Circumspectus Medicinae: Text and ContextMicrosurgical Training Opportunities at the Queen Victoria Hospital A Retrospective Review of 848 Free Flaps for Breast ReconstructionHenton, John MBBS, FRCS (Plast)a; Berner, Juan Enrique MD, MSc, MRCSb,c; Blackburn, Adam BSc, MBBS, FRCS (Plast)b; Molina, Alexandra MB, BChir, MA, FRCS (Plast)bAuthor Information From the aRoyal Victoria Infirmary, Newcastle bQueen Victoria Hospital, East Grinstead cKellogg College, University of Oxford, Oxford, United Kingdom. Received June 23, 2019, and accepted for publication, after revision September 15, 2019. Conflicts of interest and sources of funding: none declared. Presented at the 10th Congress of the World Society for Reconstructive Microsurgery, June 13, 2019, Bologna, Italy. Reprints: Juan Enrique Berner, MD, MSc, MRCS, Queen Victoria Hospital, Holtye Rd, East Grinstead, United Kingdom. E-mail: firstname.lastname@example.org. Annals of Plastic Surgery: June 2020 - Volume 84 - Issue 6 - p e27-e28 doi: 10.1097/SAP.0000000000002167 Buy Metrics Abstract Becoming a competent microsurgeon requires training in a variety of skills and competences. However, instructing the next generation of microsurgeons seems to be a challenging task, considering the current trend to reduce training hours along with increased patient expectations. To evaluate the microsurgical training opportunities at the Queen Victoria Hospital, we conducted a retrospective review of the last 3 and a half years, to identify the opportunities given to trainees during breast reconstruction cases. We also surveyed the microsurgical fellows who worked in our unit during the same period. A total of 848 free flaps were performed between November 2015 and May 2019 for 699 patients undergoing breast reconstruction, with a flap failure rate of 0.47%. For unilateral cases, more than half of the flaps were raised by trainees: 39% by fellows and 12% by specialist registrars. For bilateral breast and bipedicled reconstructions, these figures were 44% and 2%, respectively. A total of 1835 microvascular anastomoses were performed, of which 33% were done by fellows and 17% by specialist registrars, with the remaining 50% being done by consultants. Six of 8 fellows who worked in our unit during the studied period replied to our survey. All of them were pleased with their training experience, and the majority of them progressed to a consultant post after their fellowship. We consider that a standardized surgical approach, along with a high-volume caseload, allows delivering an outstanding training experience while maintaining low complications rates. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.