Ethan Clarke
Plastic surgery residency programs are available at several institutions in the United States, including Johns Hopkins Medicine, Weill Cornell Medicine, and Columbia Surgery. The programs typically last six years and provide residents with experience in various core areas of plastic and reconstructive surgery, such as cosmetic surgery, hand surgery, pediatric surgery, and craniofacial surgery. During their residency, individuals may also have the opportunity to participate in elective rotations, research activities, and mentorship programs. The goal of these residency programs is to produce highly skilled, ethical, and competent plastic surgeons who will become leaders in their field.
| Characteristics | Values |
|---|---|
| Residency length | 3 years (independent program) or 6 years (integrated program) |
| Residency focus | Plastic surgery, with rotations in general, vascular, surgical critical care, and breast surgery (integrated program) |
| Participating institutions | Weill Cornell Medicine, NewYork-Presbyterian/Weill Cornell Medical Center, NewYork-Presbyterian/Columbia University Medical Center, Memorial Sloan Kettering Cancer Center, Hospital for Special Surgery, NYC Health + Hospitals/Harlem |
| Requirements | Prerequisite degree from LCME, AOA, or certificate for foreign medical graduates from ECFMG |
| Opportunities | Research, international medical mission trips, mentorship, cosmetic clinic rotations |
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What You'll Learn
Integrated vs. independent pathways
Plastic surgery residency training programs have two pathways: the integrated pathway and the independent pathway. Both pathways require a prerequisite degree from the Liaison Committee for Medical Education (LCME), the American Osteopathic Association (AOA), or a certificate for foreign medical graduates from the Educational Commission for Foreign Medical Graduates (ECFMG).
The integrated pathway is a six-year training program (five years in some accelerated programs) where residents have a primary focus on plastic surgery and complete several ACGME-required surgical rotations in general, vascular, surgical critical care, and breast surgery. This model was pioneered in 1960 and has grown in popularity in recent years, with the number of integrated plastic surgery residency positions increasing from 92 in 2007 to 172 in 2019. Graduates of this program are eligible for board certification in plastic surgery and can pursue additional fellowship training in various specialties.
The independent pathway, on the other hand, is a three-year program where residents complete an ACGME-accredited surgical residency outside of plastic surgery and are eligible to take boards within that field. Applicants typically complete a general surgery residency, but graduates from otolaryngology, neurosurgery, orthopedic surgery, urology, and oral and maxillofacial surgery may also apply. This model was the first to gain broad acceptance as a standardized training pathway and was once the more popular option, but the number of independent residency positions has decreased in recent years. Graduates of this program will also be eligible for a second board certification in plastic surgery upon completion.
Both pathways ultimately provide admissibility to the American Board of Plastic Surgery (ABPS) examination, and there has been much debate about the effectiveness of one program over the other in terms of producing well-trained and capable plastic surgeons. Ongoing studies are encouraged to identify areas of improvement for both training models.
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Core subject areas
There are two formal training pathways for plastic surgery residencies: the Independent Pathway and the Integrated Pathway. The Independent Pathway is for residents who have completed an ACGME-accredited surgical residency outside of plastic surgery, most commonly a general surgery residency. The Integrated Pathway is for medical students who match directly into a plastic surgery residency program for six years (five years in some accelerated programs).
The core subject areas of plastic surgery residencies include cosmetic surgery, hand surgery, pediatric surgery, craniofacial surgery, and microsurgery. Residents may also have the opportunity to participate in medical mission trips to gain experience in plastic surgery in other countries.
During their residency, individuals will gain experience in a variety of surgical procedures, including general reconstruction, aesthetic surgery, craniomaxillofacial surgery, and hand and lower extremity surgery. They will also learn about the business side of plastic surgery, ethical practice, and outpatient safety.
Some plastic surgery residency programs offer the opportunity to focus on one of these core areas through elective rotations. For example, the Chief Resident Aesthetic Rotation at Johns Hopkins Medicine allows chief residents to have their own cosmetic clinic where they provide aesthetic procedures. Residents also have the opportunity to spend elective time with community surgeons in areas such as facial plastic surgery and body contouring.
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Training locations
There are two formal training pathways for plastic surgery residencies: the Independent Pathway and the Integrated Pathway. The Independent Pathway is for residents who have completed an ACGME-accredited surgical residency outside of plastic surgery. The Integrated Pathway is for medical students who will be entering directly into a plastic surgery residency program.
