On Monday mornings from 7:00 to 8:00 am, we have an Indications Conference to discuss the scheduled surgical cases for the following week. This provides an opportunity to fine tune the planning of the case as well as assignment of resident responsibilities. In addition it provides opportunities to review basic science aspects of our specialty.
On Friday mornings from 7:00 to 8:00 am, we hold Corequest, which is designed after the recommendations of the Association of Academic Chairmen of Plastic Surgery. We follow the structure of this program and allow each chief resident some flexibility in choosing topics. Faculty assigned to a topic prepare questions 1 week in advance. The resident then has a week to read broadly on the topic and to prepare responses to the questions. At the conference, the faculty quiz the residents on the specific questions. In this way a systematic review of basic science of our specialty is covered.
Life Long Learning Lab (Journal Club) is held on the first Friday of each month from 8:00 to 9:00 am. Each session is led by an assigned faculty or resident who selects recent journal articles or a topic of personal professional learning to discuss in some detail. Journal articles are critiqued using a “quality of evidence” and “usefulness in practice” rating scale. This provides an opportunity for each participant to showcase a recent or ongoing true life example of their own personal life-long learning.
On the second Friday of the month from 8:00 to 9:00 am, the section holds a team meeting with all medical and support staff from within the section. This meeting is chaired by the Section Chief. Improvement projects and team building are the focus of this monthly conference. The Section of Plastic Surgery is dedicated to continuously working on improving our delivery of patient health care. Each employee, faculty and resident is encouraged to define that area of practice that is most intrusive on their day-to-day activities. A team is then created to find a more efficient and or effective way to accomplish this task.
The 3rd Friday of each month is Practice-Based Learning and Improvement. The topics are variable and include topics such as morbidity rounds, sentinel events, clinical research, and long-term follow-up of the year’s cases. For example, we reviewed our body contouring cases utilizing before and after photographs and operative details to brainstorm “best practices” for our department. We have also used this conference to brainstorm “system” improvement opportunities for achieving a high compliance rate with recommended perioperative antibiotic use, correct site surgery and appropriate DVT prophylaxis. In addition, we have reviewed evidence regarding impact of smoking status and BMI on surgical outcomes in order to develop internal guidelines. This conference presents an opportunity to reflect on actual clinical practice through single case reports or systematic review of a case series.
On a tri-annual basis, our section is invited to present interesting cases at the clinical conference of the Department of Surgery. The chief resident is frequently called on to prepare and present at this conference. The content of this regularly scheduled conference for all surgical subspecialties is monitored so that as topics of interest to our section arise, our residents are aware and can attend.
On an annual basis, we invite 1 or more Visiting Professors to our institution to spend a day with our residents to discuss patient management issues and general philosophy towards the practice of our specialty. In addition, the Visiting Professor gives 1 or 2 lectures to the Department of Surgery and the Section of Plastic Surgery. Residents are released from clinical duties during visiting professorships.
The American Society of Plastic Surgeons (ASPS) In-training examination is administered annually.
Residents are expected to assume teaching responsibilities for junior residents assigned to the service. All surgical residents have a major responsibility to teach the Geisel School of Medicine at Dartmouth students, who are periodically assigned to the plastic surgery service during the academic year.
All faculty perform formal semi-annual evaluations of the residents using E*Value, an electronic evaluation system used at Dartmouth Hitchcock Medical Center. The program director then reviews these evaluations with the resident. The program director also monitors input from the paramedical personnel (nurses, therapists, secretaries, etc.) and patients on the residents' communication skills, and incorporates it into the formal evaluation session.
First-year independent residents are sent to a week-long microsurgery course at The University of Louisville for acquiring basic technical skills under the microscope. This is an exceptional week-long course dedicated to the development of microsurgical skills in an animal model.