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From "Coordinated" to "Integrated" Residency Training: Evaluating Changes and the Current State of Plastic Surgery
William J Rifkin1, Michael J Cammarata1, Rami S Kantar1
1From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health.
Plastic and Reconstructive Surgery
|January 10, 2019
Summary
Integrated plastic surgery residency programs show significant variability in curriculum, with plastic surgery exposure now exceeding general surgery time. Programs continue to evolve to find the optimal training structure.
Area of Science:
- Medical Education
- Surgical Training
- Plastic Surgery
Background:
- The integrated model of plastic surgery residency is evolving, with ongoing debate regarding the optimal curriculum.
- The elimination of the coordinated pathway has led to a plateau in integrated programs.
- Previous observations noted variability in the initial three years of integrated training.
Purpose of the Study:
- To examine the current state of integrated plastic surgery residency training.
- To reevaluate the variability in the first three years of training within these programs.
Main Methods:
- Gathered program information from all 68 integrated plastic surgery programs.
- Analyzed rotation schedules for 59 programs to quantify surgical exposures.
- Compared plastic surgery, general surgery, and subspecialty rotation durations.
Main Results:
- Plastic surgery exposure varied widely (3.5-25 months, mean 13.9 months).
- General surgery exposure ranged from 5 to 22.5 months (mean 12.8 months).
- Significant variability persisted in non-plastic surgery rotations, including those strongly suggested by the Residency Review Committee.
Conclusions:
- Plastic surgery training remains highly variable across integrated programs.
- There is a trend towards earlier and increased plastic surgery exposure.
- Current plastic surgery exposure now surpasses the average duration of general surgery rotations.