Indiana University School of Medicine offers both an accredited three-year Independent residency (2 residents per year) in Plastic and Reconstructive Surgery, as well as a six year Integrated residency (2 residents per year). The Integrated residency positions are filled during the NRMP match in March, and the Independent applications go through the SF Match system.
The objective is to provide broad and deep training to enable a graduate of the IU Plastic Surgery Program to obtain certification by the American Board of Plastic Surgery and enter clinical practice (either private or academic).
Visas that permit graduate medial education training here at IU are: J-1 sponsored by ECFMG, J-2 accompanied with Employment Authorization Form I-688B.
The Plastic Surgery service is active in each of the four major hospitals in the Medical Center complex. These include IU Health University Hospital, Riley Hospital for Children at IU Health, Sidney & Lois Eskenazi Hospital and the Veterans Administration Hospital. Residents gain experience at each of the component hospitals. Additionally, rotations have been designed to incorporate rotations to three community hospitals; IU Health North, IU Health West and St. Vincent Carmel.
The Division of Plastic Surgery contributes to the training of General Surgery and Orthopedic Residents in the areas of reconstructive surgery, including skin grafts, flaps, burns, management and diagnosis of facial fractures, and evaluation and treatment of hand injuries. Residents that rotate through the service each month participate in operative procedures, participate in call coverage, and function as an integrated member of the plastic surgery team.
The daily census of the combined Plastic Surgery services is between 40 and 50 patients. There are approximately 150 elective operations performed on the combined Plastic Surgery services each month. Seventy-five percent of these operations are performed by the residents. The clinical load is varied. Children and young adolescents comprise approximately 25 percent of the patient admitted. The craniofacial cleft lip and palate clinic received 1700 patient visits in 2008. The Division of Plastic Surgery manages the Acute Burn Units at Eskenazi (Adult) and Riley (Children's) Hospitals. The full gamut of Adult Plastic and Reconstructive Surgery is managed at the three adult hospitals with special interest in head and neck cancer, melanoma, hand surgery, and aesthetic surgery.
Structure and Focus of the Residency Years
The first year consists of 6 months of general surgery including colorectal surgery, trauma, emergency general surgery, pediatric surgery, VA general surgery and general surgery night float. The plastic surgery experience consists of 3 months at the VA medical center, concentrating on fundamentals of technique in the clinic procedure room. This includes local anesthesia, nerve blocks, skin cancer excisions and simple to complex reconstruction of these defects, as well as some minor hand procedures. The year also includes affiliated rotations including emergency medicine, pediatric urology, pediatric neurosurgery, and dermatology.
The PGY2 year concentrates on intensive care unit management of patients and increased operative exposure. The resident will spend 2 months in the burn unit with Dr. Sood, Chief of the division of plastic surgery, managing patients in the burn unit as well as excision and grafting in the OR. Additionally the trainee will spend 1 month in the surgical intensive care unit. 2 months are spent at the VA on plastic surgery furthering technical skills and clinical management of patients. General surgery exposure includes vascular surgery, pediatric surgery, general surgery, emergency general surgery and night float. Affiliated rotations include one month of orthopedic surgery and one month of ENT.
In the third year, the general surgery experience includes colorectal surgery, vascular surgery, surgical intensive care unit, breast surgery, thoracic surgery, VA general surgery and night float. The resident returns to the burn unit for 1 month. Additionally the resident spends one month on anesthesia and one month on ENT.
Upon entering the PGY4 year, the Integrated residents are wholly committed to plastic surgery training. The residents entering the Independent track merge with the Integrated residents and there is no differences in training structure or responsibility in the final three years.
The residents will spend 4 months at the VA, acting as primary surgeon in hand cases, complex reconstructions and wound management. Two months will be spent in the burn unit as the senior resident, spending time focusing on complex burn reconstruction and acute burn management. A total of 4 months are spent at Riley Hospital for Children, where the resident is exposed to the full breadth of pediatric plastic surgery and craniofacial surgery. A cosmetic experience is provided for 2 months at the cosmetic practice with IU affiliated surgeons, who participate in educational conferences and other aspects of the program.
The 5th year of residency includes 3 months at Sidney & Lois Eskenazi Hospital (soon to be the new Eskenazi Health) participating in lower extreminty reconstruction, facial trauma, hand surgery and general plastic surgery. The resident spends 2 months at the Indiana Hand Center participating in all aspects of upper extremity surgery, both elective and traumatic. Three months are spent at Methodist hospital, with the experience including general plastic surgery, as well as free flap reconstructions, including DIEP flaps. The year is rounded out with 2 additional months at Riley Hospital for Children and 2 months of cosmetic surgery at two different practices.
The final year of residency the trainee serves as chief resident on all services, including 4 months at Sidney & Lois Eskenazi Hospital, 4 months of cosmetic surgery, and 4 months at University Hospital. Training focuses during this final year encompass the breadth of plastic surgery, including substantial microsurgical experience. The residents also share time to serve as administrative chief.
During the "core" final three years of plastic surgery training, promotion from the first and second to third year is dependent on demonstration by the resident of acquisition of the appropriate skills in patient evaluation and care in the various aspects of Plastic Surgery. Demonstration of mastery of or significant improvement in surgical technique is required and achievement of the goals specific for each rotation they have experienced. Consistent responsible behavior in preoperative and postoperative care combined with the ability to effectively deal with peers and ancillary health care personnel, as well as a high standard of personal honesty and integrity must be demonstrated.
Successful completion of the chief year of residency depends on continued progress in the above mentioned areas as assessed by the Plastic Surgery faculty and demonstration of the ability to manage a team of residents and educate medical students. The graduating resident will not be certified as eligible to sit for the qualifying examination of the American Board of Plastic Surgery unless he/she ranks within or above the thirtieth percentile of third year residents in Plastic Surgery taking the In-service Examination.