J Reconstr Microsurg
DOI: 10.1055/s-0040-1715879
Original Article

The Ideal Microsurgery Fellowship: A Survey of Fellows and Fellowship Directors

Meera Reghunathan
1  Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California San Diego, San Diego, California
,
Michelle Zaldana-Flynn
1  Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California San Diego, San Diego, California
,
John Rose
2  Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
,
Christopher A. Crisera
3  Division of Plastic and Reconstructive Surgery, University of California Los Angeles, Westwood, California
,
Chris M. Reid
1  Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California San Diego, San Diego, California
› Author Affiliations
Funding None.

Abstract

Background Although microsurgery fellowships have existed since the 1980s, there is no established curriculum. Microsurgery fellowships vary greatly in clinical caseload, case diversity, and training resources, and there is no consensus on the appropriate composition of a microsurgery fellowship. This study surveys fellowship directors (FD) and recent microsurgery fellows (MFs), graduates, to describe the ideal microsurgery fellowship program.

Methods A 15-item questionnaire was sent to 38 FDs and 90 recent microsurgery fellowship graduates. This questionnaire addressed program attributes, case volumes and compositions, ideal experiences, and time allocation to different fellowship experiences. Data were analyzed using descriptive statistics, t-tests, and Chi-squared tests.

Results The FD and MF surveys had a response rate of 47 and 49%, respectively. Both MF and FD agreed that exposure to microsurgical breast reconstruction is the most important characteristic of a microsurgery fellowship (p = 0.94). MF ranked replantation and supermicro/lymphatic surgery as the next most important microsurgical cases, while FD ranked the anterolateral thigh (ALT) flap and free fibula flap (p < 0.001). Both agreed that revisional surgery after microsurgical reconstruction is a very valuable fellowship experience (p = 0.679). Both agreed that 1 day of clinic a week is sufficient.

Conclusion Microsurgical training programs vary in quality and resources. The ideal microsurgery fellowship prioritized breast reconstruction, head and neck reconstruction, and lower extremity reconstruction. Although microsurgical technical expertise is important, a fellowship should also train in revisional surgeries and clinical decision making.

Note

This study was presented at the American Society of Reconstructive Microsurgery (ASRM) Annual Meeting 2020 in Fort Lauderdale, FL. It was accepted as Tier-1 Abstract for Plastic Surgery the Meeting (PSTM) 2020.


Supplementary Material



Publication History

Received: 23 April 2020

Accepted: 26 July 2020

Publication Date:
01 September 2020 (online)

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