Teaching Microsurgery in Western Academic Centers and in the Developing World

ABSTRACT

Microsurgical techniques are considered to be an important part of the armamentarium of plastic surgeons. In fact, the fields of breast reconstruction, head and neck reconstruction, and hand surgery have been greatly expanded by the widespread use of reliable, consistent, and safe microsurgical techniques. The teaching of such techniques begins during plastic surgery residencies in the United States and much of Europe, but the refinement of microsurgical skills occurs in fellowship training as well as in early plastic surgical practice. The surgical educator charged with the task of teaching microsurgery must take into account the education and experience level of the trainee; the type of setting in which this training is taking place, which affects available resources; the anticipated use of the training; and medical economic conditions. Teaching microsurgery to a trainee at the fellowship level in a tertiary care setting with abundant resources is different from teaching a general plastic surgeon in the developing world. This review elaborates the issues relating to teaching microsurgery both in the controlled, resource-rich setting of an academic medical center in the United States and in the developing world. Many concerns are similar regardless of who is taught and where the teaching occurs, but the differences in location, and previous training, and resources substantially alter the focus of surgical education in the two settings.

KEYWORDS

Microsurgery - fellowship - training - Interplast

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