Introduction

The Plastic Surgery Discipline-Based Pathway will provide a basic experience in Plastic Surgery with additional areas of emphasis in fields related to Plastic Surgery. Required courses will include the Internal Medicine and Neurology courses which are required for graduation. A Plastic Surgery course based at home will be required as well. General Surgery subinternship and a choice of several electives will be offered.

Sites and Personnel

Pathway Director and Site Coordinator:
Amir Behnam, M.D.
amir.behnam@towerhealth.org


Drexel Administrative Support for Plastic Surgery Pathway:
Linda Greco
215-991-5820
lag64@drexel.edu
Queen Lane, Room C9G

Teaching Sites

The Plastic Surgery Course in the Discipline-Based Pathway will be available for one student per month and will take place at several campuses. The course will be coordinated through the course director. The site for clinical participation is/are the following:

• Reading Hospital

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The primary goal of the Division of Plastic Surgery's Senior Year Discipline-based Pathway is to provide a framework for students to structure their senior year in preparation for a planned residency in Plastic Surgery. Traditionally, Plastic Surgery has been a surgical specialty that is entered after completing training in General Surgery or a Surgical sub-specialty. The current trend is to accept students into a 6 or 7 year direct training program at the end of medical school. The Pathway includes a required course in Plastic Surgery as well as the required courses for graduation at DUCOM. The elective courses are chosen to highlight areas of clinical importance to plastic surgery. Additional elective time can be utilized to obtain training in other fields of medicine. Three electives are similarly available to participate in research or advanced studies.

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Required Courses

Emergency Medicine Subinternship
Emergency Medicine Subinternship is required by the University as a senior year course. During this course we would expect that the student will learn the principles of rapid assessment and stabilization of critically ill and injured patients; learn the initial evaluation and management of the wide range of undifferentiated patient complaints in the Emergency Department; gain skills, specialized examination technique and real-time interpretation of diagnostic studies; participate in common and more advanced procedures.

Required Subinternship Objectives: Plastic Surgery Pathway students are required to complete a Surgery Subinternship
By the end of the rotation learners will be able to:

1. Take ownership of their patients and be the primary point person regarding their care.
2. Demonstrate the ability to care for patients with increasing independence while seeking help when appropriate
3. Handle the daily tasks of an intern including preparing for rounds, presenting on rounds, interprofessional knowledge and communication skills, and patient interactions, histories and physicals, note writing of all varieties, and sign-out in a proficient and efficient manner.
4. Apply their knowledge towards diagnosis and management of common acute complaints and chronic conditions, creating care plans and communicating with consultants as necessary.
5. Perform general procedures through demonstration of the necessary preparation and key issues required for the performance of procedures, including understanding patient-specific factors, indications, contraindications, risks, benefits, and alternatives. 
6. Demonstrate reliable mechanical skills in performing procedures in most situations and knows when to seek help for procedures or situations beyond the learner’s abilities.
7. Perform safe transitions of care, coordination of care, and discharge planning.

Required Plastic Surgery Course

This course is a one month course designed to provide an overview of Plastic Surgery for the students. The course should be taken during one of the first 6 rotation periods. The course will be a well supervised educational experience designed to build upon already acquired cognitive and technical skills. Through the course, a student will be given an appropriate environment for learning technical skills, clinical skills in patient evaluation, the intellectual skills of surgical decision making, and social skills in terms of dealing with patients, family, and staff.

The optional elective menu consists of several course options, of which the student must select two.

Anesthesia is a discipline which is closely allied to Plastic Surgery. The student must be exposed to intravenous sedation, regional anesthesia, and general anesthesia. The rotation will provide the student extensive exposure to airway management, complex metabolic issues, and clinical pharmacology.

Dermatology is critical for plastic surgical training. Plastic surgeons treat multiple skin problems including wounds, skin tumors, and skin resurfacing. The student should have exposure to the clinical evaluation of skin lesions, laser treatments, dermatographic surgery and dermatopathology.

Infectious diseases is a medical subspecialty which works closely with Plastic Surgery in treating many complex infections. The student should learn how to evaluate and treat sepsis, acute and chronic infections and understand the medical treatment of serious surgical infection such as fasciitis, mediastinitis, osteomyelitis, visceral abscesses, etc. The student must learn the appropriate use of antibiotics.

Ophthalmology is an elective in which the student should learn how to properly examine the eye and recognize orbital disorders. An understanding of eye anatomy and function as well as the relationship of the orbit to the periorbital tissues is required.

Oral surgery will provide the student with an opportunity to understand occlusal pathology, maxillofacial anatomy, and transoral approaches to the facial skeleton.

Orthopaedics will provide a framework for understanding skeletal and muscular anatomy and function. The student requires exposure to the clinical evaluation and operative treatment of orthopedic trauma, congenital deformities, osteomyelitis, and hand disorders.

Otolaryngology is an important rotation during which the student should learn to do a proper head and neck examination. Head and neck anatomy, congenital deformities of the face and neck and benign and malignant masses of the head and neck are topics which will be thoroughly covered during this rotation.

Surgical Pathology is critical for the development of sound surgical decision making. The student must recognize that pathology is the foundation of many plastic surgical procedures, particularly oncologic and reconstructive surgeries. The student will be exposed to the diverse range of normal and abnormal tissue types on frozen and permanent analysis. The student should learn how to orient a surgical specimen and perform a gross examination. The student will be schooled in the diagnosis of common surgical diseases.

The student will be given 3 free elective rotations. A maximum of 3 elective courses may be chosen from the surgical disciplines. If the student elects to perform a research elective, a 3 month continuous block is required. All research electives must be pre-planned and approved by the Pathway Director.

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Grabb & Smith's Essentials of Plastic Surgery and Cohen's Mastery of Plastic Surgery are recommended for the Plastic Surgery rotations, and are available at the Libraries for reference.

The standard textbooks of Medicine are recommended as references including Harrison's, Cecil, Stein, etc. The Washington Manual is recommended as a quick reference while working on clinical wards. The standard textbooks of Surgery are also recommended as references including Greenfield, Schwartz, and Sabiston. The standard textbooks of Plastic Surgery including Grabb & Smith's, Essentials of Plastic Surgery, and Mastery of Plastic Surgery will be available at the Libraries for reference during the Plastic Surgery Rotations.

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Evaluation of the Student
The student's performance in each rotation will be evaluated by supervising physicians, and residents when appropriate, using the standard Drexel University College of Medicine clinical evaluation form. Students not receiving a grade of satisfactory or higher will be counseled and provided with remediation.

Evaluation of 4th year Courses
Upon completion of each rotation, students are encouraged to complete the end-of-rotation evaluation form in DOCSS. Students have the opportunity to provide feedback on the rotation as well as on specific faculty (and residents) with whom they worked in DOCSS. All feedback is de-identified.

Evaluation of the Pathway
Students are encouraged to complete an end-of-year Pathway evaluation for the Pathway. The feedback from this evaluation will help in advising future students more effectively.

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