Independent Plastics Model

[sscooterguy]

EDIT: So I read about Independent model, option 1, variation B, which is as I described. How do find out which programs have this coordinated program, and how do you apply? Thanks.

So I have read up on american society of plastic surg as well as american board of plastic surg webpages, and I would appreciate if someone would clarify the application process for me.

For the independent model, option one, consisting of 2-3 years of requisite plastics training following prerequisite consecutive sequential training in general surgery, WHEN do you apply for the plastics program?

Do you apply as a graduating medical student into the indepedent program with a non contractual understanding of your expressed interest in plastics and then have the spot awaiting you after fulfilling your prerequisite work? Or do you enter general surgery, finish your 2 years, and apply during your 3rd year? If its the latter, how do general surgery programs look upon this?

I appreciate any input. Thanks.

sscooterguy

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[GSresident]

For the independant model, you do training in another surgical field before doing a 2 or 3 year program in plastic surgery. The "traditional" way to do this was to do 3 to 5 years of general surgery and then a plastic surgery residency. FOr various reasons a lot of people wanted to only do 3 years of general surgery and then the 2 years of plastics. There are other surgical fields that serve as entryways into plastic surgery - ENT, ortho, neurosurgery, urology and I think OMFS. There are far fewer applicants from those types of programs though, and the feeling I got from applicants in those fields is that they were having a harder time getting interviews and/or matching.

It is now completely unrealistic to plan on doing 3 years of general surgery and ducking out into a plastic surgery residency using the independant model. It is possible but is a rare event. There are ~400 applicants for ~100 spots now, and the majority of those applicants will be fully trained general surgery residents. Many applicants will also have hand training that they did because they didn't match into plastics the first time around. With that type of applicant pool there is really no reason that a program would want/need to take an applicant after 3 years of general surgery. I know that everyone would like to think that 3 years of general surgery is equivalent to 5 years, but it just isn't. You do the majority of your real operating in your last 2 years and you mature a LOT as a surgeon. You develop judgement and a second sense for when someone is sick. You also begin to learn when not to operate. A fully trained resident means less hassle for the attendings in a program. Instead of having to teach you how to operate they can polish your skills and teach you specific techniques that are applicable to plastic surgery.

 

[ElliotAR]

GS-

While everyone wants to get out af residency in as short as time possible, there is definately something to be said about being as good a clinician/surgeon as possible. Are you saying that the 3+2 model might put out a less polished plastic surgeon compared to a traditional 5+2? I am not trying to stir the pot- I am asking because I don't know. What you said does seem to make sense.

Elliot

 

[GSresident]

I have no idea either. I guess the powers that be consider them to be equivalent or they wouldn't have the 2 paths available. That being said, you would have to look far and wide to find a GS resident at the end of the third year who was even close to one at the end of training.

 

[droliver]

Are you saying that the 3+2 model might put out a less polished plastic surgeon compared to a traditional 5+2?

This is more of a philosophical debate of much "fat" can you trim from traditional models and not diminish the final product. There is an awful lot of general surgery overlap in plastic surgery, but the subspecialties within plastic surgery itself are getting so distinct as to make it somewhat hard to really be well trained in the field as a whole.

IMO a 3+2 model is ridiculous unless you're willing to accept huge deficiencies in curriculum and experience. I've said a number of times I felt a 4+3 would be the sweet spot, but there are a # of political reasons why that might be hard at this point (PRS divisions or departments would not want to give up the manpower supply they have control over in the integrateds).