ABOUT THE PLASTIC SURGERY RESIDENCY PROGRAM
Integrated residents will have a broad training in plastic surgery, general surgery, ENT, orthopedics, ophthalmology, dermatology, burn surgery, and others during their first three years. The curriculum during the final three years consists of rotations at the University of Utah Hospital (including the Huntsman Cancer Hospital), Primary Children’s Hospital, and The Salt Lake VA Medical Center. Progressive responsibility is provided to the residents as they proceed through the rotations. This increasing responsibility is reflected in the proportion of cases, as surgeon, increasing each year. It is also reflected in their increased knowledge and technical competence expectations.
The clinical rotations consist rotations at the University of Utah Medical Center, VA Medical Center and Primary Children's Hospital. The rotations at the University of Utah and the VA Medical Center provide broad exposure to all facets of adult plastic surgery, including hand surgery, aesthetic surgery, and reconstructive surgery. They generally consist of three operative days and two clinic days per week.
The children's hospital rotation provides broad exposure to pediatric plastic and reconstructive surgery as well as cleft care and craniofacial surgery. This rotation has three or four operative days and one or two clinic days per week. The University of Utah and Primary Children's Hospital are the regional referral centers for the Intermountain West. The closest medical centers are in Denver, Colorado, and Sacramento, California. The VA Medical Center is likewise the regional referral center for the veterans' medical system.
Currently we are matching with three residents per year in the integrated program and one in the independent program. The prerequisites for entrance into the independent program are those established by the American Board of Plastic Surgery. Independent applicants apply and match through the San Francisco Match. Integrated applicants apply through ERAS and match through NRMP.
PROGRAM INFORMATION
On all plastic surgery services, residents are involved in the pre-operative, intra-operative, and post-operative care of patients. Residents are involved in clinics at all of the hospitals, thus gaining pre- and post-operative experience. The residents will see patients both independently and with the attending physicians in the clinics. Discussions are held when appropriate to maximize the educational experience for the resident. Faculty attend all surgical cases. The resident assumes a level of responsibility appropriate to his or her knowledge and capabilities.
At each institution, the residents are responsible for making daily rounds on the patients. Morning rounds and inpatient daily notes should be completed before clinic, OR, and morning conference. Attendings should be contacted by the resident and updated on all patients after rounds. It is also required that the resident round on his or her respective service in the afternoon/evening prior to leaving the hospital and update the attending on the status of all inpatients. Therefore rounds will be conducted twice daily, once in the morning and once before going home. Discharges should be completed by 9 a.m. Weekend rounds should be completed by 10 a.m. and attendings notified soon thereafter (either by phone call or text as preferred by attending).
Call runs from 7 a.m. to 7 a.m. Hand call is split evenly with orthopedic surgery, with plastic surgery covering on Tuesday and Thursday and every other weekend. Face call is split evenly with otolaryngology, with plastic surgery covering odd days. The resident call schedule is made by the chief residents.
Moonlighting is not allowed.
Residents are required to carry a pager at all times while on duty. A resident may choose to also have the pages sent to their cell phone but can not use this as a replacement for a pager.
Senior residents also participate in their own resident cosmetic clinic where they evaluate patients for cosmetic procedures. After developing an operative plan, they present each case to a faculty member who will serve as the primary staff and advisor for the resident cosmetic case.
Residents are encouraged to be actively involved in research activities throughout their training. Each residents is required to submit at least one abstract per year during the final three years of training. Division research meetings are held three times a year. A division research grant is awarded twice a year to help fund these activities.
Performance Standards
- Residents are sent the goals and objectives for each rotation prior to the rotation starting. Those goals and objectives are reviewed with them during the rotation. Resident performance is based on whether the resident meets the criteria outlined in goals and objectives for that rotation.
Clinical Evaluation
- For each rotation, the resident has an evaluation completed by the faculty member they interact with. In addition, residents are evaluated by administrative staff and nursing staff throughout the year.
- These evaluations are completed electronically and are compiled by the Medhub system.
- The program director has access to these evaluations and any significant issues identified are addressed with the resident.
