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Reconstructive surgery training: increased operative volume in plastic surgery residency programs.

Neil Tanna¹, J Brian Boyd, Henry K Kawamoto

¹Los Angeles, Calif. From the Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine, University of California, Los Angeles.

Plastic and Reconstructive Surgery

|November 18, 2011

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Plastic surgery residents perform more reconstructive procedures, including cleft lip/palate repair and hand surgeries, than other specialties. This quantitative advantage supports plastic surgeons leading reconstructive surgery.

Area of Science:

Reconstructive surgery
Surgical training comparison
Graduate medical education

Background:

Other surgical specialties are increasing reconstructive procedures historically performed by plastic surgeons.
No prior studies have compared reconstructive surgery training volumes between specialties.
This study compares the operative reconstructive case volume of graduating plastic surgery residents with those of other specialties.

Purpose of the Study:

To quantitatively compare the average operative reconstructive case volume of graduating plastic surgery residents with those of orthopedic surgery, otolaryngology, and other relevant specialties.
To identify specific reconstructive procedures where plastic surgery residents demonstrate higher case volumes.
To inform discussions on specialty training and the future role of plastic surgeons in reconstructive procedures.

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Main Methods:

Review of Accreditation Council for Graduate Medical Education (ACGME) case log statistical reports for orthopedic surgery, otolaryngology, and plastic surgery.
Analysis of average case numbers for graduating residents from the 2006 to 2010 academic years.
Statistical comparison using a two-sample Welch-Satterthwaite t test to evaluate differences in procedure volumes.

Main Results:

Graduating plastic surgery residents performed significantly more cleft lip and palate repairs, hand amputation, hand fracture, and nasal fracture procedures compared to other specialties between 2006 and 2010.
Plastic surgery trainees had a statistically significant higher volume of mandible fracture repairs from 2006 to 2009, but this difference was not observed in 2010.
Overall, plastic surgery residents demonstrated a higher quantitative operative experience in selected reconstructive procedures.

Conclusions:

Graduating plastic surgery residents possess a greater volume of experience in specific reconstructive procedures compared to average graduating trainees in other surgical fields.
The extensive training and high volume of reconstructive cases solidify the role of plastic surgeons as leaders in the field.
Plastic surgeons should continue to be at the forefront of reconstructive surgery due to their specialized training and operative experience.