Low Levels of Evidence on the Plastic Surgery In-Service Training Exam

The Most-Cited Publications in Gender-Affirming Surgery: A Cross-Sectional Bibliometric Analysis

Background: Gender-affirming surgery is becoming more common among reconstructive surgeons. Bibliometric analyses are statistical evaluations of published scientific correspondence and are a validated method of measuring influence in the scientific community. As no such bibliometric analysis has been done as of yet, the purpose of this study is to identify the characteristics of the 50 most-cited peer-reviewed articles on gender-affirming surgery. Methods: The Scopus abstract and citation database was utilized in April 2020 to search for English-language publications related to gender-affirming surgery. The 50 most-cited publications that met inclusion criteria were reviewed for various metric tabulations. Results: The 50 publications have been cited a total of 4402 times. Thirty-one (62%) were published in 2000 or later. Phalloplasty was the most discussed surgical technique, and 18 of the articles focused on female-to-male (FtM) patients. Case series (46%) and review articles (24%) were most common and there were no Level I or Level II studies. The Netherlands contributed the most, with 13 articles. Among the most frequent keywords in the 50 abstracts were "flap" and "complication". The earliest author keywords used were "transsexual" and "sex reassignment". Conclusions: The keyword usage in these abstracts over time seems to follow the trend of a more socially inclusive lexicon. A focus on studies with a higher level of evidence may optimize surgeon education and more appropriately guide clinical practice. This study reveals that the most influential and commonly referenced studies may not be sufficient to appropriately guide clinical practices.

ChatGPT Is Equivalent to First-Year Plastic Surgery Residents: Evaluation of ChatGPT on the Plastic Surgery In-Service Examination

BACKGROUND

ChatGPT is an artificial intelligence language model developed and released by OpenAI (San Francisco, CA) in late 2022.

OBJECTIVES

The aim of this study was to evaluate the performance of ChatGPT on the Plastic Surgery In-Service Examination and to compare it to residents' performance nationally.

METHODS

The Plastic Surgery In-Service Examinations from 2018 to 2022 were used as a question source. For each question, the stem and all multiple-choice options were imported into ChatGPT. The 2022 examination was used to compare the performance of ChatGPT to plastic surgery residents nationally.

RESULTS

In total, 1129 questions were included in the final analysis and ChatGPT answered 630 (55.8%) of these correctly. ChatGPT scored the highest on the 2021 exam (60.1%) and on the comprehensive section (58.7%). There were no significant differences regarding questions answered correctly among exam years or among the different exam sections. ChatGPT answered 57% of questions correctly on the 2022 exam. When compared to the performance of plastic surgery residents in 2022, ChatGPT would rank in the 49th percentile for first-year integrated plastic surgery residents, 13th percentile for second-year residents, 5th percentile for third- and fourth-year residents, and 0th percentile for fifth- and sixth-year residents.

CONCLUSIONS

ChatGPT performs at the level of a first-year resident on the Plastic Surgery In-Service Examination. However, it performed poorly when compared with residents in more advanced years of training. Although ChatGPT has many undeniable benefits and potential uses in the field of healthcare and medical education, it will require additional research to assess its efficacy.

The Plastic Surgery In-service Training Examination: An In-depth Reference Analysis

The goal of this study was to characterize the references provided as supporting evidence of the Plastic Surgery In-service Training Examination (PSITE) syllabi, including those on the novel “core surgical principles” section.

The Benefit of a Formal Plastic Surgery In-Service Conference

INTRODUCTION

Annually, residents are expected to take an in-service examination to gauge their understanding of plastic surgery knowledge and prepare them for the American Board of Plastic Surgery written examination. In addition, in-service score are now being used as an assessment tool for fellowship applicants. Because of the breadth of Plastic Surgery material, it is difficult to prepare a resident for such a comprehensive examination. At the University of Utah, a weekly conference was instituted to help prepare residents for the in-service and board examination with the goal of improving scores.

MATERIALS AND METHODS

A weekly 90min review conference was initiated at the University of Utah in an effort to improve in-service scores. Residents along with a member of the faculty reviewed old in-service examination questions and discussed the selected topics in depth. The residents' examination score averages per PGY level were compared from years before and after initiation of the conference. In addition, examination scores for each individual were compared before and after initiation of the conference. Paired t-test comparisons were performed to analyze the results.

RESULTS

Statistically significant improvement in residents examination scores averages were observed from years before and after initiation of the conference after the second year of training (42% vs 62%, p = 0.03). Furthermore, examination scores for each individual obtained the years before and the year after initiation of the conference significantly improved (31% vs 71%, p = 0.01). When comparing individuals in years prior to implementation of the conference there was no statistically significant improvement from year to year.

CONCLUSION

Implementation of a formal weekly in-service conference significantly improved performance on the in-service examination. Improvement was found when comparing between PGY training level after the second year of training and individually for residents. These results advocate for a focused educational conference for preparation for the in-service examination.