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The Best Plastic Surgeons Are the Best Anatomists

Evaluation of a Training Method and Residents as Teachers

Pflibsen, Lacey, MD*; Noland, Shelley, MD*; Langley, Natalie, PhD; Van Nuland, Sonya, PhD; Casey, William III, MD*; Smith, Anthony, MD*

Plastic and Reconstructive Surgery – Global Open: July 2018 - Volume 6 - Issue 7 - p e1815
doi: 10.1097/GOX.0000000000001815
ACAPS Abstracts

From the *Division of Plastic and Reconstructive Surgery, Mayo Clinic in Arizona, Phoenix, Ariz.

Department of Anatomy, Mayo Clinic College of Medicine and Science, Mayo Clinic, Scottsdale, Ariz.

Published online 16 July 2018.

Disclosure: The authors have no disclosures or financial interests to disclose in the preparation, presentation, or submission of this article. The Article Processing Charge for this abstract was paid for by the American Council of Academic Plastic Surgeons

ACAPS: American Council of Academic Plastic Surgeons (ACAPS) Winter Retreat in Chicago, Illinois, on February 10–11, 2018.

Lacey Pflibsen, MD, Division of Plastic and Reconstructive Surgery, Mayo Clinic in Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054, E-mail:

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 without permission from the journal.

The best plastic surgeons, first and foremost, are the best anatomists. Our integrated plastic surgery program took this principle to heart and sent our PGY 2 resident to a 7-week medical school anatomy course. There, she was a teaching assistant for first year medical students. To the best of our knowledge, giving plastic surgery residents dedicated time to study anatomy and teach medical students is novel. The benefits are many, but the major goals were to have the residents master full body anatomy and to acquire teaching skills.

In the Mayo Clinic Arizona anatomy course, our PGY 2 resident oversaw the instruction of first year medical school students in the subjects of gross anatomy, radiology, and embryology among others. An estimated 300 hours of direct student interaction were achieved through attending lecture, giving lectures, doing prosections, helping students dissect in laboratory, tutoring, grading, proctoring examinations, giving difficult feedback, attending course discussions.

Most plastic surgery residents get training in anatomy only once in their career—during their first year of medical school. At least 3 years have passed by the time they are first year residents. Ergül et al.1 found that a short anatomy course given to junior surgical residents by anatomists on inguinal anatomy resulted in significantly better identification in inguinal nerves.1 Furthermore, Weber et al.2 looked at cadaveric preoperative rehearsals by plastic surgery residents and found that there was a significant improvement in confidence and performance.2 Thus, there appears to be a correlation to the resident anatomic knowledge and intraoperative performance.

An estimated 20% of resident time is spent teaching other more junior residents and medical students.3 Most residents assume these teaching responsibilities without any preparation and despite the fact that they believe that they would benefit from instruction on how to teach.4–6 Jay et al. developed a curriculum for medical students as teachers, similar to ours, where third year medical students served as teaching assistants in an anatomy course.7 Andrew Jay et al.7 found that 100% of these TAs agreed that they felt prepared for the teaching responsibilities required in residency. Our residency has recognized how important these teaching skills are for plastic surgery residents at all levels.

This focused anatomy experience is novel to plastic surgery–integrated residency training, and to date has served as an educational anatomy experience and a course to garner teaching skills. My hope is to share this unique experience along with a review of the current literature about residents as teachers.

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1. Ergül Z, Kulaçoğlu H, Sen T, et al. A short postgraduate anatomy course may improve the junior surgical residents’ anatomy knowledge for the nerves of the inguinal region. Chirurgia (Bucur). 2011;106:599–603.
2. Weber EL, Leland HA, Azadgoli B, et al. Preoperative surgical rehearsal using cadaveric fresh tissue surgical simulation increases resident operative confidence. Ann Transl Med. 2017;5:302.
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7. Andrew Jay E, Starkman SJ, Pawlina W, et al. Developing medical students as teachers: an anatomy-based student-as-teacher program with emphasis on core teaching competencies. Anat Sci Educ. 2013;6:385–392.
Copyright © 2018 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved.