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Canadian Plastic Surgery Resident Operative Experience in Hand Surgery
Celine Yeung1, Jessica G Shih1, Aaron D C Knox2
1Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, Ontario.
The Journal of Hand Surgery
|July 13, 2020
Summary
Canadian plastic surgery residents often graduate with insufficient experience in core hand surgery procedures. Many lack operative exposure and confidence in essential hand surgery competencies.
Area of Science:
- Plastic Surgery Training
- Hand Surgery Competencies
- Surgical Education
Background:
- Core procedural competencies (CPCs) in hand surgery are established.
- The adequacy of operative experience for plastic surgery residents in these CPCs is not well-understood.
Purpose of the Study:
- To assess whether Canadian plastic surgery residents achieve sufficient exposure to core hand surgery procedural competencies during training.
Main Methods:
- Review of hand surgery case logs from 55 graduating plastic surgery residents across 10 Canadian programs (2004-2014).
- Analysis of resident role and self-competence scores for 42 hand surgery CPCs, including core essential procedural competencies (CEPCs).
Main Results:
- Residents logged an average of 271 procedures, with highest exposure in traumatic finger injuries (29%) and neuropathies (22%).
- Least common procedures included flap reconstructions (0.3%) and muscle release (0.1%).
- Many residents reported no or minimal experience (1-10 cases) with CEPCs, and 58-72% lacked confidence in performing common procedures.
Conclusions:
- A significant number of plastic surgery residents complete training with inadequate exposure to over half of essential hand surgery competencies.
- The breadth of hand surgery CPCs makes achieving comprehensive operative experience challenging within residency programs.
