ABSTRACT

Teaching aesthetic surgery at the resident level can be met with unique educational challenges. Constraints such as time, finances, resources, and patient's willingness to work with a resident physician can make case material difficult to recruit. Resident aesthetic experience can be enhanced by exposure to a clinic designed solely for this purpose in which the fees are often discounted and additional time for teaching is allocated. Focus is placed on continuity of patient care and patient evaluation. Other authors have described their experiences with resident aesthetic clinics, and we wish to share our program at the University of Kansas as well 1-5. We present a summary of one calendar year spent in our resident clinic. Additionally, a survey was conducted of plastic surgery programs across the country inquiring about similar such clinics at different institutions.

METHODS

The appointment book and operative log for the Resident Aesthetic Clinic were reviewed for one calendar year (Jan 1st 2006 through Dec 31st 2006). A chart review tracked the reasons for consultation, the resident & attending surgeon, any procedures performed, total surgeon fees, and complications or revisionary procedures. In order to assess the presence of these types of clinics, a survey was created using Surveymonkey.com and was electronically sent to the Program Director or Chair of each Plastic Surgery Residency Program in the United States. Seventy-three functional email addresses were obtained for Program Directors of the 89 accredited programs listed by the American Board of Plastic Surgery as of July 2007. Of the 73, thirty-five completed the survey (48%).

RESULTS & CONCLUSIONS

Eighty-six aesthetic patients presented with 111 procedural consultations. They were evaluated by 4 chief residents and 2 attending plastic surgeons over one calendar year. Fifty-seven surgical procedures were performed, not including revisions or additional procedures outside of the study period. The most common procedures were breast augmentation, abdominoplasty, and suction-assisted lipectomy. Five patients required operative revisions and one patient was verbally dissatisfied with her result. A survey of plastic surgery programs across the country found that about 75% programs maintain an active resident aesthetic clinic such as ours. On average, 6-10 new patients present for consultation each month, and surgeon fees are most commonly discounted by 50%. Free text comments generally reflected strong support of this type of training environment, but some disagreed with the overall concept of resident-directed clinics of any type. It is suggested that more programs adapt resident clinics as a method of teaching aesthetic surgery. This environment provides the opportunity to develop effective preoperative screening and communication skills, the time to learn intra-operative techniques, and attention to personal follow-up of operative patients.