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The Chang Gung Memorial Hospital Microsurgery Fellowship: A Review of 1 Year of Experience

Aljaaly, Hattan A., MD, FRCSC*†

Plastic and Reconstructive Surgery – Global Open: September 2016 - Volume 4 - Issue 9 - p e859
doi: 10.1097/GOX.0000000000000845
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Saudi Arabia

From the *Department of plastic and reconstructive surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan and Department of Plastic and Reconstructive Surgery, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

Disclosure: The author has no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the author.

Hattan Aljaaly, MD, FRCSC, Department of Plastic and Reconstructive Surgery, Faculty of Medicine, King Abdulaziz University, P.o.Box: 14893, Jeddah 21434, Saudi Arabia., E-mail: hattanaljaaly@gmail.com

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

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Sir:

The microsurgery fellowship at the Chang Gung Memorial Hospital in Taiwan was founded in 1984 by Professor Fu Chan Wei.1 The Department of Plastic and Reconstructive Surgery offers a 1-year fellowship in microsurgery. The fellowship setup, diversity and number of cases, and high success rate make it a sought target for training. In this article, I share my personal experience from a 1-year fellowship as a guide tool for those considering microsurgery training at this prestigious institution.

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FELLOWSHIP SETUP

This fellowship is provided by the Division of Microsurgery at the Department of Plastic and Reconstructive Surgery. In total, 6 to 8 fellows are selected annually for duration of 1 year. Different areas of reconstruction are covered during the fellowship, and rotations can be customized based on the need and interest of the fellows, and these areas include head and neck reconstruction, breast reconstruction and lymphedema surgery, upper limb reconstruction, lower limb and trauma reconstruction, peripheral nerve, and facial reanimation. The fellowship is based on the principle of mentorship, and the year is composed of six 2-month rotations, where in each rotation, the team is composed of the professor, the fellow, and 1 resident. The fellow is engaged actively in the clinical and operative activity including the preoperative planning and postoperative care. There is no assigned on-call schedule for the fellow; however, he/she is expected to be in any flap takeback for the team as part of the learning experience. Table 1 summarizes the structure of the fellowship.

Table 1.

Table 1.

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EDUCATION

Activities that emphasize educational value to enrich the theoretical knowledge and surgical judgment skills are as follows:

  1. Biweekly plastic surgery grand rounds: Valuable review of topics in plastic surgery, updates, and new researches are discussed.
  2. Weekly microsurgery teaching rounds: During this meeting, a review of scientific microsurgery articles, book chapters, and all cases mandates exploration during that week. Thirty-four scientific articles and 8 book chapters were reviewed this year.
  3. Operative education: Formal teaching about surgical cases is done at the day of surgery where there will be a full presentation of the cases followed by relevant literature review.
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SURGICAL CASES AND WORKLOAD

There was an average of 3 operative days, with 2 rooms running simultaneously, and 1½ clinic days each week. The cases included microsurgical cases (free flaps, peripheral nerve surgery, and lymphatic surgery), pedicle flap, and secondary revision for all procedures. I was involved in a total of 164 cases: 101 microsurgical cases, 4 pedicled flaps, and 59 nonmicrosurgical cases. Table 2 summarizes the areas and flaps for reconstruction.

Table 2.

Table 2.

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RESEARCH OPPORTUNITY AND FUNDING

There are ample opportunities for research in different aspects of reconstructive microsurgery. Funding is not promised for the fellow during this year.

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CONCLUSIONS

The microsurgery fellowship at the Chang Gung Memorial Hospital provides an unparalleled opportunity to learn, understand, and practice microsurgery. I personally liked the fellowship setup, diversity and surgical loads, and the advanced techniques used here, which I think are reproducible and essential to achieve competency in microsurgery.

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ACKNOWLEDGMENTS

The author would like to acknowledge all the professors at the Department of Plastic Surgery and the Ministry of Foreign Affairs of Taiwan (MOFA).

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REFERENCES

1. Abdelrahman M1. The microsurgery fellowship at Chang Gung Memorial Hospital: blossom of caterpillars. Plast Reconstr Surg Glob Open 2015;3:e376.
2. Janis JE, Hatef DA. Resident selection protocols in plastic surgery: a national survey of plastic surgery program directors. Plast Reconstr Surg. 2008;122:19291939; discussion 1940–1941.
3. Wallace C. Combined research and clinical microsurgical fellowship at Chang Gung Memorial Hospital and Chang Gung University in Taiwan. Ann Plast Surg. 2009;62:601603.
Copyright © 2016 The Author. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved.