2. Fear and Panic: Stories from Displaced Plastic Surgery Residents after Residency Closures Article Swipe

Background: In April 2021, two plastic surgery residency programs lost ACGME-accreditation. This displaced 23 trainees, including students who matched into these programs only a month before. In order to study relocation and provide assistance if future closures occur, the ASPS Resident Council formed the Program Closure Working Group and surveyed displaced residents on their experiences. Methods: A 30-item questionnaire was developed and distributed to displaced trainees. Questions addressed the program closure process, impact of relocation on education, resource availability, and faculty/organizational supportiveness. Questions were also asked regarding effects of relocation on affected trainees' personal lives. Results: The response rate was 14/23 (61%). Only half of respondents were informed of closure by program leadership (n=7). Five residents were never given formal notice; 3 of them discovered the closure via the ACGME website. No incoming intern was aware of potential program closure prior to submitting rank-lists. Nearly all displaced residents reported lack of support and/or outright antagonism from their faculty, program directors, and chairs. In contrast, ASPS and ACGME were most often considered neither helpful nor hurtful, and ACAPS was most often considered supportive but not proactive. The median relocation cost was $8,000 (IQR $15,125). No residents required additional loans, but 6/10 residents who owned homes were forced to sell. All residents reported moderate (n=6, 43%) or severe (n=8, 57%) mental health burden from displacement. In free-text responses (n=10, 71%), residents reported that programs did not allow them to step out for interviews, and threatened non-promotion if residents attempted to use vacation time to relocate prior to the end of the academic year. Receiving-institution GME offices were unsure how to intake relocating residents, causing delays. Conclusion: Plastic surgery residency closures levied steep financial and mental health costs on displaced residents. While residents did not consider plastic surgery organizations antagonistic, they reported room for improvement regarding program closures. A dedicated committee for guiding residents through these catastrophic events would be beneficial. Ongoing efforts by the ASPS Resident Council include petitioning the ACGME to announce program closures before rank-list submissions, and creating a central resource hub for future reference.