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.
Keywords
microsurgery - fellowship - training
