Best Route to Plastics for Widest Scope of Practice

It's probably more feasible to do some work outside of mainstream plastic surgery if you were previously trained in ENT or Orthopedics where you might incorporate some sinus work (or rarely some of the H&N cancer operations) or some complex upper extremity work (arthroscopy & elbow/shoulder cases). I don't know of much general surgery is really feasible to incorporate except for some of the component-release ventral hernia procedures, melanoma work, breast cancer,and some head/neck cancer resections in rare cases.

Truth be told, there's not a lot of plastic surgeons that really do that much work or have much interest in the traditional ENT & General Surgery areas

If you want to spend half your time doing ENT and are not very interested in cosmetic patients, why not become an ENT? Then you can decide to do a cosmetic fellowship and do rhinoplasties, flaps, etc for cosmesis or reconstuction..etc?

stuck_in_boston said:

Hi, I am curious what the best route to plastics is that would allow a surgeon the widest scope of practice. By that I mean, as a plastics fellowship trained general surgeon you could do some abdomen work, as a fellowship trained ENT you could do septoplastys and allergy work, versus as a graduate of an integrated program you would focus more on reconstruction and cosmetic work. Does one route offer you a better range of high reimbursement procedures? Are there any surgeons out there doing half ENT work and half plastics work, just to fill up their schedules? I apologize if this is a stupid question, I have an interest in plastics but I like to work a lot and don't want to be stuck catering to cosmetics patients just to keep busy 70 hours a week. And it would be nice if I could raise my take home a little bit even while avoiding those patients. Thanks in advance for any replies!

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Plastics is probably the broadest surgical field these days. I'm prefacing the rest of my comments with that, just so you remember that plastics training will leave you with tons of options for your career. Most people (from what I've seen) who have complete training in other fields don't seem to do much outside of plastics. I know a guy with ortho training who does a little more upper extremity than the rest of us would, but he had no interest in taking ortho call, doing hips/knees, or any of that other stuff. He's busy enough with general plastics and hand surgery to keep his kids in shoes and his wife in a Benz. Sure, some practices are slow to start up, but all you have to do is let the ER know that you're happy to be their bitch and you'll have more business than you want. And you really don't want that.

The other big problem with mixing plastics with other stuff is coverage. Who's going to take call on your patients when you're out of town? Will your plastics partners want to get calls about your general surgery/ENT/Ortho patients? If not, do you think that someone from those fields will be willing to cover your patients? After all, you're stealing business from them when you're qualified to do something different.

In the end, you need to pick a field and stick to an appropriate scope of practice.