The Integrated Pathway is six years long (five years in some accelerated programs). The resident will focus on plastic surgery but will also have several ACGME-required surgical rotations in general, vascular, surgical critical care, and breast surgery. The Independent Pathway is three years long.
Some institutions that offer plastic surgery residencies include:
- Johns Hopkins Medicine: Residents at Johns Hopkins have their own cosmetic clinic where they provide aesthetic procedures. Residents also have elective time with community surgeons, based on their interests. Elective rotations are also available.
- Wake Forest University School of Medicine: Wake Forest's program began in 1973 and became fully integrated in 2000. The program offers residents the opportunity to participate in medical mission trips to countries such as Vietnam, Togo, Romania, Moldova, and Zambia.
- Weill Cornell Medicine: The Department of Surgery at Weill Cornell Medicine offers a six-year, ACGME-accredited Integrated Plastic Surgery Residency Program. Residents rotate through NewYork-Presbyterian/Weill Cornell Medical Center, NewYork-Presbyterian/Columbia University Medical Center, Memorial Sloan Kettering Cancer Center, the Hospital for Special Surgery, and NYC Health + Hospitals/Harlem.
- Washington University: Washington University offers a plastic surgery residency program through its Office of Graduate Medical Education.
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Research opportunities
Plastic surgery residency programs offer a variety of research opportunities for residents. These programs aim to produce highly skilled, ethical, and competent surgeons who are future leaders in the field.
The Integrated Pathway is a six-year residency program that offers a primary focus on plastic surgery. It includes surgical rotations in general, vascular, surgical critical care, and breast surgery. Residents are exposed to diverse clinical disorders, from complex tertiary care reconstructions to aesthetic surgery. They also gain experience in burn care, trauma management, and cancer treatment. Additional time is dedicated to outpatient office experience, where residents learn about ethical practice, patient safety, and the business aspects of plastic surgery. During the six-year program, residents are required to pursue independent clinical or basic science research, producing academic manuscripts, publications, and presentations. They are encouraged to attend meetings and conferences, such as the American Society of Plastic Surgeons annual meeting, to further their research and professional development.
The Independent Pathway, on the other hand, is a three-year residency program. It accepts residents with diverse backgrounds, including general surgery, ENT, orthopedics, and neurosurgery. This pathway provides residents with the opportunity to pursue subspecialty training in craniofacial surgery and hand surgery. While specific research requirements may vary, residents in this pathway can still expect to engage in research activities and gain valuable mentorship from experienced faculty members.
Regardless of the chosen pathway, plastic surgery residency programs offer a wealth of research opportunities. Residents are exposed to a range of surgical specialties, allowing them to develop their skills, build their knowledge, and contribute to the advancement of plastic surgery through research and clinical practice.
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Post-residency fellowships
Plastic surgery residency programs are highly competitive, with only 194 spots available for a total of 340 applicants. The field is not very friendly to osteopathic students, with few DO spots available. Most spots are taken by MD students.
There are two pathways to plastic surgery residencies: independent and integrated. Independent residency programs are three years long and accept residents who have completed a general surgery training program or training in ENT, orthopaedics, or neurosurgery. The integrated pathway is six years long, with the resident focusing primarily on plastic surgery while also completing surgical rotations in general, vascular, surgical critical care, and breast surgery.
Following the completion of a plastic surgery residency training program, there are several fellowship opportunities available, including:
- Craniofacial surgery
- Hand surgery
- Aesthetic surgery
- Microsurgery
- Burn surgery
Fellowships provide advanced training in specialized techniques and prepare plastic surgeons for academic or high-volume practices. For example, the Temple Plastic & Reconstructive Surgery Fellowship Program offers a three-year, ACGME-accredited independent fellowship program in Plastic & Reconstructive Surgery. During their three years, fellows rotate at two-month intervals between various hospitals and medical centres, gaining diverse experiences and emphasizing the development of a broad set of techniques.
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Frequently asked questions
There are two types of residencies for plastic surgery: independent and integrated. Independent residencies are three years long and require residents to complete an ACGME-accredited surgical residency outside of plastic surgery. Integrated residencies are six years long, and medical students will match directly into a plastic surgery residency program.
Some institutions that offer plastic surgery residencies include Johns Hopkins Medicine, Weill Cornell Medicine, and Columbia Surgery.
Doing a residency in plastic surgery provides a comprehensive clinical experience encompassing the full spectrum of core plastic and reconstructive surgery subject areas. It also allows residents to gain experience in ethical medicine, practice management, and outpatient safety. Additionally, residents may have the opportunity to participate in research and attend regional and national meetings.
