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Jennifer L. Walden, MD Chief Resident, Plastic Surgery University of Texas Medical Branch Linda G.
Phillips, MD The American Board of Plastic Surgery, Inc. was organized in June 1937 by representatives of various groups interested in this type of surgery, and received recognition as a subsidiary of the American Board of Surgery in May 1938. The American Board of Plastic Surgery, Inc. was given the status of a major specialty board in May 1941 by action of the Advisory Board for Medical Specialties as approved by the Council on Medical Education of the American Medical Association. Plastic surgery is a broad-based discipline with emphasis on areas such as breast, cranio-maxillofacial, burn, aesthetic, and hand surgery as well as complex wounds and wound healing. Training Requirements Residency Requirements There are two major pathways toward obtaining acceptable graduate level training in plastic surgery including the Independent Model and the Integrated Model. In an independent model, the resident must complete both prerequisite training (general surgery) and requisite training (plastic surgery). A minimum of three years of clinical training in general surgery in the same program is required. Broad surgical training experience is required. Prospective candidates may have also completed an accredited residency training program in neurosurgery, orthopaedic surgery, otolaryngology, or urology. Satisfactory completion of a residency program in Oral and Maxillofacial Surgery approved by the American Dental Association is an alternate pathway for prerequisite training prior to plastic surgery residency. Information concerning accredited training programs for the Independent Model may be found in the Directory of Graduate Medical Education ("the green book") published by the AMA. Copies of the directory are available at most medical school libraries or may be ordered by calling toll free 1-800-621-8335. The Residency Review Committee (RRC) for Plastic Surgery inspects and makes recommendations for or against approval of a residency training program in plastic surgery only after the director of the residency has filed an application for approval by the RRC. Integrated Model - Residents must have a medical or osteopathic degree granted in the US or Canada by an institution accredited by the Liaison Committee for medical education (LCME) or American Osteopathic Association (AOA). Training of no less than five years of clinical residency under the authority and direction of the plastic surgery program director is required. No less than two years of this program must be concentrated plastic surgery training and the final twelve months must entail senior clinical responsibility. Although there are certainly both independent and integrated models of training available, there is a growing trend towards matching competitive candidates out of medical school into integrated programs. Residency - Requisite Training: Graduate Education in Plastic Surgery Two years of plastic surgery training is required, and the final year must be at the senior level. Residents entering a plastic surgery residency accredited for three years of training must complete the entire three years, including one year of senior responsibility. Training in plastic surgery must be obtained in either the US or Canada. Training in plastic surgery must cover the entire spectrum of plastic surgery and include experience in both the functional and aesthetic management of congenital and acquired defects of the head, neck, trunk, and extremities. This period of specialized training should emphasize the relationship of basic science -- anatomy, pathology, biochemistry, and microbiology -- to surgical principles fundamental to all branches of surgery and especially plastic surgery. In addition, the training program must provide in-depth exposure to the following subjects: emergency care, shock, wound healing, blood replacement, fluid and electrolyte balance, pharmacology, and anesthetics. Board Certification The board conducts two types of examinations including the Written and Oral examinations. The Written examination is given in the fall each year and consists of multiple choice and true/false questions. Traditionally held in Houston, Texas each fall, the exam will soon be administered via computer at approved testing facilities in the US. The Oral examination is conducted in the fall each year as well, and candidates will be deemed admissible to this exam only if they have done the following:
