Why No Pathway from Ob/Gyn?

[chartero]

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Despite our beginning as an ABMS Board more than 65 years ago, plastic surgery residency education has changed little in this time period. The original format required three years of prerequisite training (internship and two years of general surgery residency), followed by two years of plastic surgery residency. Minor changes in design followed over many years. Subsequently, alternate training pathways were accepted, initially in otolaryngology, orthopaedics, obstetrics-gynecology, urology, and oral and maxillofacial surgery. Obstetrics-gynecology was later deleted and neurosurgery was added.

The integrated format (with residents accepted into plastic surgery residency from medical school) was initiated in the early 1990’s, affording an expanded flexibility in plastic surgery experience, including the granting of independent responsibility of the training program format to the program director of plastic surgery.

Plastic Surgery Residency Training: A Time for Change? (John A. Persing, M.D., Annual Newsletter To Diplomates of The American Board of Plastic Surgery, Inc., January 2006)

Anyone know why the pathway from ob/gyn was removed?

 

[Winged Scapula]

I would venture its the increased outpatient/non-surgical exposure found in Ob-Gyn residency when compared to the other fields who also require a Prelim year of Gen Surg.

 

[skiz knot]

I would venture its the increased outpatient/non-surgical exposure found in Ob-Gyn residency when compared to the other fields who also require a Prelim year of Gen Surg.

I was going to go with because they are not real surgeons, but what you said will piss less people off.

 

[Winged Scapula]

I was going to go with because they are not real surgeons, but what you said will piss less people off.

Yea, that wouldn't be very PC now would it?

 

[JackADeli]

I would venture its the increased outpatient/non-surgical exposure found in Ob-Gyn residency when compared to the other fields who also require a Prelim year of Gen Surg.

If I understand what is said correctly, at some point in the past, Ob-Gyn was able to be the primary training that preceded accredited training in PRS?

If I am reading that correctly, I will be a little cynical as to why that paradigm was abandoned....

1. No large component of general surgery training (as noted by WS). I may be wrong, but during my med-school it seemed most of the surgical experience was trans-umbo tubals, CSxns (which seemed frightenning surgical techniques), post-partem repairs. There was also some strange tradition of a Cardiac surgery rotation. Yes, there may be more now. But, in general I would be curious to see what the foundation in surgery really is.... it isn't taught by GSurgeons. It's kind of like ER that gets most of its ortho training from ER attendings....

2. The cynical part, why would PRS that do all components of PRS and have a wide surgical foundation want to have their bread & butter cases snatched away? You see, OB/Gyns often regard themselves as women primary care. In theory, they would find the breast lumps & they would deal with the post-partem sag. I suppose they would do all the cash breast aug and post cancer breast aug, and abdominal plasties..... However, I doubt they would be taking hand call, or doing alot of burns, grafting, etc.... They would have a captive, relatively young, cash population.


JAD

PS: the relative abandonment of broad foundation training in GSurgery has been systematically diminished and/or abandoned in numerous fields.... often at the demand of the individual subspecialty organizations & residents..... look at Urology, NSGY, CT, & vascular, etc...

 

[Baritonebass]

"PS: the relative abandonment of broad foundation training in GSurgery has been systematically diminished and/or abandoned in numerous fields.... often at the demand of the individual subspecialty organizations & residents..... look at Urology, NSGY, CT, & vascular, etc... "

Umm... Don't all those guys do like a year or 2 of general surgery and CT& Vascular aren't exactly main stream intergrated programs

 

[WentForitandWon]

"PS: the relative abandonment of broad foundation training in GSurgery has been systematically diminished and/or abandoned in numerous fields.... often at the demand of the individual subspecialty organizations & residents..... look at Urology, NSGY, CT, & vascular, etc... "

Umm... Don't all those guys do like a year or 2 of general surgery and CT& Vascular aren't exactly main stream intergrated programs

Ortho, ENT, Urology 1 year of general surgery
PRS- 3 years general surgery
Vascular- I'm not really sure but there are ~15 integrated progams
Neurosurgery- Not sure, at least 1 year

 

[JackADeli]

...Umm... Don't all those guys do like a year or 2 of general surgery and CT& Vascular aren't exactly main stream intergrated programs

Ortho, ENT, Urology 1 year of general surgery
PRS- 3 years general surgery
Vascular- I'm not really sure but there are ~15 integrated progams
Neurosurgery- Not sure, at least 1 year

I think when we speak of "1 year GSurgery" we need to be specific. I recall as an intern the one year of gsurgery including some months of non-GSurgery rotations. So, it was not like a true 12 month surgery internship. I suspect different programs do it differently. I haven't been an intern for quite some time so I leave it to those with closer knowledge on that detail point.

JAD

 

[howelljolly]

I think when we speak of "1 year GSurgery" we need to be specific. I recall as an intern the one year of gsurgery including some months of non-GSurgery rotations. So, it was not like a true 12 month surgery internship. I suspect different programs do it differently. I haven't been an intern for quite some time so I leave it to those with closer knowledge on that detail point.

JAD

Some GS internships have almost no OR exposure, not much different than the OB/Gyn people.

You can still do Plastics as an OB/Gyn, you'll just have to shell out your own cash for seminars and courses.

Thats how Dr. Matlock from Dr. 90210 did it... i think.

 

[deleted144060]

Anyone know why the pathway from ob/gyn was removed?

I don't know this for a fact so it's just speculation on my part. Ever hear of that saying, "if you're not at the table, you're on the menu?"

Persing is boarded in neurosurgery and plastic surgery. There is also plenty of representation from other specialties who are also double boarded. I would venture to guess that OB-Gyn wasn't invited to dinner.

 

[maxheadroom]

I'm not sure that guy Matlock is really the role model that you want to bring to the argument.

Plastics has benefited from having surgeons from multiple specialties enter our field. The contributions of our ENT/OMFS/Orthopaedic colleagues has been substantial. While GU and Neurosurg are approved pathways, they are rarely used.

Good to see you back, Moravian. You headed to Seattle next weekend?

 

[deleted144060]

I'm not sure that guy Matlock is really the role model that you want to bring to the argument.

Hey Max,

I'm telling Persing you said that 🙂

Good to see you back, Moravian. You headed to Seattle next weekend?

Not this year. I went to the international craniofacial meeting last month, have oral boards coming up, and someone has to stay home and watch the store. My practice has also picked up significantly. I'm currently the only craniofacial guy in my area still taking the California state medicaid. The reimbursements suck, but that's not really why I got into this. Hope you are well.

 

[maxheadroom]

Oral Boards? Like that's an excuse. Just take the Stanford Course and piss off the examiners. Heck, I'm taking the written on Monday. Ugh.

What, MediCal isn't the best payor around? No idea. Glad to hear you're busy, even if you aren't really getting paid for all that work.