Pay to Play: A Cost Analysis of Open Access Publications For Successfully Matched Integrated Plastic Surgery Applicants

Authors

• W F. Bohler, Oakland University William Beaumont School of Medicine Medical Student
• Zachary A. Koenig
• James R. Burmeister, Oakland University William Beaumont School of Medicine Medical Student
• Jesse C. Selber, Corewell Health East
• Ethan Dimock, Oakland University William Beaumont School of Medicine Medical Student
• Ava Harvey, Oakland University William Beaumont School of Medicine Medical Student
• John M. Felder, Corewell Health East

Document Type

Conference Proceeding

Publication Date

6-2026

Publication Title

Plastic and Reconstructive Surgery. Global Open

Abstract

Introduction: With USMLE Step 1 now pass/fail, research productivity has become a critical differentiator for residency applications. As publication expectations rise in the integrated plastic surgery (IPS) match, the financial burden of open access (OA) publishing represents an often overlooked barrier. Prior studies have highlighted the prohibitive costs of away rotations and conference attendance, particularly for students from lower socioeconomic backgrounds, yet the specific monetary cost of publishing in OA journals has not been quantified. This study evaluates the average article processing charges (APCs) borne by matched IPS applicants and explores spending trends in the post-Step 1 era. Methods: Bibliometric data from 555 matched IPS applicants (2022–2024) were collected by identifying residents on program websites and recording PubMed-indexed publications prior to application deadlines. Publications in exclusively OA journals were included, and APCs were obtained from publicly posted journal fees. The Top 20 IPS programs were defined using the “Reputation” filter on Doximity’s Residency Navigator for subgroup analysis. Results: Of 555 matched applicants, 68.9% had at least one OA publication, and 79.7% of those with any publication had published in OA journals. Overall, 27.8% of all publications were OA, including 26.2% of first-author and 27.8% of second-author works. OA articles appeared in journals with lower mean impact factors than subscription-based publications (2.85 vs. 4.85). Across all cohorts, $2,706,256 was spent on OA fees. Average per-applicant spending rose from $4,016 (Class of 2022) to $4,667 (2023) and $5,869 (2024), a 46.1% increase in three years, with the largest rise coinciding with the first cycle after Step 1 became pass/fail. The highest single-applicant APC expenditure exceeded $98,000. Applicants at Top 20 programs spent $5,936 on average compared to $4,354 at non-Top 20 programs, a 36.3% difference. Conclusion: OA publication fees for IPS applicants have escalated steeply, averaging nearly $6,000 in the most recent cycle, exceeding estimated application, away rotation, and interview costs. These expenses are invisible to selection committees yet may restrict who participates in the academic publishing ecosystem. While some students benefit from institutional support, many, particularly those from non-research-intensive schools or low-income backgrounds, lack such resources. Applicants at Top 20 programs spent 36% more on these costs suggesting institutional resources may magnify cost disparities. This is the first study to quantify OA publication costs among medical students in any specialty, underscoring how such expenses may reinforce inequities in residency selection.

Volume

14

Issue

S1

First Page

3

Last Page

3

Recommended Citation

Bohler WF, Koenig ZA, Burmeister JR, Selber JC, Dimock E, Harvey A, et al. [Felder JM]. Pay to play: a cost analysis of open access publications for successfully matched integrated plastic surgery applicants. Plast Reconstr Surg Glob Open. 2026 Jun;14(S1):3. doi:10.1097/01.GOX.0001204024.54813.64

Comments

13th Annual Meeting American Council of Educators in Plastic Surgery (ACEPS), February 12-15, 2026, Nashville, TN

DOI

10.1097/01.GOX.0001204024.54813.64