Baltimore, Md. From the Curtis National Hand Center and the Resident Education Subcommittee of the American Society for Surgery of the Hand.
Plast Reconstr Surg. 2010 Jan;125(1):248-260. doi: 10.1097/PRS.0b013e3181c496a2c.
A growing trend of diminished presence of plastic surgery within the field of hand surgery has been observed in the membership of the American Society for Surgery of the Hand, applications for Certificate of Added Qualifications in Surgery of the Hand, and applications for hand surgery fellowships.
The American Society for Surgery of the Hand resident education subcommittee has investigated this trend, collecting data from the Association of American Medical Colleges, the American Board of Orthopaedic Surgery, the American Board of Plastic Surgery, the National Residency Matching Program, the Accreditation Council for Graduate Medical Education, the American Society for Surgery of the Hand, the American Association of Hand Surgery, and the Certificate of Added Qualifications in Surgery of the Hand and from an online survey of plastic surgery-trained hand surgeons in the United States.
These data indicate that the subspecialty of hand surgery enjoys growing popularity with increasing fellowship applicants annually; uses an effective, fair, and multidisciplinary match; and demonstrates continued and healthy growth in its premier academic society. Despite these positive indicators, the percentage of new plastic surgery diplomates obtaining Certificate of Added Qualifications in Surgery of the Hand has decreased from 10 percent (20 applicants per year) to 4 percent (8 applicants per year), the percentage of examinees for the Certificate of Added Qualifications in Surgery of the Hand originating from plastic surgery training backgrounds has decreased from 30 percent to 15 percent, the percentage of the overall body of actively practicing plastic surgeons in the United States that hold Certificate of Added Qualifications in Surgery of the Hand qualifications is steadily decreasing (now to 10 percent), and the plastic surgery membership in the American Society for Surgery of the Hand is demonstrating negligible growth despite the overall expansion of the American Society for Surgery of the Hand.
This report serves as a detailed and systematic account of these findings, a balanced interpretation, and a proposal of specific potential solutions. These include recommendations for changes in the structure and content of plastic surgery training programs and the National Residency Matching Program hand surgery fellowship designations.
在手外科领域，美国手外科学会的会员、手部外科附加资格证书的申请以及手部外科研究员的申请中，观察到整形外科的参与度呈下降趋势。
美国手外科学会住院医师教育小组委员会对此趋势进行了调查，从美国医学院协会、美国骨科委员会、美国整形外科学委员会、国家住院医师匹配项目、研究生医学教育认证委员会、美国手外科学会、美国手部外科学会和手部外科附加资格证书收集数据，并对美国接受过整形外科培训的手部外科医生进行了在线调查。
这些数据表明，手外科亚专业的 fellowship 申请人每年都在增加，越来越受欢迎；采用了有效的、公平的和多学科的匹配方式；并且在其主要学术协会中表现出持续和健康的增长。尽管有这些积极的指标，但获得手部外科附加资格证书的新整形外科院士的比例从 10%（每年 20 名申请者）下降到 4%（每年 8 名申请者），来自整形外科培训背景的手部外科附加资格证书考试考生比例从 30%下降到 15%，美国活跃的整形外科医生中持有手部外科附加资格证书的比例稳步下降（现在为 10%），尽管美国手外科学会的整体规模不断扩大，但该学会的整形外科会员人数增长甚微。
本报告详细系统地记录了这些发现，进行了平衡的解释，并提出了具体的潜在解决方案。这些建议包括对整形外科培训计划的结构和内容以及国家住院医师匹配项目手部外科研究员指定的更改建议。
