From “Coordinated” to “Integrated” Residency Training: Evaluating Changes and the Current State of Plastic Surgery Programs

Background: Since the inception of the integrated model, educational leaders have predicted its ongoing evolution, as the optimal plastic surgery curriculum remains a source of debate. With the now complete elimination of the "coordinated" pathway, the total number of integrated programs has arguably reached a plateau. As such, this study examines the current state of training in integrated residencies and re-evaluates the variability in the first 3 years of training observed previously. Methods: Program information was obtained for all 68 integrated plastic surgery programs, of which rotation schedules were available for 59. Plastic surgery, general surgery, and surgical subspecialty exposures were quantified and compared. Inclusion of rotations "strongly suggested" by the Residency Review Committee and the American Board of Plastic Surgery was also examined. Results: PGY1-3 plastic surgery exposure ranged from 3.5-25 months (mean 13.9 ± 5.4). General surgery rotations ranged from 5-22.5 months (mean 12.8 ± 4.7). Surgical subspecialty rotations ranged from 0-8 months (mean 3.6 ± 1.8). There was no difference in mean plastic surgery exposure between programs based within departments versus divisions (15.4 vs. 13.3 months; p=0.184). There remained significant variability in the inclusion of 18 non-plastic surgery rotations including the "strongly suggested" rotations. Conclusions: Plastic surgery exposure remains highly variable with over a 7-fold difference between programs. This suggests that programs are still sorting out the "ideal" curriculum. However, there is an overall trend towards earlier and increased plastic surgery exposure in PGY1-3, which now exceeds the average time spent on general surgery rotations. Financial Disclosures: None Financial Support: None Prior Presentations: None Corresponding Author: Pierre B. Saadeh, MD, Vice Chair of Education and Program Director, Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, 305 E 33rd St . New York, New York, 10016, pierre.saadeh@nyumc.org, Phone: (212) 263-5834, Fax: (212) 263-8492 ©2019American Society of Plastic Surgeons

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