Recent events and ongoing horror-stories about the risks of plastic surgery remind us that it is important to make sure our surgeon is certified to practice by the American Board of Plastic Surgery (ABPS) of the American Society of Plastic Surgeons (ASPS). After all, any doctor is allowed by law to call him or herself a plastic surgeon, but only the ABPS is capable of certifying that a doctor is qualified as a medical specialist.
But how, exactly, does the ABPS certify its doctors? This article is a brief analysis of the standards that the ABPS uses to determine which candidates are worthy of certification.
Prerequisites
We are considering the steps for certifying a candidate that has already received a medical or osteopathic degree from an AMA-accredited institution in the United States or Canada. Remember, these people are already doctors, which means an undergraduate degree, medical school, residency, etc. For these doctors, a minimum of three years of clinical training in general surgery is required. The three years have to be conducted in the same program with an increasing degree of responsibility to show that the surgeon is gaining the trust of supervising doctors. Of these three years, at least half of the time must be devoted to rotations in the essential content areas of:
· General surgery
· Alimentary tract surgery
· Abdominal surgery
· Breast surgery
· Head and neck surgery
· Vascular surgery
· Endocrine surgery
· Surgical oncology
· Trauma
· Critical care
· Pediatric surgery
· Transplantation
And, in addition, they may have no more than one year in areas considered less critical for plastic surgery:
· Gynecology
· Neurologic surgery
· Ophthalmology
· Orthopedic surgery
· Urology
· Anesthesia
· Burns
· Surgical pathology
· Surgical dermatology
· Oral and maxillofacial surgery
· Cardiothoracic surgery
The program of surgical training must be a fully-accredited program, acknowledged by the Residency Review Committee for Surgery and accredited by the Accreditation Council fo Graduate Medical Education in the US, or by the Royal College of Physicians and Surgeons of Canada. The program must be completed before the candidate can begin training for plastic surgery.
Additional Training
A doctor who has received a degree with at least three years of progressively-increasing responsibility in surgery, now must take two years of plastic surgery training. Both years must be at the same institution to ensure adequate supervision of the candidate’s progress. During this period, the candidate will receive training in the entire spectrum of plastic surgery, including both the functional and cosmetic management of congenital and acquired defects of the head and neck, trunk, and extremities. The candidate’s training emphasizes the relationship of basic science (including anatomy, pathology, physiology, biochemistry, and microbiology) to applied surgical principles. The training also gives in-depth treatment of: the care of emergencies, shock, wound healing, blood replacement, fluid and electrolyte balance, pharmacology, anesthetics, and chemotherapy.
Application
Having completed both the general surgery residency program and the plastic surgery residency program, the doctor is now eligible for consideration for certification. The actual certification consists of an oral and written examination. In order to qualify for the exams, the candidate must hold medical staff privileges in plastic surgery in a hospital in the United States, Canada, or a foreign country through the examination process, and they must have medical licenses without restrictions or sanctions.
The written examination takes six hours and 40 minutes, and it covers:
· Gross and functional anatomy
· Basic pathology
· Surgical techniques and wound healing (incl. microsurgery and transplantation)
· Nutrition, metabolism, endocrinology, hematology, burns, sepsis, trauma, shock, and resuscitation
· Pre-and postoperative care, anesthesia, cardiorespiratory care, complications, and clinical pharmacology
· Cosmetic surgery
· Characteristics and treatment of tumors of the head and neck, skin, and breast.
· Rehabilitation of the trunk, lower extremities, and musculoskeletal system
· Rehabilitation of the hand and peripheral nerves
· Maxillofacial and craniofacial surgery and microsurgery
· Congenital anomalies, genetics, teratology, speech pathology, deformity, gynecology, and genitourinary problems
· Psychiatry and legal medicine
Prior to the oral examination, a candidate must assemble a case list of all procedures performed during a single seven-month period, including all patients hospitalized by the candidate as admitting physician, even if no operative care was performed and all emergency room patients who were treated operatively. The candidate must specify his or her diagnosis of the case, the procedure(s) performed, if any, the outcome of the operation, and the procedure’s duration. The case list also includes photographic documentation of all cases.
The board reviews the cases to determine if the candidate is even eligible to take the oral exam. Finally, during the oral exam the candidate is asked to defend his/her treatment planning, execution of the operation, and to present alternate treatment plans. A candidate will be asked to consider ethical and economic ramifications of his/her decisions. In addition to discussing the case list, the candidate will have two theory and practice sessions, leading to a total of three oral examination sessions conducted over three days.
A candidate will be certified if and only if he or she passes all phases of training and examination.
Therefore, when you choose an ABPS-certified plastic surgeon, you are choosing someone with years of surgical experience and extensive knowledge in all aspects of general and specialized surgery. The candidate’s surgical skill has been assessed and proven to be of the highest caliber. This standard of treatment ensures that an ABPS-certified surgeon will be able to give you the best results with the lowest risks of any surgical professional.
To find more resources that can help you select your ABPS-certified plastic surgeon, consult the webpage of the Virginia Center for Plastic Surgery.