- The resident also has access to these evaluations and has the ability to question the validity if he/she disagrees with it. Significant issues that require formal intervention because of disagreement will be managed though the Program Director’s office.
- More details regarding this are in the Standards of Performance and Evaluation Policy.
Semi-Annual Evaluations
- Residents will have their performance evaluated semi-annually by the Plastic Surgery Clinical Competency Committee. The PS CCC will discuss each resident based on milestones and a report of the resident’s performance will be generated.
- These reports will be discussed with each resident.
- The program director and associate program director meet with each resident individually semi-annually to discuss all of their evaluations, other performance factors, and review the residents individual learning plan.
- More details regarding this are in the Standards of Performance and Evaluation Policy.
Addressing Performance Issues
- The Graduate Medical Education Committee has a policy section available for review. More details and the steps regarding this are in the GME Institutional policies. These steps will be followed by the program as needed.
Yearly Evaluations
- Every resident will have a yearly evaluation done prior to last day of February. This is similar to semi-annual evaluations and all of the issues addressed above can be implemented.
- Additionally, this is a retention meeting.
- More details regarding this are in the Standards of Performance and Evaluation Policy.
The University of Utah Division of Plastic Surgery holds weekly conferences that provide both didactic and interactive learning opportunities for the residents and students. The series of rounds and conferences have been developed to assure residents in the program are educated in the broad scope of plastic surgery.
Wednesday Morning Grand Rounds include didactic lectures of a wide range of topics in relevant to plastic surgery. Presentations are given by faculty, local plastic surgeons, and members of other divisions and departments. Additionally, visiting professors are invited several times per year with a dinner the evening before and a half or full day of lectures that includes a grand rounds presentation and hands on labs.
Thursday Morning Conference is two hours conference that covers the entire core curriculum in plastic surgery over an 18-month cycle. A brief didactic presentation of the topic is followed by discussion and questions and answers involving residents and faculty. This is followed by a Case Presentation Conference, which is led by a faculty member, and cases are presented and discussed in an oral boards style. This is also an opportunity for residents and attendings to present challenging upcoming cases and discuss indications and approaches. The second hour is an In-Service Review. Review of questions follows a pre-set curriculum.
Every other month we hold a Morbidity and Mortality Conference on Wednesday mornings.
Mock oral and written exams are also held multiple times per year.
Research meetings are held three times a year.
Journal Club is held every other month with a faculty member. Selected papers from the primary plastic surgery journals are reviewed and critically discussed over dinner.
These are brief summaries of the program's policies. For the full policy, please contact the program directly.
- All residents will receive $2,500 at the beginning of their residency for academic purposes. These funds will be used to help defray costs for surgical loupes, a tablet or textbook purchases during residency. These funds may be used for career building conferences or workshops. These funds can also be used to reimburse costs associated with USMLE Step 3.
- Additionally, the Division of Plastic Surgery will cover the cost of membership to the ASPS Resident Forum for all residents. This gives residents’ access to ASPS Education Network (formerly PSEN), a subscription to Plastic and Reconstructive Surgery, and subscription to Plastic Surgery News, registration for the ASPS annual meeting, as well as other benefits found on the ASPS website.
- Residents are given two coats at the beginning of residency and then are able to purchase one more per year, if needed. If residents need/want more than one additional per year, that additional one will come out of their academic fund.
- The Division of Plastic Surgery has a call room in Area E of the University of Utah Hospital, lower level, room B106. EVS will clean and change linens daily Monday-Friday. In addition to the designated call room, residents have an office space in the HELIX building, a room with a sleep chair in HELIX room 4S135 as well as an additional shared wellness room with a bed for napping and overnight purposes in HELIX room 4S117.
- Should a resident feel too fatigued to safely return home and the resident elect to go home, the Division of Plastic Surgery will reimburse the resident for the cost of the ride from the hospital to their home
- It is a valuable educational opportunity for junior residents (PGY-1 and PGY2) to evaluate and manage patients when on call. However, these patients must then be seen with the senior resident as well, as this also provides an opportunity to teach and provide feedback to the junior resident, whether it is a laceration, facial fracture evaluation, splinting of a finger, etc. The attending may then be notified by the junior resident or senior depending upon the level of acuity.
