January 2026 Edition
- thestitchprs
- Jan 2
- 8 min read
10 min read
Welcome to the January edition of The Stitch. As we enter a new year, this issue focuses on reflection, preparation, and awareness, themes that resonate across every stage of medical training. From national health policy shaping reconstructive access, to lifestyle factors influencing surgical outcomes, to critical updates in the residency application process, this month’s articles highlight how decisions made both inside and outside the hospital directly impact patients and physicians alike.
As medical students, it is easy to stay focused on the immediate demands of training. This issue encourages readers to step back and consider the broader systems, habits, and policies that will define the care we deliver and the careers we build.
If you are interested in submitting a guest contribution or wish to share announcements or opportunities, please complete our Contributor Submission Form.
Happy New Year! Wishing everyone clarity, purpose, and momentum in the year ahead.
The Stitch Editorial Board
Plastic Surgery Word Scramble
Fatima Khan, University of Toledo College of Medicine & Life Sciences
Instructions: Can you crack the code? Unscramble each set of letters to uncover a plastic surgery related term. All answers are one word! - Answers are at the end of the newsletter!
National Policy & Plastic Surgery: Why Medical Students Should Care
Article by Virginia Bailey, Florida State University College of Medicine Class of 2027
As medical students, it’s easy to become absorbed in the day-to-day grind… mastering anatomy content, learning new sutures, prepping for cases, and navigating the residency application process. But becoming thoughtful physicians also means staying aware of the national policies that shape patient care, access, and outcomes.
This month, that broader perspective is especially relevant. A new federal bill, the Women’s Health and Cancer Rights Act Modernization Act of 2025 (H.R. 5813), was introduced in the U.S. House of Representatives, aiming to update a landmark law that directly affects reconstructive surgery coverage for breast cancer patients.
What Is H.R. 5813? - Originally enacted in 1998, the Women’s Health and Cancer Rights Act (WHCRA) requires most health plans that cover mastectomies to also cover breast reconstruction and related procedures. However, as reconstructive techniques have evolved over the past two decades, the law has not kept pace. As a result, insurers have exploited ambiguities to deny coverage for newer procedures, staged reconstructions, or complication management.
H.R. 5813 seeks to modernize WHCRA, clarifying coverage requirements to reflect contemporary plastic and reconstructive surgery. The bill supports patient access to the full spectrum of breast and chest wall reconstruction, reinforcing that reconstruction is not cosmetic… it is a medically necessary component of cancer care.
From Capitol Hill to Prime-Time Television - Importantly, this issue has reached far beyond legislative chambers, it has entered the cultural conversation. A recent episode of Grey’s Anatomy (Season 22, Episode 4) highlighted the very real consequences of insurance denial for breast reconstruction. The storyline featured Jason George, also known as Dr. Ben Warren, advocating for a breast cancer patient whose reconstructive care was denied despite federal protections. The episode underscored the emotional, physical, and ethical stakes of these decisions, and more importantly how gaps in policy translate into challenges in patient care.
Pop-culture moments like these matter. They reflect real clinical challenges and help bridge the gap between policy language and patient lived experience, reminding us that legislation directly shapes the care we provide.
Watch Jason George’s preview to the episode and message about WHCRA here - https://www.instagram.com/reel/DQchg6oEjoG/?igsh=MWE1aW1oZWdlcG9ubQ==
Why This Matters to Medical Students - Even early in training, national policy affects:
Patient autonomy and outcomes, by determining which reconstructive options are accessible
Clinical decision-making, especially when insurance coverage limits evidence-based care
Health equity, as outdated policies disproportionately impact vulnerable populations
Understanding this landscape prepares you to advocate effectively, not just in the operating room, but in interdisciplinary teams and policy discussions.
How You Can Get Involved - Physician advocacy is not reserved for senior attendings. Medical students play a critical role in shaping the future of healthcare.
One powerful opportunity is the ASPS Advocacy Summit, where physicians and trainees engage directly with lawmakers to advocate for patients and the specialty. While the next summit is scheduled for 2027, now is the time to start learning, staying informed, and preparing to lend your voice.
Learn more about the ASPS Advocacy Summit:https://www.plasticsurgery.org/for-medical-professionals/education/events/advocacy-summit
Final Takeaway - What happens in Washington affects what happens in clinic, in the operating room, and in patients’ lives. As you focus on building surgical skills and advancing your training, don’t lose sight of the policies shaping the care you will one day deliver.
Medicine happens at the bedside, but it is protected, expanded, or restricted by policy.
