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Top five craniofacial techniques for training in plastic surgery residency.
Kenneth Fan1, Henry K Kawamoto, Joseph G McCarthy
1Los Angeles, Calif.; Miami, Fla.; New York, N.Y.; Philadelphia, Pa.; and Chapel Hill, N.C. From the Division of Plastic and Reconstructive, David Geffen School of Medicine at UCLA; University of Miami, Miller School of Medicine; the Institute of Reconstructive Plastic Surgery, New York University Langone Medical Center; Division of Plastic and Reconstructive Surgery, Children's Hospital of Philadelphia; Division of Plastic Surgery, University of North Carolina School of Medicine; Plastic and Reconstructive Surgery, Miami Children's Hospital; and the Department of Biostatistics, University of California, Los Angeles.
Core craniofacial surgery techniques are essential for all plastic surgeons. While program directors agree these should be mastered in residency, comfort levels vary among practicing surgeons without specialized fellowship training.
Area of Science:
- Plastic Surgery
- Craniofacial Surgery
- Surgical Education
Background:
- Increasing specialization in craniofacial surgery necessitates identifying universally applicable techniques.
- Five widely applicable craniofacial techniques were selected for evaluation.
Purpose of the Study:
- To assess practicing plastic surgeons' comfort levels with five key craniofacial procedures.
- To evaluate plastic surgery residency program directors' opinions on training for these techniques.
Main Methods:
- A consensus panel of senior craniofacial surgeons identified five core procedures.
- Surveys were administered to American Society of Plastic Surgeons members and program directors.
- Residency curricula were analyzed to determine if these procedures are taught.
Main Results:
- The five techniques include bone grafts (cranial, iliac, orbital floor), perialar rim grafting, lateral canthopexy, and osseous genioplasty.
- Surgeon comfort generally increased with years in practice, with most (>75%) feeling competent except in osseous genioplasty (53%).
- A majority of surgeons with craniofacial fellowship training reported competence in all five procedures.
Conclusions:
- Program directors believe all five craniofacial procedures should be mastered during residency.
- Plastic surgeons without craniofacial fellowship training reported lower comfort levels with these techniques.
- Residency training should prioritize competence in fundamental craniofacial surgical techniques.
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