The Effect of a New Integrated Plastic Surgery Residency on Surgical Case Volume and Complexity.

Abstract

New integrated plastic surgery residency programs are needed to meet the ongoing demand for practicing plastic surgeons in the United States. This study assessed surgical data before and after the start of a new residency program. This should help guide expectations for plastic surgery groups interested in establishing a residency and will also provide objective data to aid conversations between the department departments and their hosting hospital administration. All surgical cases at an academic medical center from July 2014 to June 2022 were retrospectively collected. Cases were divided into preresidency and postresidency periods. All cases were assigned a case type, complexity, and free flap designation. Metrics were analyzed for each period and adjusted per surgeon full-time equivalent. Case volume peaked during the final study year (2021-2022) at 272 cases per surgeon full-time equivalent per year. Case variety increased, with notable growth in gender affirmation and adult craniofacial trauma reconstruction. Routine reconstructive breast and body contouring cases declined. There was a significant increase in cases involving multiple free flaps within the same encounter. Complexity had been declining over time prior to the start of the residency and subsequently increased steadily after the start of the residency. The start of a new integrated plastic surgery residency had a rejuvenating effect on faculty practice that had previously been trending toward routine. As the demand for plastic surgery residency positions increases, this single-program experience may help guide expectations for departments seeking to begin a new program.