Business Education in Plastic Surgery Residency: A National Audit of Training Programs

Plastic surgery residents frequently graduate with limited preparation in essential business skills such as billing, contract negotiation, and practice management. Although the importance of these competencies is frequently recognized, the extent to which they are integrated into residency curriculum remains undocumented.

A curriculum audit of 138 AGCME-accredited integrated and independent plastic surgery residency programs was conducted. Program websites were reviewed for resident-facing business education. The presence, content, and instructional formats of business education were recorded.

Among 109 plastic surgery residency programs reviewed, 4 programs (3.7%) offered structured, plastic surgery-specific education, 2 programs (1.8%) offered structured department-wide business instruction, 7 programs (6.4%) had unstructured or topic-only references to business education, and 2 programs (1.8%) cited nonspecific business content. Of the programs referencing resident-facing business education, most referenced private practice management (n = 11, 73.3%) and leadership/administrative training (n = 8, 53.3%). Didactic teaching (n = 8, 53.3%) and clinical exposure (n = 7, 46.7%) were the most common instructional formats.

Despite the increasing importance of business acumen in modern health care, structured business education remains largely absent from plastic surgery residency training. Given the prevalence of graduates entering private practice models in the field, this educational gap leaves plastic surgery graduates at a disadvantage and underprepared. The integration of structured business education into plastic surgery residency curriculum provides an opportunity to strengthen professional readiness and prepare residents for the transition to clinical practice.