Wanzel Kyle R, Fish Joel S
Department of Surgery, University of Toronto, Ontario, Canada.
Plast Reconstr Surg. 2003 Sep;112(3):723-9; discussion 730. doi: 10.1097/01.PRS.0000069705.52702.80.
With the advent of integrative plastic surgical training programs, requirements for earlier specialization decisions, and an increasing subspecialization within the practice of plastic surgery, the educational goals of residency training may have changed. The duration and extent of training required are also currently being questioned. This study was performed to better understand the necessary roles of plastic surgery residencies and to determine how these demands might optimally be met. Of 151 practicing plastic surgeons in the Ontario, Canada, region, 81 (53.6 percent) responded to a survey. General agreement was that 2 years was an optimal length of time for core surgical training, which should then be followed by at least 3 years of plastic surgical training. Opinions on the ideal length of time training in specific medical and surgical disciplines are discussed. Overall, respondents thought that two thirds of training should occur in tertiary care centers, with the remaining time spent at smaller community centers and private clinics. Nearly half of respondents thought that research training should be a mandatory part of the residency, although the amount of protected time for this activity varied substantially. Most thought that unrestricted elective time should also be available. Academic plastic surgeons rated the importance of research training (p < 0.01), critical appraisal skills (p < 0.05), and teaching skills (p < 0.05) as significantly more important than did their nonacademic colleagues. The authors present results from the Ontario region and a template for determining optimal characteristics for training programs. Further investigation may be of timely importance during a foreseeable future transition from traditional to integrative plastic surgery residency training.
随着整形外科学综合培训项目的出现、早期专业选择要求的提高以及整形手术实践中专科化的不断增加,住院医师培训的教育目标可能已经发生了变化。目前,培训所需的时长和范围也受到了质疑。开展这项研究是为了更好地理解整形外科学住院医师培训的必要作用,并确定如何以最佳方式满足这些需求。在加拿大安大略地区的151名执业整形外科医生中,有81人(53.6%)回复了一项调查。普遍的共识是,核心外科培训的最佳时长为2年,之后应至少进行3年的整形外科培训。文中还讨论了关于特定医学和外科学科理想培训时长的观点。总体而言,受访者认为三分之二的培训应在三级医疗中心进行,其余时间在规模较小的社区中心和私人诊所度过。近一半的受访者认为研究培训应成为住院医师培训的必修部分,尽管用于此项活动的受保护时间差异很大。大多数人认为也应该有不受限制的选修时间。学术整形外科医生认为研究培训(p < 0.01)、批判性评估技能(p < 0.05)和教学技能(p < 0.05)的重要性明显高于非学术同行。作者展示了安大略地区的研究结果以及确定培训项目最佳特征的模板。在可预见的未来,从传统整形外科学住院医师培训向综合培训的转变过程中,进一步的调查可能具有及时的重要性。