References:
WHCRA Past, Present & the Push for Modernization (ASPS PSN Extra)
Text of H.R. 5813 (119th Congress)
https://www.congress.gov/bill/119th-congress/house-bill/5813/text
ASPS Advocacy Summit — Get Involved
https://www.plasticsurgery.org/for-medical-professionals/education/events/advocacy-summit
New Year, New Beginnings
Article by Colton Brown, University of Florida Class of 2028
With the New Year comes fresh beginnings and memories, opening new doors and closing others. It is a time people commit to pursuing opportunities to realize their highest potentials, strengthening their resolve to become their healthiest selves. This includes resolutions to adopt new habits and cease others. Our lifestyles mold our overall well-being while directly impacting how the body heals in post-operative plastic surgical recovery.
Nutrition is foundational. The cascade that contributes to optimal wound healing requires sufficient energy, proteins, metals, minerals and other vitamins to fuel cellular proliferation, collagen synthesis for tissue strength, and restoring skin barrier and integrity1. Guidelines recommend 60 to 120 grams of protein per day for optimal angiogenesis, immunity and integrity; vitamin C for collagen synthesis; vitamin A for epithelialization and cytokine release; and zinc for DNA and protein synthesis. While factors like age and hormones influence healing, proper nutrition is one essential aspect of managing what we can control.
A healing essential is smoking cessation. Nicotine within cigarettes impairs adequate oxygenation as it constricts blood vessels interfering with nutritional blood flow. Combined with carbon monoxide binding hemoglobin with great affinity, this perpetuates prolonged tissue hypoxia and impaired immune function2. Smoking hinders beneficial inflammatory cell chemotaxis, migratory functions, and oxidative bactericidal mechanisms which further complicate risk of post-operative infection risk3. Individuals who smoke face 1.37 times higher odds of surgical complications, particularly surgical site infections, wound dehiscence, and reoperation4,5.
Stay active. Encouraging early mobilization and moderate pre-operative exercise enhances wound healing, lowering risk of post-operative complications. Sustained physical activity prior to surgery accelerates wound healing by reducing inflammatory mechanisms and improving macrophage polarization, leading to notably better closure, epithelialization, and granulation tissue formation6,7. Patients with higher pre-operative physical activity demonstrate improved resilience with no decline in psychosocial or sexual well-being.
Make this year count. Take this opportunity to implement positive change. Maximize nutrition with lean meats, poultry, fish and eggs for complete amino acid profiles; citrus fruits and berries for vitamin C; sweet potatoes, carrots, and leafy greens for vitamin A; and red meats, beans and nuts for zinc. Take the stride to cease smoking looking to other methods of stress management. Aim for 150 minutes of moderate intensity exercise weekly. These habits support recovery while building a healthier, stronger you.
For personalized guidance, consult your plastic surgeon. Your journey to healing starts with the choices you make today.
References:
1. Kavalukas SL, Barbul A. Nutrition and wound healing: an update. Plast Reconstr Surg. 2011 Jan;127 Suppl 1:38S-43S. doi: 10.1097/PRS.0b013e318201256c. PMID: 21200272.
2. Silverstein P. Smoking and wound healing. Am J Med. 1992 Jul 15;93(1A):22S-24S. doi: 10.1016/0002-9343(92)90623-j. PMID: 1323208.
3. Sørensen LT. Wound healing and infection in surgery: the pathophysiological impact of smoking, smoking cessation, and nicotine replacement therapy: a systematic review. Ann Surg. 2012 Jun;255(6):1069-79. doi: 10.1097/SLA.0b013e31824f632d. PMID: 22566015.
4. Goltsman D, Munabi NCO, Ascherman JA. The Association between Smoking and Plastic Surgery Outcomes in 40,465 Patients: An Analysis of the American College of Surgeons National Surgical Quality Improvement Program Data Sets. Plast Reconstr Surg. 2017 Feb;139(2):503-511. doi: 10.1097/PRS.0000000000002958. PMID: 28121897.
5. Toyoda Y, Fu RH, Li L, Otterburn DM, Rohde CH. Smoking as an Independent Risk Factor for Postoperative Complications in Plastic Surgical Procedures: A Propensity Score-Matched Analysis of 36,454 Patients from the NSQIP Database from 2005 to 2014. Plast Reconstr Surg. 2018 Jan;141(1):226-236. doi: 10.1097/PRS.0000000000003963. PMID: 29280887.
6. Zogaib FG, Monte-Alto-Costa A. Moderate intensity physical training accelerates healing of full-thickness wounds in mice. Braz J Med Biol Res. 2011 Oct;44(10):1025-35. doi: 10.1590/s0100-879x2011007500115. Epub 2011 Sep 2. PMID: 21881807.
