Simple advice:
1. Get the best possible grades. Honors in Surgery will be necessary. Honors in Medicine would be desirable. Other rotations, while nice, aren't as necessary. Put on your game-face for third year and work your butt off.
2. Get to know your chairman. Ask him/her to be your advisor. Pick one of the teaching conferences that he participates in on a regular basis and try to show up. Plastics programs usually have a pre-op photo conference that tends to be very useful for students. Helps you learn the lingo and gets you in the mode of looking at reconstructive problems in the same way that the PRS folks do.
3. Get the residents on your side. Talk to the residents about what makes the chairman look upon a student with favor. Most of the residents will be happy to help you do the "right things" to get good notice from the chairman. Don't be an ass-kiss, but do let people know that plastics is what you want and that you're willing to do whatever it takes to get it. One of the best things in my corner was the fact that the plastics residents at my school always made sure that the chairman knew that I'd shown up for an early morning conference when I wasn't on the service, or that I had everything ready for them to close a big nasty head wound on a trauma patient during my SICU month (that also guaranteed that I did the closure).
4. Read, read, read . . . while no one expects you to be a PRS resident yet, know the hand exam and common hand problems, general reconstructive approaches for common wounds (breast recon, sacral pressure sores, nasal reconstruction), learn about cleft lip/palate repairs and management, become the master of the skin graft (no resident should ever have to harvest a graft when you're in the building). Your best resource as a student will be Advanced Surgical Recall, Plastic Surgery Secrets (must have), Mathes' Atlas of Flaps for Recon (don't remember the proper name). Try to look at UTSW's series "Selected Readings in PRS" for the most concise, up to date info on lots of subjects. Should be in the plastics library or the medschool library.
5. Try to publish. If you can't, don't worry too much.
6. Rotate at another program. It's OK to rotate at two programs. More than two tends to look desperate. I'd say you should stick to one. Look over the list of integrated/combined programs and come up with a list of places that you'd like to look at for residency. Talk to your chairman about them as possible rotation sites. Ask for his opinion on which would suit you best, given the probable strength of your application (don't rotate at MGH unless you're an all-star). BTW, MGH isn't really all that hot for PRS, I just used it as a sample prestigous hospital.
7. Rotate on a Burn service. These services are usually small (only one or two residents), which means you'll get to do lots of work. You'll see lots of problem wounds (another plastics problem), get some ICU experience (you should still take SICU), and might work with some of the PRS residents during their off-service months. And you'll get to work on being the zen-master of the skin graft.
8. Be an interesting person. Plastics is full of cool, interesting, smart people. One of the attendings at Rochester is a concert violinist. We talked music for most of my interview. Many are accomplished sketch artists, painters, or sculpters (many are not). Many do third world work (cleft lip/palate, burn reconstruction, hand recon). The chairman at my school always said that he wanted someone that he could have an interesting conversation with on a long case.
9. Win a Nobel Prize. Two if possible. One for Medicine and one for Peace would be ideal. Literature would also be acceptable.
OK, item number nine might be a stretch, but when you meet the folks on the PRS interview trail, you'll wish you had that Nobel Prize.
Seriously, work hard, listen to your PRS residents & chairman, and go for it. Be prepared to apply to GenSurg CATEGORICAL back up programs. One of the best applicants on the trail this year picked a top 15 GenSurg program over lots of PRS programs because he felt it would serve his needs better.
Max
