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Comprehensive Rotation Analysis of Integrated Plastic Surgery Residency in the United States: Clarification of

Zachary A Koenig¹, Niki K Patel¹, Rebecca Norcini¹

¹Division of Plastic, Reconstructive, & Hand Surgery, West Virginia University, Morgantown, West Virginia.

The Journal of Surgical Research

|July 23, 2025

Summary

Integrated plastic surgery residency programs are increasing, leading to varied rotation schedules. Programs are experimenting with curricula, favoring earlier exposure to plastic surgery and fewer non-plastic surgery rotations.

Keywords:

Education General surgery rotations Integrated plastic surgery residency Rotation curriculum Subspecialty rotations

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Area of Science:

Medical Education
Surgical Training
Plastic Surgery

Background:

The integrated residency model is favored in plastic surgery training.
Accreditation bodies provide guidelines, but curricula vary significantly.
This study investigates rotation trends in response to the rise of integrated programs.

Purpose of the Study:

To examine trends in rotation block structures within integrated plastic surgery residency programs.
To analyze the composition of rotations in response to program growth and evolving training standards.

Main Methods:

Utilized data from the National Resident Matching Program and the American Council of Educators in Plastic Surgery (2012-2023).
Identified 89 accredited integrated plastic surgery programs and collected rotation schedules.
Categorized rotations into plastic surgery and 18 subcategories of non-plastic surgery.

Main Results:

Integrated programs grew by 68% while independent programs declined by 33% over a decade.
General surgery rotations decreased by 20%, averaging 10.3 months across analyzed programs.
Significant variability exists in subspecialty rotation distribution among programs.

Conclusions:

The optimal rotation structure remains undefined, with programs tailoring curricula to specific priorities.
There is a discernible trend towards earlier plastic surgery exposure and reduced non-plastic surgery rotations in early years.
Programmatic experimentation reflects the ongoing search for effective educational strategies in plastic surgery training.