L’apprentissage de la chirurgie plastique : comparaison de la formation française et du programme de résidence canadien du Collège royal

[State of affairs and optimization of plastic surgery training in France]

BACKGROUND

Concerns have been growing for several years among masters, as to the quality and quantity of training in plastic surgery in France. They are mainly based on the reduction in the working time of residents, the appearance of new residents from generation Z to be trained, and finally the multidisciplinarity of plastic surgery in the current context of overspecialization of training center.

METHODS

In order to objectify these concerns, a survey was carried out among French residents and young heads of plastic surgery to assess their training in the specialty since 2019. We then looked in the law for possibilities to alleviate these concerns.

RESULTS

All the respondents think that their training in the specialty is incomplete, and few of them have been able to supplement it with rotations outside the subdivision or visits from private practitioners. However, in the law, it is possible to carry out: three residents rotations outside the subdivision, clinics rotations and international exchanges.

DISCUSSION

At the end of this analysis, we propose three solutions to optimize training in plastic surgery in France: a system of exchange of residents, the opening of residents rotations in clinics, and finally, to facilitate the realization of operating aids with private practitioners.

CONCLUSION

With these solutions, the field of training for residents could extend from one region to the whole of France. These solutions could easily be applied to other specialties, surgical and medical.

National survey of Canadian ophthalmology residency education

OBJECTIVE

To describe the current clinical, surgical, and other educational activities of Canadian ophthalmology residents.

DESIGN

Cross-sectional study.

PARTICIPANTS

Canadian ophthalmology residents postgraduate year (PGY) 2 to 5.

METHODS

An online survey was sent to residents in 2011 and 2014. The data sets were merged and analyzed using descriptive statistics.

RESULTS

The response rate was 41% with an equal distribution across sexes and PGY level. Residents from each program responded. Clinical rotations were led by emergency and comprehensive ophthalmology. The least number of days were spent in oncology, refractive, and low-vision clinics. The mean number of full cases performed by PGY5 was 324 cataracts, 9 trabeculectomies, and 48 horizontal muscles. Most PGY2 to PGY5 students performed more than 10 laser procedures of each type surveyed. Subspecialty surgical volumes varied and were lowest for scleral buckle, refractive laser, penetrating keratoplasty, and floor fracture. The majority of residents received up to 10 hours per week of teaching and 4 to 6 weeks of Royal College study time. Most respondents attended at least 1 funded conference annually and met with program directors twice a year. Research time and grand rounds presentations varied greatly. Forty-six percent of residents had fellowship plans.

CONCLUSIONS

This study describes the current clinical, surgical, and other educational activities across Canadian ophthalmology residency programs. The data allows individual programs to evaluate their training models in relation to broader national trends.