- Any calls or requests for patient care (from patients, nurses, or other providers) that are directed to the intern must be discussed with the senior resident. If the call is from a patient, the senior resident will call the patient back with directions. Once an intern has completed one rotation on the Plastic Surgery service, then he/she may manage patient calls with direct supervision available from the senior resident.
- July to September and April to June will have a resident assigned to an in house night float rotation. The schedule for the night float rotation will be Sunday to Thursday 5 p.m. to 7 a.m. No Holidays, no vacation, no personal days are allowed when on this rotation.
Expectations when on the Night Float Rotation
- There will be in person sign-out from each service
- Nightly rounds: The night float will see all patients who were operated on that day, all post operative free flaps for their entire stay, all patients admitted to the plastic surgery service, and any patient that day team/faculty would like seen overnight. A short note will be written documenting that evening's visit.
- Calls from nurses on the floor and calls from the ER are evaluated in person in a timely fashion
- Checking that patients scheduled for the OR are appropriately Pre-Op’d (consent, NPO)
- In person signout in the morning as teams arrive
- Completion of all work that came in on the night shift before leaving the hospital. The schedule is a 70 hour workweek that still leaves room to finish before reaching the 80 hours allowed.
- There will be a senior level back up for the resident on night float rotation. PGY 1 and 2 will take half night buddy call.
Night at home call will be taken by residents from October to March
- Residents are encouraged to attend a surgical mission trip during their last 3 years of plastic surgery training. Senior residents will be given priority to participate. If the senior resident is unable to go or has previously gone, then the next senior resident will be eligible. Residents may attend a trip in conjunction with a University of Utah faculty member or through a separate established program (ie. Op Smile).
- We have two established trips through the Division of Plastic Surgery. One trip to Guatemala, under the direction of the craniofacial team, is focused on pediatric disorders, primarily cleft lip and palate. The second trip to Ghana, under the direction of Dr. Brad Rockwell, is focused on hand and trauma care in an underserved region. Residents also have access to the University of Utah Center for Global Surgery who can assist in identifying trips to other regions.
- Residents will be allowed to have 7 days for travel on a surgical mission trip during their final 3 years. If a resident requires any additional time for the trip or if a resident plans to attend more than one 7 day trip, he/she will be required to use vacation time. The fees for the trip (travel, food/lodging) will come from either division funds (Ghana and Guatemala), the faculty member with whom they are traveling, the resident, or the organization they are traveling with.
- Residents are given 15 days of vacation, 5 personal business days and 5 sick days per year. These do not roll over year to year. If a resident needs to be on an extended leave they may qualify for FMLA or ELOA and need to reach out to the program to apply.
- One of the three weeks of vacation must be taken by October, another week must be taken during the months of November thru February and the last week must be taken March to June. No vacation can be taken during the last two weeks of June or the first two weeks of July. Residents in the first two years, may need to adjust this due to their rotation schedule and outside rotation vacation limitations.
- No resident is allowed to leave for vacation until operative logs are complete and up to date. The same holds true for attending meetings or other activities within the division.
- All days off will count towards vacation/personal business days. If there are no scheduled cases for you on a certain day, you should call your rotation director or chief of service.
- No vacation or personal days may be taken during the night float rotation.
- Only two residents can be on vacation at a time. Extenuating circumstances will be evaluated on an individual basis and must be approved by both the rotation faculty and the Program Director.
- The Division of Plastic Surgery performs Gender Affirming Surgery (GAS) as part of the University of Utah’s Transgender Health Program. The surgeries offered include masculinizing chest surgery, breast augmentation, vaginoplasty, metoidioplasty, phalloplasty, body contouring, and facial feminization. During a number of your rotations, specifically with Dr. Cori Agarwal, Dr. Courtney Crombie, Dr. Isak Goodwin, Dr. Dana Johns, and Dr. Erinn Kim you will be caring for these patients. If you are not planning to participate in these surgeries, please discuss this with the Program Director and they will rearrange your operative schedule accordingly. You will still be expected to care for the patients before and after surgery.
