Plastic & Reconstructive Surgery Residencies Rotations

Each year, junior, senior, and chief residents spend a total of six months at Lahey Hospital & Medical Center. Residents’ time is divided into three, two-month rotations. This is a broad-spectrum rotation that represents the residents’ first exposure to a wide variety of plastic surgical problems and their management.

Residents participate in all facets of care. They develop surgical and treatment skills appropriate for management of hand, breast, microsurgery and trauma plastic surgical cases.

The rotation provides a unique insight into practice management and patient care within the setting of a suburban comprehensive healthcare system.

Senior rotations at Lahey Hospital & Medical Center have several objectives, including:

• Broadening the residents’ aesthetic exposure
• Providing mentorship to the junior residents
• Reinforcing training in general plastic surgical problems

The chief year serves to refine and hone plastic surgery and practice management skills prior to entering practice or fellowship. In addition to the additional responsibilities above, there are increased administrative and clinical responsibilities to ensure that the service is kept running smoothly.

This year provides expanded aesthetic experience including laser and skin care management. A higher responsibility level in postoperative management is expected.

The chief resident has the additional administrative responsibilities for arranging Journal Club, morbidity and mortality and determining the case distribution for the service. This requires a higher level of communication with residents, staff and office personnel.

Many patients will rely on the chief resident as the “first call” person with aesthetic questions after surgery. The resident should be capable of selecting the best method from the multiple approaches they have been exposed to in the earlier year of training.

Each year, junior, senior and chief residents will spend two consecutive months at Beth Israel Deaconess Medical Center.

The multi-year rotations at BIDMC are designed to expose residents to a range of procedures, including:

• Breast reconstruction with DIEP flaps
• General plastic surgery
• Hand surgery
• Major reconstruction of head and neck cancer

Lahey residents are integrated directly into the BIDMC plastic surgery service and assigned to cases by the chief resident. Progressive responsibility is expected over each subsequent year. Call is shared.

Residents are required to attend the hand and plastic surgery clinics as assigned. They will work within the system to optimize patient care and medical management of critically ill patients or patients with extensive reconstructions. Complex reconstructive problems, including exposure to complicated trauma cases and head and neck cancer, will be addressed.

These rotations allow residents the opportunity to learn and practice within the framework of an urban academic center with a large referral base that has a large number of complex reconstructive problems.

Residents gain additional experience through the preoperative workup and post-operative care of these patients. They attend clinic as assigned.

Residents attend the BIDMC conferences in addition to the mandatory conferences at Lahey Hospital & Medical Center. This double exposure to teaching conferences and to cases seen within the urban university setting greatly enhance the depth and breadth of plastic surgery knowledge.

Parking is reimbursed for this rotation.

Each junior and senior resident spend two consecutive months rotating at Boston Children’s Hospital. This rotation is designed to provide broad exposure to pediatric plastic surgical problems, including cleft lip and palate, craniofacial anomalies and vascular abnormalities. Residents will have additional exposure to oral/maxillofacial surgical problems in conference and the operating room as provided by the expertise of the surgeons there.

Each year, junior, senior and chief residents will spend two consecutive months at Maine Medical Center. The rotation provides excellent clinical education in an independent practice setting at Plastic and Hand Surgical Associates, which is also affiliated with Maine Medical Center. The rotation is an intensive operative experience. It provides a unique opportunity for exposure to private practice plastic surgery in a group setting where the staff is dedicated to teaching.

Although all facets of plastic surgery are performed, the rotation is expected to provide emphasis on hand, aesthetic and reconstructive surgery with additional exposure to cleft and pediatric problems.

During this rotation, pet-friendly housing with parking is provided. Residents will continue to participate in the academic curriculum at Lahey via video conference call.

As an adjunct and enhancement to training, a Chief year elective block is built into the rotation schedule. Residents may elect to have an away rotation, rotate within the area at various cosmetic centers or choose an area of sub-specialization. The rotation should be free from call responsibilities and is designed to enhance the educational experience.

Prior elective experiences have included international rotations such as the People’s Ninth Hospital in Shanghai, China. Such experiences are designed to provide the Chief resident summative exposure major reconstructive procedures, leading-edge free tissue transfers, craniofacial techniques and cosmetic procedures.

Away rotations must be approved in advance by the program director, have direct contact between the program director and a site director, and have defined educational goals. This is also a great opportunity to schedule mission trips such as Operation Smile.