Microsurgery Education Among United States Plastic Surgery Residency Programs.

Background: Microsurgery is a core component of United States (US) plastic surgery residency curriculum. This study compares publicly available information on microsurgery curricula and training among US plastic surgery residency programs, while evaluating the background and experience of microsurgeon faculty at these institutions.

Methods: The authors performed a cross-sectional web-search search on 103 accredited US plastic surgery residency programs in March 2023. Publicly available information evaluated for each program included non-clinical microsurgery education, clinical microsurgical exposure, and the number of microsurgeon faculty. The perceived gender and race, professorship title, previous training, academic productivity, and scope of practice were determined for each individual faculty member.

Results: While approximately one-half of programs had evidence of microsurgical skill labs with anastomosis models (n=56; 54%), fewer had a formal microsurgery curriculum (n=36; 35%) or benchmark examinations (n=25; 24%). Significantly more home institutions provided clinical exposure to breast, trauma or cancer, head and neck, and hand-related microsurgery than gender (p<0.001) and lymphedema microsurgery (p<0.001). Of the 724 faculty microsurgeons, most were male (n=543), Caucasian (n=488), and Assistant Professors (n=316). Faculty underrepresented in plastic surgery were most often Assistant Professors with significantly fewer years of experience than their male (p<0.001) and Caucasian counterparts (p<0.023).

Conclusion: Great variability exists in clinical and non-clinical microsurgery training among US plastic surgery residency programs. As the demand for microsurgery continues to rise, we can expect microsurgery education to become more uniform. Most microsurgeon faculty underrepresented in plastic surgery were earlier in their career, suggesting a potential shift in diversity as these individuals ascend the academic ladder.