Residency training in plastic surgery: a survey of educational goals

With the advent of integrative plastic surgical training programs, requirements for earlier specialization decisions, and an increasing subspecialization within the practice of plastic surgery, the educational goals of residency training may have changed. The duration and extent of training required are also currently being questioned. This study was performed to better understand the necessary roles of plastic surgery residencies and to determine how these demands might optimally be met. Of 151 practicing plastic surgeons in the Ontario, Canada, region, 81 (53.6 percent) responded to a survey. General agreement was that 2 years was an optimal length of time for core surgical training, which should then be followed by at least 3 years of plastic surgical training. Opinions on the ideal length of time training in specific medical and surgical disciplines are discussed. Overall, respondents thought that two thirds of training should occur in tertiary care centers, with the remaining time spent at smaller community centers and private clinics. Nearly half of respondents thought that research training should be a mandatory part of the residency, although the amount of protected time for this activity varied substantially. Most thought that unrestricted elective time should also be available. Academic plastic surgeons rated the importance of research training (p < 0.01), critical appraisal skills (p < 0.05), and teaching skills (p < 0.05) as significantly more important than did their nonacademic colleagues. The authors present results from the Ontario region and a template for determining optimal characteristics for training programs. Further investigation may be of timely importance during a foreseeable future transition from traditional to integrative plastic surgery residency training.     

Advances in plastic surgery

The influence of the war period has been reflected in an active trend toward the conservation of time in the execution of reconstructive operations. The myriad improvements in the technique of tissue transplantation and the use of large flaps rather than tubed pedicles have been in keeping with this trend. The goal of the complete restoration of function and appearance applies not only to the correction of post-traumatic defects but also to the cosmetic repair of defects created by the surgical excision of malignant tumors and to correction of congenital anomalies.     

Priorities in plastic surgery

The study of historical priorities in plastic surgery must be based on established principles in the field instead of mere chronology. Examples of application of these principles to two landmarks in plastic surgery are given. The reader is commended to adhere to these principles in the study of other developments in plastic surgery.