Cosmetic Surgery Training in Plastic Surgery Residency Programs in the United States: How Have We Progressed in the Last Three Years?
ABSTRACT In 2006, a survey performed by Morrison et al analyzed the experience of aesthetic surgery training from the perspective of residents and their program directors in plastic surgery programs across the United States.
The authors conducted a survey to follow-up on the Morrison results three years after publication, to assess the changes in plastic surgery residency programs.
In December 2009, a 17-question survey was sent to program directors, and a 19-question survey was sent to senior residents in all Accreditation Council for Graduate Medical Education-approved plastic surgery residency programs in the United States. The questions were posed in a five-point ranking format. The two additional questions included in the senior resident survey related to career aspirations and desirable areas of additional training. Ninety-two program directors and 397 senior residents received the survey.
Forty-four program director surveys (47.8%) and 117 (29.5%) senior resident surveys were returned. Two-thirds of programs offered a residents' clinic, which was considered the preferred method of cosmetic surgery education by residents. Residents reported increased exposure to nonsurgical procedures such as lasers and injectables. Abdominoplasty, breast augmentation, and breast reduction remained the procedures most frequently performed by residents with confidence, as in the 2006 survey. Facial aesthetic procedures, including rhinoplasty and facelift, remained challenging to residents. Many residents (55.7%) felt confident integrating cosmetic surgery into their practice. One-third of residents reported that they would apply for a cosmetic fellowship.
This survey shows an improvement in cosmetic surgery training for plastic surgery residents in the United States, particularly in that noninvasive cosmetic treatments are being increasingly taught. Since 2006, steps have been taken to provide more comprehensive cosmetic surgery education to residents, encouraging the delivery of the safe, high-quality care expected of a board-certified plastic surgeon.
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ABSTRACT: BACKGROUND: As interest in surgical simulation grows, plastic surgical educators are pressed to provide realistic surgical experience outside of the operating suite. Simulation models of plastic surgery procedures have been developed, but they are incomparable to the dissection of fresh tissue. We evolved a fresh tissue dissection (FTD) and simulation program with emphasis on surgical technique and simulation of clinical surgery. We hypothesized that resident confidence could be improved by adding FTD to our resident curriculum. METHODS: Over a 5-year period, FTD was incorporated into the curriculum. Participants included clinical medical students, postgraduate year 1 to 7 residents, and attending surgeons. Participants performed dissections and procedures with structured emphasis on anatomical detail, surgical technique, and rehearsal of operative sequence. Resident confidence was evaluated using retrospective pretest and posttest analysis with a 5-point scale, ranging from 1 (least confident) to 5 (most confident). Confidence was evaluated according to postgraduate year level, anatomical region, and procedure. RESULTS: A total of 103 dissection days occurred, and a total of 192 dissections were reported, representing 73 different procedures. Overall, resident predissection confidence was 1.90±1.02 and postdissection confidence was 4.20±0.94 (p<0.001). The average increase in confidence correlated with training year, such that senior residents had greater gains. When compared by anatomical region, confidence was lowest for the head and neck region. When compared by procedure, confidence was lowest for rhinoplasty and face-lift, and highest for radial forearm and latissimus flaps. CONCLUSIONS: A high-volume FTD experience was successfully incorporated into the residency program over 5 years. Training with FTD improves resident confidence, and this effect increases with seniority of training. Although initial data demonstrate that resident confidence is improved with FTD, additional evaluation is needed to establish objective evidence that patient outcomes and surgical quality can be improved with FTD.Journal of Surgical Education 07/2013; 70(4):466-474. DOI:10.1016/j.jsurg.2013.02.008 · 1.39 Impact Factor
- Aesthetic surgery journal / the American Society for Aesthetic Plastic surgery 11/2011; 31(8):980-1. DOI:10.1177/1090820X11424871 · 2.03 Impact Factor
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ABSTRACT: The specialty of plastic surgery has evolved to encompass a wide breadth of both reconstructive and aesthetic surgery. Practitioners in other specialties have increasingly advanced on procedures and areas that have traditionally been served by plastic surgeons. To date, no evaluation and comparison of the operative experience of graduating residents from various specialties has been performed. The authors review the case log statistical reports of the Accreditation Council for Graduate Medical Education. For each specialty, this annual report highlights the average number of cases performed for all graduating residents. The national case log reports were reviewed for dermatology, ophthalmology, otolaryngology, and plastic surgery. Four procedures (i.e., blepharoplasty, face lift, liposuction, and rhinoplasty) were compared for residents graduating in the 2006 to 2010 academic years. The hypothesis that no difference exists between the average numbers of aesthetic procedures performed by various specialty residency training was tested using a two-sample t statistic. For blepharoplasty, face lift, and liposuction, the higher number of cases performed by graduating plastic surgery residents was statistically significant (p < 0.00001) for all years examined. Although plastic surgery trainees graduating from 2006 to 2010 had a higher number of recorded rhinoplasties, this difference in case logs was statistically significant only for plastic surgery residents graduating in 2008. The quantitative operative experience of graduating plastic surgery residents for selected aesthetic surgery cases exceeds that of other surgical subspecialties. Given the exposure and strength of plastic surgery training, plastic surgeons should remain at the forefront of aesthetic surgery.Plastic and Reconstructive Surgery 03/2012; 129(3):528e-534e. DOI:10.1097/PRS.0b013e3182402efd · 3.33 Impact Factor