Medical student perceptions of the scope of plastic and reconstructive surgery

The scope of plastic surgery is not well understood by people outside the field. Better educating medical students about plastic surgery may improve understanding of the field, establish appropriate referral patterns early on, and assist with career decision-making. The purpose of this study was to assess medical student understanding of plastic surgery and to analyze the impact of prior plastic surgery clinical exposure on this understanding.

An online survey consisting of 24 clinical scenarios was administered to medical students of the University of Utah. After indicating their level of training and whether they had prior clinical exposure to plastic surgery or other surgical subspecialties, students selected one or more appropriate surgical subspecialties to manage each scenario.

Of 408 students, 230 (56.4%) responded to the survey. Prior clinical exposure to plastic surgery was reported by 15.8% to 29.4% of students (first to fourth year). Overall, 92% of students chose at least one acceptable surgical specialty for referral. Plastic surgery was selected by only 54% of students for all conditions, and this did not improve throughout medical school. Senior students (third and fourth years) with prior plastic surgery exposure chose plastic surgery more often than those without prior exposure (71% vs. 51%, P < 0.0001). Plastic surgery was chosen most frequently for rhinoplasty and breast reconstruction and less frequently for hand/peripheral nerve surgery and wound surgery.

Improved medical student education about the scope of plastic surgery is needed, especially in the areas of hand/peripheral nerve surgery and general reconstructive surgery.