Importance of Facial Plastic Surgery Education in Residency: A Resident Survey

THIEME 278 Original Research Importance of Facial Plastic Surgery Education in Residency: A Resident Survey Steven A. Curti1 J. Randall Jordan1 1 Department of Otolaryngology, University of Mississippi Medical Center, Jackson, Mississippi, United States Int Arch Otorhinolaryngol 2020;24(3):278–281. Abstract Keywords ► facial plastic surgery ► residency ► survey ► education Introduction Facial plastic and reconstructive surgery (FPRS) is a key part of the curriculum for otolaryngology residents. It is important to gain an understanding of the breadth of exposure and level of competence residents feel with these concepts during their residency. Objective To determine the level of FPRS exposure and training otolaryngology residents receive during their residency. Methods A survey was emailed to all Accreditation Council for Graduate Medical Education (ACGME) accredited otolaryngology residents. The survey aimed to find the level of exposure to FPRS procedures otolaryngology residents get and how confident they feel with their training in cosmetic FPRS. Results A total of 213 residents responded to the survey for an overall response rate of 13.4%. There was an even mixture of residents from all postgraduate year (PGY) levels, with 58% of respondents being male. Almost all (98%) of the residents felt FPRS was important to otolaryngology residency training. Exposure to procedures varied with 57% performing or assisting with cosmetic minor procedures, 81% performing or assisting with cosmetic major procedures, and 93% performing or assisting with reconstructive procedures. Only 49% of residents felt their programs either very or somewhat adequately prepared them in cosmetic facial plastic surgery. Conclusion There was a wide variability in the FPRS procedure exposure. Most residents felt procedures were a vital part of otolaryngology residency training, but not all were able to participate in them. Only half of the residents felt well-prepared in cosmetic procedures. Introduction Facial plastic and reconstructive surgery (FPRS) is a broad field encompassing both aesthetic and reconstructive surgery. All aspects of FPRS are important in the training of otolaryngology residents. These authors have sensed a variation in the level of training for facial plastic and reconstructive surgery, and in particular cosmetic procedures while in residency. In 2017, there were > 17.5 million cosmetic procedures performed in the United States, a number that continues to grow. There are received April 14, 2019 accepted September 17, 2019 published online December 13, 2019 Address for correspondence Steven A. Curti, MD, Department of Otolaryngology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, United States (e-mail: ). DOI https://doi.org/ 10.1055/s-0039-1700584. ISSN 1809-9777. well-known complications to these procedures and little to no regulation of the practitioners who preform them.1 It is apparent that there is a need for well-trained practitioners in cosmetic procedures. While there is significant overlap in the cosmetic surgery world between different medical specialties, otolaryngologists make up a large portion of specialists who perform facial plastic surgery.1 Although a fellowship can improve the knowledge of facial plastic surgery with specific training, the interest in facial plastic surgery procedures continues to rise among Copyright © 2020 by Thieme Revinter Publicações Ltda, Rio de Janeiro, Brazil Facial Plastic Surgery Education in Residency practicing otolaryngologists and residents in training.2–5 Facial plastic surgery continues to be a mainstay in the core curriculum as specified by the American Board of Otolaryngology and the Accreditation Council for Graduate Medical Education (ACGME) for otolaryngology residency training programs. In the past few decades, there has been a call for an increase in the facial plastic surgery curricula.6–8 Our goal was to assess the level of training that otolaryngology residents receive in FPRS, with an emphasis on cosmetic surgery, across the United States. We used a survey, sent out to residents at otolaryngology residency-training programs, to help us assess how residents perceive their training in FPRS. Curti, Jordan Program Directors and Residency Coordinators via list serve email with the assistance of the Otolaryngology Program Directors Organization. The Program Directors and Residency Coordinators were asked to forward to all residents. Two separate reminder emails were subsequently sent out during the three-week period that the survey was open, each one week apart. The survey was open from October 8, 2018 to October 31, 2018. The study was exempted by the Institutional Review Board. The goal of the survey was to assess resident exposure to different aspects of facial plastic surgery and their comfort with minor and major facial plastic surgery procedures. Results Methods 3. Does your residency program have a facial plastic surgery fellowship? A total of 213 residents responded to the survey for a response rate of 13.38% (213/1592). The basic demographic information can be viewed in ►Table 2. Over three fourths (82%) of the residents responded that they feel cosmetic minor procedures (injections, lasers, chemical peels, etc.) are either somewhat or very important as part of otolaryngology residency training; however, 22% (47/211) of the residents have no exposure to such procedures in their training, and another 21% (45/211) only have the ability to observe these procedures. Out of the respondents that participate in minor cosmetic procedures, 29% (61/211) serve in the role of assistant surgeon, and 28% 4. How many facial plastic surgery physicians are involved with resident education at your program? Table 2 Demographics of survey participants A 15-question survey was created by the authors using Qualtrics (www.qualtrics.com). The survey can be viewed in ►Table 1. The survey was sent to all United States Otolaryngology Head and Neck surgery residency program’s Table 1 List of Survey Questions 1. Are you Male or Female? 2. What is your PGY level? 5. Do you have the opportunity to participate in cosmetic minor procedures (injections, lasers, chemical peels, etc.) during your residency training? n (%) Total responses 213 (100) 6. Which cosmetic minor procedures have you personally administered? (Select all that apply) Gender 7. Do you feel cosmetic minor procedures (injections, lasers, chemical peels, etc.) are a vital part of otolaryngology residency training? Male 124 (58.2) Female 89 (41.8) PGY level 8. Do you have the opportunity to participate in cosmetic major procedures (facelift, rhinoplasty, blepharoplasty, etc.) during your residency training? 1 40 (18.8) 2 38 (17.8) 9. Do you feel that cosmetic major procedures (facelift, rhinoplasty, blepharoplasty, etc.) are a vital part of otolaryngology residency training? 3 42 (19.7) 4 48 (22.5) 5 (...truncated)