Northeastern Society of Plastic Surgeons

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National Trends in Integrated Plastic Surgery Training Structure
Tyler Jarvis1, Jinpyo Hong*2, John Roberts1, John Ingraham1
1Division of Plastic & Reconstructive Surgery, Penn State Hershey Medical Center, Middletown, PA; 2College of Medicine, Pennsylvania State University, Hershey, PA

Background: The integrated pathway is the predominant training model for plastic surgery in the US. In its relative youth, integrated plastic surgery residency curricula have evolved significantly over the last decade. This study seeks to reassess trends in integrated plastic surgery curriculum structure, summarize the state of variability in clinical exposure to plastic surgery during the first three years of residency, and determine movement toward a more standardized model. Methods: Publicly published information was obtained for 89 ACGME accredited integrated plastic surgery programs. Of these, 44 had complete rotation schedules stratified by post-graduate year (PGY). Rotations were quantified and categorized as plastic surgery, general surgery, or non-general surgery clinical rotations. Rotation data by PGY was evaluated using descriptive statistics. Results: For PGY 4-6, 36.4% of programs required 1-4 months of a non-general surgery clinical service and 0.02% required 2 months of general surgery. All programs denoted an exclusive focus on plastic surgery by PGY 4. For PGY 1, 70.1% of programs required at least 3 months of plastic surgery (mdn=3 months, R=0-7 months). For PGY 2, 61.4% of programs required at least 6 months of plastic surgery (mdn=6 months, R=2-11 months). For PGY 3, 61.4% of programs required at least 9 months of plastic surgery (mdn=9 months, R=3-12 months). For PGY 1-3 across all programs, non-general surgery clinical rotations ranged from 3-12 months (M=6.2 ± 2.2), general surgery ranged from 6-23 months (M=10.8 ± 3.5 months), and plastic surgery ranged from 7-25 months (M=17.8 ± 4.3 months). Conclusions: There appears to be a continued trend toward more clinical time spent on plastic surgery in the first three years of residency. General surgery appears to be increasingly replaced by plastic surgery as well as other subspecialty rotations. Clinical education during the first three years of residency continues to vary widely across US integrated plastic surgery programs.

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