7. Goh J, Ladiges WC. Exercise enhances wound healing and prevents cancer progression during aging by targeting macrophage polarity. Mech Ageing Dev. 2014 Jul;139:41-8. doi: 10.1016/j.mad.2014.06.004. Epub 2014 Jun 13. PMID: 24932991.
ERAS Application Updates: What Medical Students Need to Know
Article by Virginia Bailey, Florida State University College of Medicine Class of 2028
Applying to residency can feel overwhelming, and the application process itself is evolving just as quickly as medical education. Following the AAMC Learn Serve Lead Annual Conference, several important updates were announced regarding upcoming changes to the ERAS application, program signaling, and best practices for applicants. Below is a high-yield summary of what’s changing, and what we as medical students should take away from it.
ERAS Is Changing — Starting in 2026 - To address concerns about the growing “research arms race,” ERAS is restructuring how academic work is presented.
Beginning with the 2026 application cycle, the current “Publications” section will become “Scholarly Works.” Key changes include:
Three “Most Meaningful” Scholarly Experiences - Applicants will be able to designate up to three research experiences as most meaningful, shifting emphasis from volume to impact.
Consolidation of Presentations - Multiple presentations with the same title (e.g., regional and national posters) will be grouped under one experience, with all venues listed together.
New “Collections” Feature - A new tab will allow applicants to link posters, presentations, and publications from the same project, highlighting longitudinal involvement and scholarly growth.
Removal of the “Other” Publications Category - Op-eds, policy papers, and similar work will now need to be entered as experiences, encouraging clearer contextualization of non-traditional scholarship.
Bottom line: ERAS is intentionally shifting toward depth, continuity, and reflection, not raw numbers.
Looking Ahead: Potential ERAS Changes in 2027 - The AAMC also previewed a potential, yet not yet finalized, feature planned for 2027 This will be a “Interview Prediction Tool” that would allow applicants to estimate interview likelihood at specific programs based on available data. While still under development, this signals a broader effort toward greater transparency and data-driven advising.
Program Signaling: What the Data Shows - Program signaling has emerged as one of the most influential components of the residency application process, and recent data underscore its importance for plastic surgery applicants. Across specialties, signaling is the strongest predictor of receiving an interview invitation, surpassing even traditional metrics such as Step 2 CK performance, with home program affiliation also playing a meaningful role. Importantly, professional societies have explicitly advised programs to use signals solely for interview selection rather than rank order decisions. Since the implementation of signaling, the average number of applications submitted per applicant has declined, suggesting that signaling may help curb application inflation and promote a more targeted, intentional application strategy.
Choosing a Specialty & Programs: Trusted Resources - Speakers strongly encouraged students to rely on verified tools, not anecdotal forums. Recommended resources include; Careers in Medicine (CiM) (values-based specialty exploration), FREIDA & Residency Explorer (program-level data and filters), and OPDA (2024 PDFs) (specialty-specific guidance on signals, away rotations, letters, and interviews). There is one clear message echoed across sessions: “Do not trust Reddit.”
Advice from Program Directors - Advice from program directors across specialties was notably consistent and highly applicable to plastic surgery applicants. They emphasized that depth and longitudinal commitment in experiences are far more valuable than a long list of superficial activities, noting that sustained growth and leadership signal genuine interest and maturity. Application “fluff” was strongly discouraged, with specific guidance to exclude high school activities and generally avoid college experiences unless truly exceptional. Program directors highlighted the personal statement as a critical component, cautioning that applicants perceived as disingenuous or self-focused are often screened out early. Strategically, they recommended applying to approximately 75–80% programs within a realistic range, reserving only 10–20% for reach programs. Finally, applicants were encouraged to trust experienced faculty advisors over anecdotal peer advice, as advisors draw on patterns observed across hundreds of applicants rather than single success stories.
Final Takeaway - The residency application process is changing intentionally. ERAS updates, signaling data, and PD guidance all point toward the same message:
Be authentic. Be intentional. Focus on meaningful growth, not box-checking.
Staying informed now allows you to prepare thoughtfully, reduce anxiety, and approach the application process with clarity and confidence.
Helpful Links
ERAS 2027 Application Overview (AAMC):
AAMC Learn Serve Lead Session Recording:
Plastic Surgery Word Scramble - Answer Key
Fatima Khan, University of Toledo College of Medicine & Life Sciences
If you are interested in submitting a guest contribution or wish to share announcements or
opportunities, please complete the form at the link below.
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