Our independent program is a three-year training program with time spent at Lahey Hospital & Medical Center, Maine Medical Center, Beth Israel Deaconess Medical Center, Boston Medical Center, and Boston Children’s Hospital. Rotations are divided into two-month blocks. For Junior, Senior, and Chief years, three blocks will be spent annually at Lahey Clinic, one block annually at Beth Israel Deaconess Medical Center, and one block annually at Maine Medical Center. In addition, residents will spend one block at Boston Children’s Hospital during their Junior year, one block at Boston Medical Center during their Senior year, and have one elective block during their Chief year.
Each year, Junior, Senior, and Chief residents will spend a total of 6 months at Lahey Hospital, broken up into three 2 month rotations. This is a broad-spectrum rotation, which represents the first exposure to a wide variety of plastic surgical problems, with specific attention focused on assessment and management. Residents will participate in all facets of care and will develop surgical and treatment skills appropriate for management of hand, breast, microsurgery and trauma plastic surgical cases. The rotation provides a unique insight into practice management and patient care within the setting of a suburban comprehensive healthcare system.
The senior rotations at Lahey Hospital & Medical Center are designed to reinforce training in general plastic surgical problems, serve as a mentor to the junior resident and to begin to broaden the aesthetic exposure.
The chief year serves to refine and hone plastic surgical and practice management skills prior to entering practice or fellowship. In addition to the additional responsibilities above, there are increased administrative and clinical responsibilities as chief resident to ensure that the service is kept running smoothly. There is also an expanded aesthetic experience including laser and skin care management. A higher responsibility level with regards to postoperative management will be expected, and the chief resident will have the additional administrative responsibilities for arranging Journal Club, M&M and determining the case distribution for the service. This requires a higher level of communication with residents, staff and office personnel. Many patients will rely on the chief resident as the “first call” person with aesthetic questions after surgery, in consultation with the staff attending. The foundations for critical review of practice methods should be in place, and the resident should be capable of selecting a “best method” from the multiple approaches they have been exposed to in the earlier year of training.
Each year Junior, Senior, and Chief residents will spend two consecutive months at Beth Israel Deaconess Medical Center. Integrated residents will also spend one rotation each year from PGYs 1-3 at BIDMC.
The multi-year rotations at BIDMC are designed to expose residents to hand surgery, general Plastic Surgery and major reconstruction, including reconstruction of head and neck cancers as well as breast reconstruction with DIEP flaps. The Lahey Resident is integrated directly into the BIDMC Plastic Surgery Service and is assigned to cases by the Chief Resident and progressive responsibility is expected over each subsequent year. Call will be shared. Residents are required to attend the Hand and Plastic Surgery clinics as assigned. They will work within the system to optimize patient care and medical management of critically ill patients or patients having undergone extensive reconstructions. Complex reconstructive problems, including exposure to complicated trauma cases and head and neck cancer will be addressed.
These rotations allow the opportunity to learn and practice within the framework of an urban Academic Center with a large referral base with a focus on complex reconstructive problems. Residents will gain additional experience through the preoperative workup and postoperative care of these patients, and will attend clinic as assigned. An Academic Center provides an excellent opportunity for systems-based practice. The patients may be critically ill and require a level of subspecialty care that is only offered by this Center. The challenge for the resident is to manage complex reconstructive patients, as there is no ability to refer beyond the tertiary care and ultra-subspecialized level.
The resident will attend the BIDMC conferences in addition to the mandatory conferences at Lahey Clinic. This double exposure to teaching conferences and to cases seen within the urban University setting will greatly enhance the depth and breadth of Plastic Surgical knowledge. Parking will be reimbursed for this rotation.
Each year Junior, Senior, and Chief residents will spend two consecutive months at Maine Medical Center. The rotation provides excellent clinical education in an independent practice setting at Plastic and Hand Surgical Associates which is also affiliated with Maine Medical Center, a 650 bed level 1 trauma center. It is an intensive operative experience designed to provide a unique opportunity to be exposed to private practice plastic surgery in a group setting where the staff is dedicated to teaching. Although all facets of plastic surgery are performed, the rotation is expected to provide emphasis on hand, aesthetic and reconstructive surgery, with additional exposure to cleft and pediatric problems. During this rotation, pet-friendly apartment housing with parking is provided at Back Bay Tower. Residents will continue to participate in the academic curriculum at Lahey via video conference call.
