2014 ACAPS Congress: Abstracts
Both the American Board of Plastic Surgery (ABPS) and the plastic surgery Residency Review Committee (RRC) require training in core surgical disciplines as part of an integrated plastic surgery residency, yet there is no description of the expected knowledge or skills that should be learned. The ABPS does publish a Content Outline that describes the plastic surgery subject matter that is expected to be mastered by a practicing plastic surgeon. The Content Outline serves as the source for written and oral examination question topics and can provide subjects for the goals and objectives of plastic surgery training activities. There is no similar content outline for the core surgical subjects beyond a requirement for experience in specified subject areas.
According to the ABPS, “Clinical experiences … should be provided in alimentary tract surgery, abdominal surgery, breast surgery, emergency medicine, pediatric surgery, surgical critical care, surgical oncology, transplant, trauma management, and vascular surgery,” as well as “acute burn management, anesthesia, dermatology, oculoplastic surgery, oral and maxillofacial surgery, and orthopedic surgery.” In order to fill the gap and assist program directors as they develop the core surgical experiences, the American College of Academic Plastic Surgeons (ACAPS) has developed an outline describing the subjects that a plastic surgery resident should master as part of their integrated training. A committee of senior plastic surgeons with both plastic surgery and general surgery training developed a suggested outline; the outline was vetted internally and then distributed to the RRC and ABPS for comment. At the same time, the proposed Core Surgery Content Outline was presented to the ACAPS membership for input.
The proposed content outline covers the competencies of Medical Knowledge and Patient Care. The topics covered under Medical Knowledge are Anesthesia; Biostatistics and Evaluation of Evidence; Fluids, Electrolytes, and Acid-Base Balance; Geriatric Surgery and End-of-Life Care; Infection and Antimicrobial Therapy; Minimally Invasive Surgery; Nutrition and Metabolism; Oncology and Tumor Biology; Patient Safety; Pharmacology; Preoperative Evaluation and Perioperative Care; and Transfusion Medicine and Disorders of Coagulation. Patient Care subjects include the fundamentals and plastic surgery–related aspects of Abdominal Surgery; Breast Surgery; Burn Surgery; Dermatology; Head and Neck Surgery; Neurosurgery; Oculoplastic Surgery; Oral and Maxillofacial Surgery; Orthopedic Surgery; Pediatric Surgery; Surgical Critical Care; Thoracic Surgery; Transplantation; Trauma; and Vascular Surgery. The other 4 competencies such as Systems-Based Practice are addressed in the section on The Practice of Surgery.
The headings described above are further broken down to a level detailed enough to provide specific topics for learning. For example, the Breast Surgery section is divided into Management of Breast Masses, Management of Breast Cancer, Management of High-Risk Breast Patients, Management of Anaplastic Large Cell Lymphoma (ALCL), and Management of Benign Breast Disease; each of these with further subsections. ACAPS is also in the process of developing a fifth module on the Plastic Surgery In-Training Exam that will assess a resident’s competence in these areas. The Core Surgery Content Outline thus provides guidance for program directors to develop rotation goals and objectives that specifically cover the material that integrated plastic surgery residents need to learn to prepare them for the practice of plastic surgery.