Variable Experience in Microsurgery and Flap-Based Procedures Among Canadian Plastic Surgery Residents

Area of Science:

• Plastic Surgery
• Surgical Education
• Microsurgery

Background:

• Canadian plastic surgery residencies are transitioning to competency-based education.
• Trainee proficiency in microsurgical techniques is a concern.
• Operative experience in core microsurgical flap procedures among residents is not well-defined.

Purpose of the Study:

• To define the operative experience in core microsurgical flap procedures among Canadian plastic surgery residents.
• To assess resident proficiency and identify gaps in microsurgical training.
• To inform curriculum development for competency-based surgical education.

Main Methods:

• Retrospective review of case logs from graduating plastic surgery residents (2004-2014) at 10 Canadian programs.
• Analysis of operative experience in 27 microsurgical core procedural competencies (CPCs).
• Collection and analysis of perceived role and competence scores.

Main Results:

• Residents performed an average of 37.9 microsurgical procedures.
• Significant variation in experience, with 10.9%-14.5% lacking experience in common flaps.
• Most residents reported zero experience in many CPCs and lacked confidence for independent performance in 50% of procedures.

Conclusions:

• Wide variation exists in resident operative experience with microsurgical CPCs.
• Many residents graduate with insufficient experience in essential microsurgical procedures.
• Findings can guide curriculum refinement within competency-based medical education models.