The first year rotation at Children’s Hospital is designed to provide broad exposure to pediatric plastic surgical problems, including cleft lip and palate, craniofacial anomalies and vascular abnormalities. Residents will have additional exposure to oral/maxillofacial surgical problems in conference and the OR as provided by the expertise of the surgeons there. Initial evaluation, operative and long term craniofacial and pediatric management, and assessment of complex reconstructive problems are the focus of this rotation, where the Lahey Hospital & Medical Center resident integrates with the Harvard Plastic Surgery Service.
Boston Medical Center is a unique educational opportunity that focuses on trauma reconstruction in an underserved urban/ inner city environment. BMC is the receiving hospital for the underserved population in Boston and has an abundance of complex and diverse patient population. The rotation will also expose residents to gender affirming surgery for both breast cases and urogenital reconstruction. The three full time staff that are present will focus their attention on the single resident rotator and the 4 physician extenders will ensure that the focus is on education and not service. The inner city rotation will enhance the suburban experience at Lahey Hospital & Medical Center. As there is only one resident for three attendings, education will be the definitive focus and operative experience will be broad and plentiful.
As an adjunct and enhancement to your training, a third year elective block has been added to the rotation schedule. Residents may elect to have an away rotation, rotate within the area at various cosmetic centers or choose an area of sub-specialization. The rotation should be free from call responsibilities and is designed to enhance the educational experience. Away rotations must be approved in advance by the Program Director, have direct contact between the PD and a site director and have defined educational goals. This is also a great opportunity to schedule mission trips such as Operation Smile. It is NOT to be used as an interview or ‘audition’ for prospective employment opportunities.
Our integrated program is a six-year training program with time spent at Lahey Hospital & Medical Center, Maine Medical Center, Beth Israel Deaconess Medical Center, Boston Medical Center, and Boston Children’s Hospital. The first three years are spent primarily at LHMC, with the exception of Plastic Surgery rotations at Beth Israel. PGYs 4-6 will be entirely plastic surgery focused rotations, with the rotation schedule mirroring the Junior, Senior, and Chief years of our Independent program. For PGYs 1-6, educational time is protected and residents will attend our weekly Wednesday morning didactics.
PGYs 1-3 will be spent primarily at Lahey Hospital & Medical Center, and will also include Plastic Surgery rotations at Beth Israel Deaconess. Rotations in these years will be divided into 1 month blocks.
PGY1 rotations include Plastic Surgery at LHMC, Plastic Surgery at Beth Israel, General Surgery, Transplant Surgery, Vascular Surgery, Colon and Rectal Surgery, Anesthesia, Emergency Medicine, and Neurosurgery.
PGY2 rotations include Plastic Surgery at Lahey Hospital & Medical Center, Plastic Surgery at Beth Israel, Breast Surgery, Otolaryngology, General Surgery, Orthopedic Surgery, SICU, and Vascular Surgery.
PGY3 rotations include Plastic Surgery at Lahey Hospital & Medical Center, Plastic Surgery at Beth Israel, Breast Surgery, Colon and Rectal Surgery, Dermatologic Surgery, General Surgery, Hand Surgery, and Vascular Surgery.
During PGYs 1-3, Integrated residents will have the opportunity to take primary plastic surgery call under the supervision of a Chief Resident while on plastic surgery and non-general surgery off-service rotations. During these calls, the resident will critically evaluate plastic surgery consults and have the opportunity to perform bedside and ER procedures independently.
PGYs 4-6 of our Integrated program will mirror the Junior, Senior, and Chief years of our Independent program. Rotations during PGYs 4-6 are divided into two-month blocks. For PGYs 4-6, three blocks will be spent annually at Lahey, one block annually at Beth Israel Deaconess Medical Center, and one block annually at Maine Medical Center. In addition, residents will spend one block at Boston Children’s Hospital during their Junior year/PGY4, one block at Boston Medical Center during their Senior year/PGY5, and have one cosmetic or elective block during their Chief year/PGY6.