature of matching into integrated PRS, the expectations for competitive applicants, including research productivity and networking at conferences, incur significant expenses. Our study is the first to detail the comprehensive costs of pursuing PRS, highlighting many hidden expenses that precede the application process. Design and Setting A branched logic survey was created to inquire about respondents' demographics, personal finances, expenses related to education and research, and opinions on the comprehensive costs of pursuing PRS. Qualitative and quantitative data were collected and analyzed using descriptive statistics. Participants The survey was distributed to PRS residency applicants in the 2023–2024 cycle and to senior members of a virtual PRS research group. The survey achieved a 28.9% response rate. Results Most respondents were fourth-year medical students (57.3%) and attended a school without a home integrated residency program (42.7%). Of students who pursued a research year (37.1%), 40.7% were unpaid, and 53.3% reported living expenses exceeding their income. Most attended more than 5 PRS conferences (29.9%), corresponding to a median total cost of $2000 to $3000. Fourth-year students typically participated in 3 away rotations (40.0%) at a cost of $6000 to $9000. The financial burden of pursuing a career in PRS, including PRS-related extracurricular activities and application-associated costs, is estimated to be $33,400–$45,479. Nearly all respondents (96.6%) believed this cost was too high or excessively high; however, 93.3% determined that it was probably or definitely worth a career in PRS. Conclusions The lofty costs associated with pursuing PRS are unsustainable for many. Additional efforts should be made to reduce financial barriers for PRS applicants. Ensuring funding to all students pursuing a research year, diversifying scholarships for conference attendance and away rotations, increasing loan forgiveness opportunities, and expanding use of lower-cost application options such as the Plastic Surgery Common Application are potential solutions to offset the cost of pursuing PRS.

Cleft lip with or without cleft palate (CL/P) is a common congenital facial pathology that occurs at higher incidences in Hispanic communities. The authors analyzed the availability and readability of Spanish-written patient education materials (PEMs) on CL/P from top-ranking U.S. children’s hospitals to determine the presence of health literacy barriers. Availability of PEM was evaluated by 2 methods: (1) Google search and (2) evaluation of the official hospital websites. For each institution, a Google search was conducted using the phrase, “labio leporino y/o paladar hendido (translation: CL/P) + (hospital name).” In addition, each hospital website was assessed for Spanish PEM availability. Spanish PEMs were then categorized by whether they had been generated by an automated translation function or if they were independently written Spanish text. English PEM readability was assessed using the Simple Measure of Gobbledygook (SMOG). Spanish PEM readability was assessed using spanish orthgraphic length (Spanish Orthographic Length), the SMOG converted for the Spanish language. Unpaired 2-tailed t tests were used to compare readability. Of a total of 85 pediatric hospitals, 28 (37.3%) had Spanish PEM. Five (6.7%) hospitals created their own Spanish-language document. The average spanish orthgraphic length reading level was 9.49 compared with an average SMOG of 11.38 (P < 0.001). Institutions that did not provide Spanish PEM in any format had a significantly higher SMOG for English PEM of 12.13 compared with 11.38 of those that had SMOG with English PEM (P = 0.04). Health literacy barriers not only exist for Spanish PEM but also for English PEM, indicating an opportunity to improve communication.