Plastic Surgery Training Plan

Six-Year Integrated Plastic Surgery Training Plan

The Loma Linda University Medical Center, Plastic Surgery Training Program has been accredited as a six-year integrated residency in plastic surgery with a total of 12 positions distributed two per year.

The rotations have been specifically designed to fulfill all the program requirements or taining an integrated resident in clinical plastic surgery as outlined by the Plastic Surgery Residency Review Committee.

We have developed a curriculum for the early years of training (PGY I-III) with distinct goals to prepare our residents for their concentrated training in plastic surgery (PGY IV-VI). Our philosophy is to ensure that our trainees are, firstly good physicians, secondly, good surgeons, and finally excellent plastic surgeons. In addition to the requirements of the core surgery residency program (conferences, testing, etc.) we have added additional requirements (i.e., monthly attendance at a minimum of one plastic surgery grand rounds conferences, attendance at all quarterly residency/faculty meetings, special lectures, and all division social activities). In addition, our requirements for performance of yearly In-Service examinations are more rigorous than the requirements of the core surgery-training program.

Activities which are provided separately during the PGY I-III years include defined rotations on Plastic Surgery, ENT/Head and Neck Surgery, Urology, Vascular Surgery, Transplantation Surgery, Surgical Oncology, Emergency/Trauma Surgery, Anesthesiology, Critical Care, Orthopedic Surgery, Cardiothoracic Surgery/Intensive Care Unit (CICU), Neurosurgery, Burn Surgery and Management, and Pediatric Surgery. The residents go through a six-year progressive increase in clinical responsibility. This is accomplished in two phases with increasing patient care duties and operating room participation during PGY I-III and then increasing surgical autonomy and decision-making in PGY IV-VI.

The training program, as outlined below, presupposes a complement of two residents at each level in a three-year program. It will consist of a series of six rotations of equal length (see following chart). At Loma Linda University Medical Center, two residents, one at the first-year level and one at the third-year level, will be assigned simultaneously. All other rotations will be at a specific affiliated institution and will be covered by one resident at a time.

We strongly believe that the body of knowledge that current plastic surgery residents are required to master is best achieved in a three-year curriculum. Our education rational is as follows:

  1. We realize that plastic surgery residents will never be able to see or perform all procedures that are under our purview; however, a three-year curriculum allows greater exposure to the depth and breadth of clinical material.
  2. In addition, didactic conferences and reading requirements can be more specific and focused when completed over a three- (rather than a two-) year period.
  3. A three-year curriculum allows the opportunity to incorporate dedicated research time within the scope of a busy clinical residency training program.
  4. Three years of training adds an additional year of "surgical maturation," not only technically, but also allowing the resident a better understanding of plastic surgery principles and, hopefully, culminating in better judgment and, ultimately, superior patient care.

We believe that our overall training program fulfills those requirements as outlined in special requirements. In addition, our requirement for dedicated research time expands those of the special requirements, thus necessitating additional time of training.

By design, each institution affiliated with this program will contribute a different practice setting, research opportunity, and a special clinical focus to the overall depth of resident training. Taken together, they will afford the resident trainee exposure to adequate numbers of patients from all walks of life and with clinical problems in all major areas of our specialty.

At all institutions and at all times, the resident will be under the direct supervision of a board certified/eligible plastic surgeon who has an academic appointment within the division of plastic and reconstructive surgery. The overall training exposure will be uniform for each individual. Service rotations selected for the first-year trainee emphasize a broad exposure to general plastic surgery, while rotations for the second and third years have been selected to allow the more senior residents to act as chief residents, with increased service oversight responsibility to allow them increased latitude for independent activity and judgment.

Additionally, each resident will be required in the first training year to complete the basic 40-hour microsurgery laboratory course in the microsurgical training laboratory at Loma Linda University Medical Center. Time for this course (exclusive of vacation) and tuition will be provided.