Aesthetic surgical training: the Lenox Hill model

This program enhances residency training in aesthetic surgery. It provides hands-on operating experience in a supervised hospital setting. Concerns of financial support and liability are addressed. Four chief residents from two university programs each spend 3 months conducting a "private" practice in a service population. A separate resident operative consent form unambiguously specifies the resident as the operating surgeon. Patients are derived from an advertised, free screening clinic every 3 months. The hospital has a special aesthetic surgical fee schedule for the residents. A resident operative fee is collected in support of resident salaries and insurance. An additional fee is collected on behalf of our anesthesiologists. During their 3 months the residents perform 30 to 40 operations as primary surgeon and 50 to 60 as the first assistant. Patient discontent, though rare, is resolved in conference with the patient, the resident, the attending surgeon, and the chief of section. Didactic training consists of monthly surgical conferences, journal club, and guest speaker presentations. Residents experience a practice setting by overseeing appointments to their clinic, booking operating room cases, and providing all paperwork for preadmission testing and certification, as well as fulfilling utilization and quality assurance requirements. They are responsible for their operative patients 24 hours a day, 7 days a week. The program is in its seventh year and its success is noted by continued full certification of the two participating university programs and absence of litigation.