The Plastic Surgery Residency Program provides a wide range of plastic surgery experience including reconstructive surgery, maxillofacial surgery, head and neck surgery, hand surgery, surgery of congenital anomalies, aesthetic surgery and microsurgery.
Saint Louis University Hospital is the home base of the program. Experience here is primarily in the areas of trauma, reconstruction, hand, and microvascular surgery. There are five general plastic surgery clinics every week and two hand clinics every week. At Cardinal Glennon Children's Hospital experience is gained in congenital disorders, clefts, burns, pediatric reconstructive surgery and hand surgery. There are two general plastic surgery clinics every week and a cleft palate/craniofacial clinic twice a month. Both hospitals have busy emergency departments with a variety of trauma and hand surgery cases. The Veterans Administration Medical Center provides experience in head and neck, hand, and reconstructive surgery. There is a general plastic surgery clinic once a week and a hand clinic every two weeks. At St. Mary's Health Center the majority of the patients are private patients with problems in general reconstructive plastic surgery and aesthetic surgery. This setting provides the residents experience in treating and processing patients in a private practice atmosphere. In addition, residents have a rotation at Saint John's Mercy Medical Center and gain further experience in the private setting as well as in resuscitation of acute burns and operative burn treatment at St. John's Burn Unit.
The supervision and degree of independent operative experience is carefully graduated to meet the abilities, initiative, and educational needs of each resident. The overriding concern in all operative activities is the quality of our service and the safety of the patient. These are never compromised for the sake of independent operative experience by the residents. Excellence in patient care is a prerequisite to excellence in teaching and surgical education.
The plastic surgery residency program is structured along three major educational activities:
Patient care including patient selection, preoperative planning, operative experience and postoperative follow-up is emphasized. The residents are provided with a rich, well-rounded experience in all aspects and categories of Plastic Surgery.
- Surgical Education
- Formal didactic teaching includes the full spectrum of teaching conferences including case presentations, seminars, review of selected readings, journal review, mortality & morbidity conferences, anatomy dissections and lectures on basic science topics related to plastic surgery. In addition, the in-service examination is required of all our residents, a mock oral board examination is organized each year and a microsurgical workshop is held each year.
- Basic and clinical research is encouraged. A microsurgery laboratory is available for practice of microsurgical techniques and research. In addition, a large animal research facility located in the medical school is available for basic research.
Complete training in General Surgery and board eligibility have long been a prerequisite for Plastic Surgery Residency. In fact, over the past ten years almost 70% of resident candidates successfully matching into a Plastic Surgery Program had completed their training in General Surgery. It is highly unlikely that this attitude and emphasis on complete training in General Surgery can be maintained for long in the present climate of health care reform and the strong emphasis on spending cuts. Moreover, General Surgery program directors feel it is a waste of resources to train general surgeons for five years and then lose them to another specialty.
Currently there are two pathways which lead to Plastic Surgery training:
- The Independent model where candidates apply to Plastic Surgery following three years or more of General Surgery training or after complete training and board eligibility in Otolaryngology, Orthopedic Surgery, Urology, Neurosurgery, or Oral and Maxillofacial Surgery.
- The Coordinated model where medical students in their senior year apply through the National Residency Match Program (NRMP) with no prerequisite training required. This model for training plastic surgeons is similar to other surgical subspecialties which require one or two years of surgery training before starting specialty training, e.g., Orthopedic Surgery, Otolaryngology, Neurosurgery, Urology. When accepted into the Coordinated Program the resident goes through three years of General Surgery followed by two years of Plastic Surgery. All five years are controlled and directed by the Plastic Surgery Program Director.