intergrated vs. not

[jkin]

What are the actual differences in the residency (length, hours, call, etc.) between the 2?

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[Winged Scapula]

What are the actual differences in the residency (length, hours, call, etc.) between the 2?

Integrated:
Match from medical school
Length varies from 3+2, to 3+3 (most common)
Hours varies from program to program
Call schedule varies from program to program

Independent:
Match generally from General Surgery residency; technically can match after 3 years but ability to do so is exceedingly rare. Most successful applicants will have completed full 5 years in Gen Surg +/- some lab/research years.
Length will thus be 5+2-3 +/- some lab years (ie, 7-8 years minimum)
Hours varies from program to program
Call schedule varies from program to program

 

[jkin]

So are the hours, call, .... different between the 2?

 

[GSresident]

It really depends on the program, but if you do the integrated route its 2 less years of general surgery call. That might be a good thing or it might be bad. Remember, the 2 years of general surgery that you would be missing are chief years - the years when you actually learn to operate in most programs. I don't know what it is like at other institutions, but at my institution chief call isn't as bad as intern or mid level call. Mostly we just sleep unless we go to the operating room. No floor calls and the midlevels handle most of the consults and traumas. We call staff and decide to go to the operating room and thats about it. There are those who say that the 2 years of general surgery aren't really applicable to plastic surgery. I don't know if they are right or wrong. It does seem strange, however, that those same people argue that the breadth and scope of a 'plastic and reconstructive surgery' practice demands a fully trained surgeon and not just a OMFS etc. I chose to complete 5 years of general surgery training so I am naturally biased. All I can say is that there is a HUGE difference between residents who have done 1200 cases and residents who have done 400. (400 being how many cases you will probably get by the time you finish your 3rd year.) There is a HUGE difference between residents who have done 750 cases and those who have done 400 for that matter. Oh well. I hope this doesn't just throw fuel on the age old debate. I don't really feel like getting flamed, so just keep in mind, this is just my opinion.

 

[River13]

It does seem strange, however, that those same people argue that the breadth and scope of a 'plastic and reconstructive surgery' practice demands a fully trained surgeon and not just a OMFS etc. .

Interesting point...

 

[OzDDS]

It really depends on the program, but if you do the integrated route its 2 less years of general surgery call. That might be a good thing or it might be bad. Remember, the 2 years of general surgery that you would be missing are chief years - the years when you actually learn to operate in most programs. I don't know what it is like at other institutions, but at my institution chief call isn't as bad as intern or mid level call. Mostly we just sleep unless we go to the operating room. No floor calls and the midlevels handle most of the consults and traumas. We call staff and decide to go to the operating room and thats about it. There are those who say that the 2 years of general surgery aren't really applicable to plastic surgery. I don't know if they are right or wrong. It does seem strange, however, that those same people argue that the breadth and scope of a 'plastic and reconstructive surgery' practice demands a fully trained surgeon and not just a OMFS etc. I chose to complete 5 years of general surgery training so I am naturally biased. All I can say is that there is a HUGE difference between residents who have done 1200 cases and residents who have done 400. (400 being how many cases you will probably get by the time you finish your 3rd year.) There is a HUGE difference between residents who have done 750 cases and those who have done 400 for that matter. Oh well. I hope this doesn't just throw fuel on the age old debate. I don't really feel like getting flamed, so just keep in mind, this is just my opinion.

Are you saying that you feel Oral and Maxillofacial surgeons are not fully trained surgeons? How does OMFS differ to ENT in that respect? Do you not consider an ENT to be a fully trained surgeon? They both may not be doing boob jobs or treating full body burn victims which obviously fall within the scope of plastics. But both are just as capable in handling head and neck oncology, trauma reconstruction, as well as head and neck cosmetic procedures. ENT just handles a bit more of the ear and sinus infections, tonsillectomies, and neck dissections; and OMFS handles more of the orthognathic, distraction, and cleft palate cases.

 

[GSresident]

"Are you saying that you feel Oral and Maxillofacial surgeons are not fully trained surgeons?"

Not at all. I think you may have misread what I was saying.

 

[toofache32]

I think GSResident means to say "fully-trained general surgery resident." General surgeons tend to refer to themselves simply as "surgeons" in contrast to "oral & maxillofacial surgeons" and "head & neck surgeons." I could also be reading it wrong, but this is just my observation.

 

[GSresident]

I wasn't really speaking from my own point of view, except that I was trying to point out that it might be useful to complete the last two years of general surgery before getting training specifically in plastics. Likewise, if I were in the ENT or OMFS tract, I would think it would be valuable to complete the ENT or OMFS training instead of just doing 60% of it and then doing a plastics fellowship.

I said:
"There are those who say that the 2 years of general surgery aren't really applicable to plastic surgery. I don't know if they are right or wrong. It does seem strange, however, that those same people argue that the breadth and scope of a 'plastic and reconstructive surgery' practice demands a fully trained surgeon and not just a OMFS etc."

I have read the other threads on this and other forums about OMFS doing plastic surgery in California etc. Some of the arguments brought forth by the anti-OMFS crowd were that they were not trained enough to do plastic surgery because plastic and reconstructive surgery is such a broad field demanding much expertise. I was merely pointing out the irony that on one hand some of these people argue that you don't need the extra 2 years of general surgery, and on the other argue that OMFS/ENT aren't qualified to be plastic surgeons because they don't have enough training. I personally could care less what you do. I make decisions about myself and my own needs and abilities. I felt like I needed to be board eligable in GS to be able to meet my goals. You may have entirely different goals and abilities, and I am sure that you have chosen the right path for you.