The Board will select five cases from the candidate's compiled seven month case list and request each candidate prepare case reports. The Oral examination is given over two days. Effective 1995, certificates issued by the Board are dated and will be valid for ten years and revalidation will be accomplished by the Board's Maintenance of Certification process. The Plastic Surgery Educational Foundation has recently developed the PSEF Oral and Written Board Preparation Course, which will be held annually. It is designed to concisely and interactively review the plastic surgery principles and management problems presented on the test as well as expose the test-taker to the oral board format. Residency, Research and Travel Fellowships Medical Students If a student is interested in plastic surgery, she or he should try and identify a mentor early. Doing a surgical clerkship in the junior and/or senior year is strongly encouraged in order to gain appreciation for the discipline and to become acquainted with a specific program and its members. Motivated students also tend to do "acting internships" and take call with the residents to increase their visibility within the program. High USMLE scores, high grades in medical school (including membership in Alpha Omega Alpha), strong letters of recommendation from other plastic surgeons, and research activity are generally helpful. Away rotations at specific programs are helpful for candidates who are interested in going to the program and feel that they need the additional exposure provided by a month at the outside institution. No spots went unmatched in the NRMP plastic surgery integrated model programs last year. Residents/Faculty There are several opportunities for research fellowships. The Plastic Surgery Educational Foundation (PSEF) sponsors the Smile Train, Inc. and the PSEF Cleft Lip and Palate Research Initiative Grant. This program provides funds for healthcare professionals to perform meritorious research projects in the areas of etiology, treatment, and care of people with cleft lip and palate. The National Endowment for Plastic Surgery through the PSEF also funds meritorious projects in the field of plastic surgery. Numerous traveling fellowships exist including but not limited to the Reconstructive Surgeons Volunteer Program (RSVP), Operation Smile International, Interplast, Operation Rainbow, and Austin Smiles. More information regarding research and travel fellowship opportunities in the field may be found at the American Society of Plastic Surgeons website. Society Membership ASPS Residents' Affiliate Group The American Society of Plastic Surgeons has established a Residents' Affiliate Group. There are a number of advantages including savings on the Journal of Plastic and Reconstructive Surgery, Plastic Surgery News, and access to Plastic Surgeons Forum online. Membership in the affiliate group does not confer membership in the Society. Rather, it serves as a way residents can become familiar with the benefits of Society membership and to maintain communication with the Society. For more information contact:
Membership Services Those plastic surgeons who have become Candidates for Active Membership are eligible to become active members in the ASPS after they have completed a formal application process which may be reviewed on the ASPS website. The ASPS Young Plastic Surgeons Committee identifies problems or concerns of the young plastic surgeon. The term young is used to connote physicians in training or those newly established in the practice. The committee participates in the annual Senior Residents Conference promoting membership and participation in the ASPS and by offering assistance to residents in career planning. As well, the YPS recommends final candidates to the AMA Plastic Surgery Caucus and nominates candidates for delegate positions to the AMA Young Physicians Section. Other key Societies within the field of Plastic Surgery include but are not limited to the following: American Association of Plastic Surgeons, American Society for Aesthetic Plastic Surgery, American Assocation for Hand Surgery, American Burn Association, American Cleft Palate-Craniofacial Association, American College of Surgeons, American Society of Maxillofacial Surgeons, Plastic Surgery Research Council, and American Society for Reconstructive Microsurgery. Each society has specific criteria for membership with varying levels of training, sponsorship, and benefits. As well, each society tends to have its own annual scientific meeting for its members, residents, and candidates for membership. Research opportunites are available by submitting material for paper or poster presentation at these meetings. Society journals also accept original work for publication for those interested in this aspect of plastic surgery. For a detailed list of societies and annual meetings visit the ASPS website. Journals A number of journals deal entirely with plastic surgery topics, and some of them offer discounts to residents. The following is a partial list of some key journals, but a complete list is available with subscription information on the ASPS website.
Plastic and Reconstructive Surgery
- Journal of the American Society of Plastic and Reconstructive
Surgeons, Inc. ("the white journal") References Most of the above information may be found on the American Society of Plastic Surgeons website. Chang, P., Korman, JM, Rockwell, WB, and Wong, GB. Resource Book for Plastic Surgery Residents, In ASPS website, 2001. The American Board of Plastic Surgery, Inc. Primary Booklet of Information, 21-46, 2000. Seven Penn Center, Suite 400, 1635 Market Street, Philadelphia, PA 19103-2204 Further inquiries
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