Plastic and Reconstructive Surgery: SURP-440
Instructor: Kenneth Fan, MD
Contact: Sachet Barnett
Location: MedStar Georgetown University Hospital
Duration: Four Weeks
Description: Plastic and reconstructive surgery is a diverse and unique surgical specialty. It encompasses operative techniques for the management of a plethora of disease presentations or physical deformities. Our clinical approach to preparing students in this practice involves the basic tenets of clinical practice, research, and education. Additionally, plastic surgery education requires innovation, as a field based on principles and ideas, not an organ system.
While there are many focuses in plastic surgery, our program is split into two broad categories: general plastic surgery and limb salvage. General plastic surgery procedures include breast reconstruction, defect closure with local or free flap transfer, hand surgery, lymphedema, nerve repair, pediatric and adult craniofacial surgery, and other cosmetic procedures. We offer our patients and learners cutting edge treatments for breast cancer and reconstruction through microvascular free flaps and physiologic lymphedema repair. Our treatments for nerve pain and deformity are unique and pioneered at MGUH.
These patients may present for emergent, oncologic, or elective treatment. Limb salvage involves operative intervention in limb threatening disease occurring mainly in the diabetic population, peripheral vascular disease population, and traumatic injuries. Diabetic foot wounds, ischemic disease and non-healing wounds of the lower extremity are difficult to treat due to intrinsic medical illness, compliance issues and complex psycho-social factors that center around a chronically diseased population. Our algorithmic approach to restore blood flow to the extremity, optimize nutrition, manage blood sugar, control infection, provide wound care, surgical debridement of infected tissue, and correct underlying biomechanical abnormalities is highly unique in the country. By providing an opportunity to practice care management in each of these distinct areas in the field of plastic surgery, we hope student will complete this program with an experience beyond what most programs offer nationwide and the skills necessary to excel in residency.
During the 4-week rotation, the medical student will participate in all aspects of our clinical setting which includes: inpatient consults, outpatient clinic, in and outpatient surgery and clinical procedures. Students will rotate between MGUH and MWHC. Our team’s surgical volume is around 1600 cases per year with an average inpatient census of 40-50 patients. We have over a 16-year history of offering this rotation, and it has been a pillar in our program and selection process. The robust clinical volume will provide the student with an intensive approach to wound healing, tissue transfers, breast reconstruction, and limb salvage. The inpatient floor management allows for students to participate in all aspects of patient care including wound dressing changes, flap viability monitoring, understanding medical orders, multidisciplinary work with surgical oncologists, orthopedic surgeons, infectious disease consultants and hospitalist consultants. Teaching is provided through direct patient care, bedside teaching, rounds, small-group discussions, and weekly didactic conferences. The student will participate in history, physical, admissions, surgical cases and clinic settings. As an acting intern, students will be required to help with outpatient clinic, complete overnight call and have weekend responsibilities. Assessment for this acting internship will be based on faculty observations of clinical skills (80%), and an oral presentation by the student (20%).