Following prerequisite training in general surgery, the resident is trained in all
major areas of plastic and reconstructive surgery so he or she will be able to practice
this specialty completely; be prepared to take and pass the board certifying examination;
and to understand and have the ability to perform research in plastic and reconstructive
surgery.
The program goals and objectives are distributed to faculty and residents at the plastic
surgery orientation each July. Residents are required to review their assigned rotation
goals and objectives prior to each rotation change.
All rotation goals and objectives include general competencies and the principles
of plastic and reconstructive surgery.
The overall goals and objectives are to:
- Provide residents with quality instruction and experience in a wide range of plastic
surgery areas, including both the functional and aesthetic management of congenital
and acquired defects of the face, neck, trunk, body, and extremities.
- Produce residents who are well trained in the broad areas of general plastic and reconstructive
surgery.
- Produce residents who exhibit continued competent skills and characteristics in the
six general competencies (assessed on each rotation by the faculty member or members
to whom the resident is assigned):
- Patient care: Compassionate, appropriate, effective management of responsibilities and promotion
of health. The resident will gather essential and accurate information. He will perform
all essential skill required for the rotation. He is expected to work effectively
with patients, families, and other professionals.
- Medical knowledge: The resident will demonstrate investigative and analytical thinking in problem solving
by applying basic and clinical sciences principles.
- Practice‐based learning and improvement: The resident will analyze practice experience and locates evidence from scientific
studies. He is expected to utilize information technology. He will study and understand
study design and statistical methods.
- Interpersonal and communication skills: The resident will maintain sound relationships and communicates effectively with
patient, family, and other members of the healthcare team.
- Professionalism: The resident will demonstrate respect, integrity and responsiveness that supersede
self‐interest. He will develop a commitment to excellence and professionalism and
high ethical standards. He will respect confidentiality and sensitivity to patients
regardless of culture, age, gender or disabilities.
- Systems-based practice: The resident will demonstrate awareness of the larger context of healthcare. This
includes cost‐effective care and resource allocation. He will assist and partner with
patients in dealing with system complexities. This includes working with managers
to coordinate and improve healthcare and system performance.
The competency based goals and objectives are outlined for each rotation over a three‐year
period. Upon reaching the second- and third-year rotations, the senior (chief) residents
have increased responsibilities and authority in patient and operative care. This
includes supervisory responsibility for junior residents. The clinical and specific
milestones to be reached are outlined for each year demonstrating progressive responsibilities
toward the third and final year.
Residents will receive specific training in:
- Congenital defects of the head and neck, including clefts of the lip and palate, auricular
deformities, and craniofacial surgery.
- Neoplasms of the head and neck, including the oropharynx and training in appropriate
endoscopy.
- Craniomaxillofacial trauma, including fractures.
- Aesthetic (cosmetic) surgery of the head and neck, trunk, and extremities.
- Plastic surgery of the breast.
- Surgery of the hand and upper extremity.
- Plastic surgery of the lower extremities.
- Plastic surgery of the congenital and acquired defects of the trunk and genitalia.
- Burn management, acute and reconstructive.
- Microsurgical techniques applicable to plastic surgery.
- Reconstruction by tissue transfer, including flaps and grafts.
- Surgery of benign and malignant lesions of the skin and soft tissues.
Residents will gain experience in:
- Surgical design
- Surgical diagnosis
- Surgical and artistic anatomy
- Surgical physiology and pharmacology
- Wound healing
- Surgical pathology and microbiology
- Adjunctive oncological therapy
- Biomechanics
- Rehabilitation
- Surgical instrumentation
Residents completing the program must display judgment and technical capability for
achieving satisfactory surgical results.
Instruction in the basic sciences is provided as an integrated part of the clinical
training. Formal conferences and lectures enable discussion to broaden the resident’s
knowledge in basic sciences (anatomy, pathology, physiology, embryology, radiation
biology, genetics, microbiology, and pharmacy) and surgical principles fundamental
to clinical plastic surgery. These didactic sessions and discussions allow time for
evaluation of current medical literature and studies. Each faculty member is assigned
didactic lectures in their area of expertise. In addition, attending physicians provide
a great deal of one-on-one teaching regarding specific cases and problems encountered
during ongoing patient care. Residents participate in the presentation of educational
material at the conferences.
Residents are not encouraged to emphasize a particular area of plastic and reconstructive
surgery during the three-year program; e.g. hand, head and neck, aesthetic, micro-vascular,
or craniofacial surgery. However, if residents develop a specialized interest during
their training, they are encouraged to seek a fellowship at another institution or
remain with our program for an additional year to develop further expertise in that
specialized area.
During each rotation, the resident will gain understanding of medico-legal and psychiatric
aspects of plastic surgery practice. Residents regularly obtain informed consent from
the patient.
During training, each resident demonstrates the following:
- Obtain informed consent from all patients and effectively document the consent agreement.
- Evaluate patients for aesthetic surgery from a physical and psychological perspective
Upon completion of training, the resident demonstrates competence as follows:
- Identify the medical and legal perspectives of the contractual agreement between physician
and patient.
- Identify the concepts of informed consent and implied guarantee.
- Identify the role of the medical record as a legal document.
- Identify the impact physical deformity can have on patients and their families.
- Recognize and implement techniques to explore the motivations of patients seeking
cosmetic surgery and how to distinguish acceptable, unacceptable, and pathological
motivations.
It is the goal and objective of our training program to produce clinically and professionally
competent independent surgeons in plastic surgery.
The close daily working relationship with a faculty member allows direct observation
and interaction by the faculty with the resident in the clinics, office, conference,
and operating room. This provides an excellent way to assess the general competencies
and the accomplishment of all goals and objectives of the residents.
The program has a detailed goals and objective systems of rotations that are competency
based. Close supervision of residents by faculty using multiple assessment tools documents
yearly progression toward milestones and ultimate obtainment of goals. Completion
of this process documents competency of the resident to independently practice plastic
surgery.