- Every resident will take the Plastic Surgery In-Service exam each spring. Residents are expected to score above the 35th percentile compared to PGY level peers in the same training track. If a resident does not meet this minimum requirement the resident informal remediation will take place. The resident will be required to meet with the program director and devise a plan for improvement. The resident will then be required to take a full make-up exam four months later to show that the plan has worked. If the following year the resident is still unable to score above the 35th percentile then formal remediation will occur. If the resident fails to meet the minimum of 35th percentile three years in a row, the resident will be put on academic probation. In addition, if the resident scores below the 35th percentile in their 4th and/or 5th year of training they will not be allowed to attend a foreign trip that following year
- In the final three years of training, for each year that a resident scores in the 80th percentile or higher, compared to PGY level peers in the same training track, the Division of Plastic Surgery will contribute 20% of the written board examination fee to the resident.
- The night before the exam, all residents will be excused from clinical duties starting at 8 p.m. The microsurgery fellow will take call the night before the in-service exam. On the day of the exam, the Division APCs will carry the residents’ pagers and manage or refer all calls appropriately.
Residents are encouraged to participate in both clinical and basic science research. Residents in the final three years of training will be given up to $2,500 per year to cover costs to attend meetings. Residents in PGY 1-3 years will be allowed to attend one conference per year and will be given up to $2,000 to cover costs to attend that meeting. If residents want to attend additional meetings, they can discuss funding options with the faculty PI of that project. The same requirements below will apply. Residents are expected to attend at least 80% of the conference programming.
Abstracts from this research that may result in travel to a meeting must go through the following process: Approval of abstract submission by research mentor and approval of meeting location by research mentor and the Division of Plastic Surgery (Form for approval is available from the Division Office).
Meeting travel will be sponsored as follows:
- Research done in Division of Plastic Surgery
- 100% of travel expenses (up to the allowable limit) is funded by the Division of Plastic Surgery
- Research done in the Department of Surgery
- 50% by the Division of Plastic Surgery (up to the allowable limit)
- 50% by the sponsoring entity
- Research done outside the Department of Surgery
- 100% covered by the sponsoring entity
The Division of Plastic Surgery will not reimburse any meeting/travel expenses for the following:
- Poster Presentation
- Case Reports
- International Travel
In addition to the optional conferences outlined above. The Division of Plastic Surgery will also support residents to attend an additional conference each year. This designated conference is by PGY level.
ROTATION INFORMATION
The goal of each rotation is to provide satisfactory clinical material and educational supervision to allow residents to make appropriate preoperative assessment, become proficient in intraoperative technique, and learn appropriate postoperative care in both inpatient and outpatient settings. Ethical and moral principles as well as billing procedures are discussed on all rotations. The specific goals for each rotation are provided and discussed with the resident at the start of each rotation. The specific goals for each rotation are provided and discussed with the resident at the start of each rotation. Below are summaries of these goals and objectives.
Year 1
- Plastic Surgery - 3 months
- Pediatric Plastic Surgery (Primary Childrens Hospital Team) - 1 month
- Pediatric Surgery (Primary Children’s Hospital)- 1 month
- Anesthesia – 1/2 month
- General Surgery/Abdominal surgery - 1 month
- Surgical Oncology – 1 month
- Vascular Surgery- 1 month
- Emergency Medicine- 1/2 month
- Burn Surgery- 1 month
- Orthopedic Trauma – 1 month
- Otolaryngology- 1 month
Year 2
- Plastic Surgery - 7 months
- Pediatric Plastic Surgery (Primary Childrens Hospital Team) - 1 months
- Orthopedic Surgery- 1 month
- Dermatology- 1 month
- Transplant Surgery- 1 month
- Surgical Intensive Care Unit- 1 month
Year 3
- Plastic Surgery - 9 months
- Oncologic Breast Surgery - 1 month
- Oculoplastic Surgery- 1 month
- Night float – 1 month
Year 4
- General Plastic Surgery (University Team)- 3 months
- Reconstruction Surgery (Huntsman Hospital Team) – 4 months
- Pediatric Plastic Surgery (Primary Childrens Hospital Team) - 2 months
- Plastic Surgery Hand Team - 1 month
- South Jordan (Ambulatory site)-1 month
- Night float- 1 month
Year 5
- General Plastic Surgery (University Team)- 2 months
- Reconstruction Surgery (Huntsman Hospital Team) – 3 months
- Pediatric Plastic Surgery (Primary Childrens Hospital Team) - 1 month
- General Plastic Surgery (Veteran’s Affair Hospital) – 2 months
- Hand Team - 2 months
- South Jordan (Ambulatory site)-1 month
- Private Practice - 1 month
Year 6
- General Plastic Surgery (University Team)- 2 months
- Reconstruction Surgery (Huntsman Hospital Team) – 2 months
- Pediatric Plastic Surgery (Primary Children’s Hospital Team) - 1 month
- General Plastic Surgery (Veteran’s Affair Hospital) – 2 months
- Hand Team - 2 months
- South Jordan (Ambulatory site)-2 month
- Private Practice - 1 month
University of Utah Hospital
- While on the University of Utah rotation, residents are required to evaluate and treat general plastic surgery problems including pressure sores, abdominal and chest wall reconstruction and wound care. Plastic surgery trauma training is also provided.
