Commentary on: Cosmetic Surgery Training in Canadian Plastic Surgery Residencies: Are We Training Competent Surgeons?

In “Cosmetic Surgery Training in Canadian Plastic Surgery Residencies: Are We Training Competent Surgeons?” Chivers et al discuss the results from a survey of Canadian senior plastic surgery residents assessing their perceptions regarding the quality of their cosmetic surgery training. This mirrors in design our 2 recent publications regarding plastic surgery resident cosmetic training in the United States.1,2 The results and conclusions of these articles are also quite similar.As stated by the authors, major dichotomies face plastic surgery residents and educators in both Canada and the United States: (1) Major advances in plastic surgery over the past 20 years have led to greater levels of sophistication, requiring increased time and effort to gain the necessary knowledge base and technical skills. Yet recent restrictions on resident work hours have reduced training time, so, paradoxically, there are less training hours in the day. (2) Although plastic surgery residencies have increasingly been concentrated in academic centers, the focus of cosmetic surgery has mostly moved outside these centers. This makes the resident cosmetic surgery experience, at times, less than ideal.Dealing with the flight of cosmetic surgery to private outpatient facilities is not an easy task for residency program directors. How does the department match the convenience, the privacy, and the inviting atmosphere of the private surgicenter? Can the academic plastic surgeon be as clinically productive as the private practice surgeon, given his or her many nonclinical mandated responsibilities? …