Trainee Perspectives After Nonvoluntary Plastic Surgery Program Closures: Lessons Learned and Steps Forward

In the last decade, only 3 plastic surgery programs have faced nonvoluntary closure by the Accreditation Council of Graduate Medical Education. These closures all occurred unexpectedly in April 2021 and affected 23 trainees. Although the dust has largely settled from this event, the insights of the affected trainees remain uncharacterized.

The Program Closure Working Group of the American Society of Plastic Surgery's Resident Council created a 30-item questionnaire and distributed it to displaced trainees 1 year after program closures to capture their perspectives.

Seventeen trainees (84%) responded to the survey with respondents from all postgraduate year years, including incoming interns. Only 24% (4/17) trainees were notified of program closure on the day of closure decision, and 18% (3/17) never received official notice from their program. All trainees (100%, 17/17) reported that their home institution did not provide guidance regarding the relocation process, which cost a median of $10,000 and up to $50,000. No incoming intern was informed about potential program closure prior to rank list submission. The most difficult part of the relocation process was mental hardship (59%, 10/17), followed by finding an available residency spot (47%, 8/17). Department/division chairs (76%, 13/17) and program directors (71%, 12/17) were predominantly viewed as unsupportive and antagonistic.

The plastic surgery community needs to be proactive in ensuring the support of trainees during nonvoluntary program closures. Fortunately, these events are rare, but when they do occur, they can be devastating. Moving forward, we propose tasking a single party to be responsible for ( a ) timely dispersion of information during program closures, ( b ) creating a protocol for leadership, ( c ) allocating a relocation stipend for trainees, and ( d ) facilitating the delivery of mental health resources to trainees.