Huntsman Cancer Institute
- While on the Huntsman Team service, you will have participate in clinic and operate at Huntsman Cancer Hospital. Graduated responsibility for the management and surgical care of these patients will be provided. This will include outpatient evaluation and follow-up care, participation in microsurgical reconstruction of the breast, head and neck, trunk and extremity.
University South Jordan Ambulatory Center
- While on the South Jordan rotation, residents are exposed to an ambulatory experience. Residents receive training in all facets of plastic surgery, in particular cosmetic surgery, gender affirming surgery, and general plastic surgery procedures.
Hand Surgery
- While on the hand surgery rotation, the resident is trained in the evaluation and treatment of patients needing hand and extremity reconstruction. This service will focus on working with the hand team including hand therapists, radiology, etc. Residents are required to attend hand conference. Graduated responsibility for the management and surgical care of these patients will be provided. Hand trauma training is also provided.
Primary Children’s Hospital
- While at Primary Children's Hospital, the residents spend one to two days per week in the general plastic surgery clinic and cleft clinic. The remaining days are spent in the operating room learning a range of pediatric surgical techniques, including cleft lip/palate repair and cranial vault remodeling.
- This rotation provides a complete education in congenital, craniofacial, and pediatric plastic surgery. The objectives are diagnosis and treatment of congenital and craniofacial disorders as well as care for pediatric diseases stressing aesthetics, fracture management, and tissue coverage. Residents should learn how to communicate with both the patient and the family members. Diagnosis and treatment of congenital hand anomalies should be learned. Pediatric maxillofacial trauma is also provided at Primary Children’s
VA Salt Lake City
- While at the VA, clinics are held two days a week and the remaining days are spent in the operating room. Residents also staff a procedure clinic where they are able to gain experience in minor surgeries performed under local anesthesia. A broad spectrum of procedures and disease are encountered during this rotation. This rotation provides the residents with a very broad experience in facial skin cancers and their reconstruction, hand surgery, and head and neck cancer surgery.
PROGRAM APPLICATION
We are currently matching three integrated positions each year. Applicants apply though Central App (PSCA) and match with NRMP.
Application packets are reviewed via criteria set forth by the ACGME Program Requirements, the Resident Recruitment Committee and this institution. A designated committee member reviews applicants who meet the criteria. Based on the quality of the application packet and academic credentials, the applicant is subsequently invited, if appropriate, for an interview. On the interview day, applicants receive an informational packet and interview with members of the faculty, including Program Director, and the Division Chief, whenever possible. All applicants meet with residents. At the conclusion of the interview, the interviewers complete a standard evaluation form for each applicant they interviewed. The results are tallied and form the basis of the preliminary rank order. The Resident Recruitment Committee bases final match rank order on preliminary ranking and review. A match list is developed and submitted to the NRMP. Strict conformance with the rules of the match is maintained throughout the selection process.
CONNECT WITH US
Program Leadership
Dana Johns, MD, Program Director
Greg Hobson, DO, Assistant Program Director
Program Coordinator
Kallie Handy, C-TAGME
Email: kallie.handy@hsc.utah.edu
Phone: 801-581-8419
