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The Impact of Training Pathway on Breast Surgery Cases Performed during Plastic Surgery Residency

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Abstract

Background

Operative volume is a critical component of surgical resident education. This study compares reported breast surgery case volume between resident training pathways in plastic surgery.

Methods

This retrospective cohort study reviewed case logs of plastic surgery residents in the independent/combined and integrated training pathways. Breast surgery case volume was compared via t tests across two major categories: reconstructive and aesthetic. Differences in intra-pathway variability were compared with F tests. Five consecutive cohorts of plastic surgery residents (n = 818): independent/combined (n = 526, 64%) and integrated (n = 292, 36%) at Accreditation Council for Graduate Medical Education (ACGME) accredited residency programs, were included (2011–2015).

Results

Independent/combined residents reported significantly more aesthetic cases than integrated residents, but similar reconstructive cases. Independent/combined residents reported more breast augmentations, mastopexy, cosmetic breast fat grafting, and other cosmetic breast cases. Within the reconstructive category, independent residents reported more breast reconstruction fat grafting cases while integrated residents reported more breast reconstruction with pedicle flap, other breast reconstruction, and breast reduction cases. Independent residents had greater intra-pathway variability in five case subcategories, while integrated residents had greater variability in one case subcategory.

Conclusions

Disparities in breast surgery case volume exist by plastic surgery residency training pathway. Given the importance of case volume to residents and faculty, these disparities may warrant greater attention.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Authors and Affiliations

  1. The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Jason Silvestre, Vincenza A. Caruso, Jade M. Hernandez, Joseph M. Serletti & Benjamin Chang

  2. Hospital of the University of Pennsylvania, 3400 Spruce St, 10 Penn Tower, Philadelphia, PA, 19104, USA

    Jason Silvestre, Vincenza A. Caruso, Jade M. Hernandez, Joseph M. Serletti & Benjamin Chang

Authors
  1. Jason Silvestre
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  2. Vincenza A. Caruso
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  3. Jade M. Hernandez
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  4. Joseph M. Serletti
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  5. Benjamin Chang
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Correspondence to Jason Silvestre.

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Supplemental Table 1

Current Procedural Terminology Codes in Breast Surgery for Plastic Surgery Residents (DOCX 20 kb)

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Silvestre, J., Caruso, V.A., Hernandez, J.M. et al. The Impact of Training Pathway on Breast Surgery Cases Performed during Plastic Surgery Residency. Aesth Plast Surg 43, 1663–1668 (2019). https://doi.org/10.1007/s00266-019-01424-3

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  • DOI: https://doi.org/10.1007/s00266-019-01424-3

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