Plastic Surgery

Residency Program

Overview

Dear Applicant,

We are pleased that you are interested in training in Plastic and Reconstructive Surgery at the University of Utah.

For independent resident applicants, we participate in the San Francisco Match and would request that you apply for residency training through this program at www.sfmatch.org. Late December we will select applicants for the interview on-site in Salt Lake City. Interviews are tentatively set for January and February, with the match deadline being in May, and match results published two to three weeks later.

If you are interested in the newly approved integrated 6 year residency, please apply through ERAS by visiting their website www.aamc.org/eras.  Matching will be done through NRMP. Interviews are held in December and January.

The Plastic Surgery residency at the University of Utah conforms to the guidelines set forth by the American Board of Plastic Surgery. One resident each year is accepted through the independent match and one is accepted as a PGY 1 through the combined match.

The clinical rotations of the last 3 years cover 4 hospitals.  The University of Utah Medical Center is the primary teaching institution with approximately 12 months of the 2 years being spent there.  Primary Children's Medical Center is the only comprehensive children's hospital in the Intermountain West.  This rotation occupies approximately 6 months of the total residency.  The Veterans Administration Medical Center is the regional referral center for the VA medical system and also supplies 6 months of clinical work.   Our group also covers the plastic surgery service at Shriners Hospital.

The University of Utah Medical Center and the Primary Children's Medical Center are the regional referral centers for adult and pediatric medical care respectively.  The entire range of plastic surgical procedures is provided by these institutions. In addition, the Madsen Surgical Center, on the campus of the University of Utah, provides an outpatient surgical facility very well suited to cosmetic procedures and other outpatient surgeries.  As the VA Medical Center is the regional referral center for the VA medical system, a wide spectrum of hand and reconstructive procedures are available as well as head and neck cancers.

A full microsurgery training facility exists in conjunction with the Division of Plastic Surgery.  Opportunities for plastic surgery, hand, and craniofacial research are available.

The teaching program is centered at the University of Utah and is coordinated by the full time faculty.  Clinical faculty at Primary Children's and the VA Medical Center add variety and a different perspective to the resident teaching.   Weekly conferences consist of grand rounds covering the main topics in plastic surgery, case conference discussing the upcoming weeks interesting cases, hand conference held in conjunction with the department of Orthopedics, and a general review conference oriented towards studying for the in-service test and board examinations.

In the last few years, about half of our residents have gone on to secondary fellowships, primarily Hand or Craniofacial, in order to sub-specialize.  Most have subsequently gone into private practice throughout the country.

The regional area is one of the most beautiful in the country.  Situated at 5,000 feet elevation, the Medical Center is at the base of the Wasatch Mountains.   While providing a wide variety of biking and hiking trails in the summer, the mountains provide unparalleled skiing in the winter.  While outdoor activities are very popular, a wide variety of cultural and artistic activities are also available.  Salt Lake City presents a very enjoyable living environment.

We feel that we have an excellent, dynamic training program set in one of the most beautiful and livable areas of this country.  We welcome your application to become part of our program.

Sincerely Yours,

W. Bradford Rockwell, M.D.
Professor of Surgery
Chief, Division of Plastic Surgery 
Program Director

Program Format

We match with one applicant each year in both the independent and integrated formats.

The curriculum during the final three years consists of the same clinical rotations each year. Progressive responsibility is provided to the residents as they proceed through the rotations. This increasing responsibility is reflected in the proportion of cases, as surgeon, increasing each year. It is also reflected in their increased knowledge and technical competence expectations.

The clinical rotations consist of four rotations each year for three months each. Two rotations take place at the University of Utah Medical Center while one is at the VA Medical Center and one at Primary Children's. In addition to these, a three-week rotation is completed during the first year in the Intermountain Burn Center at the University of Utah Medical Center. This rotation provides exposure to both acute and chronic reconstructive burn care. The rotations at the University of Utah and the VA Medical Center provide broad exposure to all facets of adult plastic surgery, including hand surgery, aesthetic surgery, and reconstructive surgery. They both consist of three operative days and two clinic days per week. The children's hospital rotation provides broad exposure to pediatric plastic and reconstructive surgery as well as cleft care and craniofacial surgery. This rotation has three or four operative days and one or two clinic days per week.  The University of Utah and Primary Children's Medical Center are the regional referral centers for the Intermountain West. The closest medical centers are in Denver, Colorado and Sacramento, California. The VA Medical Center is likewise the regional referral center for the Veterans' medical system. Two and one-half resident workdays per month are spent at Shriners Hospital. The majority of this clinical activity is devoted to wound coverage for the orthopedic service as well as chronic burn reconstruction.

Two residents are accepted each year, currently one position is filled through the independent match and one is filled as a PGY 1 position through the integrated format. The prerequisites for entrance into the independent program are those established by the American Board of Plastic Surgery. Independent applicants apply and match through the San Francisco Match. Integrated applicants apply through ERAS and match through NRMP.

Educational Goals

The goal of each rotation is to provide satisfactory clinical material and educational supervision to allow residents to make appropriate preoperative assessment, become proficient in intraoperative technique, and learn appropriate postoperative care in both inpatient and outpatient settings. Ethical and moral principles as well as billing procedures are discussed on all rotations.  The "Comprehensive Plastic Surgery Curriculum" produced by AACPS serves as a detailed list of objectives for the entire residency.

University of Utah Medical Center

During this rotation, the residents are exposed to a wide variety of elective and traumatic clinical cases.  They are expected to learn head and neck, trunk, and extremity anatomy with an emphasis on hand anatomy.   Clinical areas stressed on this rotation are head and neck trauma, breast reconstruction and aesthetic breast surgery, hand surgery including elective and traumatic reconstruction and post-operative therapy, pressure sore care, extremity reconstruction, cutaneous malignancies, microsurgery, and aesthetic surgery.  Residents should learn appropriate anatomy, be able to diagnose properly, become technically proficient in surgical care, know the various options for treatment, and learn appropriate post-operative care.  During the Burn Unit rotation, resuscitative and surgical burn care should be learned.

Primary Children's Medical Center

This rotation provides a complete education in congenital, craniofacial, and pediatric plastic surgery.  The objectives are diagnosis and treatment of congenital and craniofacial diseases as well as care for pediatric diseases stressing aesthetics, fracture management, and tissue coverage.  Residents should learn how to approach parents as well as the patients and include family members in the medical care.  Diagnosis and treatment of congential hand difference should be learned.

Veteran's Administration Medical Center

Head and neck anatomy and disease and treatment should be learned.  Otherwise, objectives are the same as for the University of Utah Medical Center rotation.

Shriners Hospital

The clinic cases are predominantly reconstructive ones following burn injury or orthopedic surgery.  Objectives to be learned include wound coverage, tissue mobility, aesthetics, and congenital and pediatric hand surgery principles.

Resident Responsibilities

On all plastic surgery services, residents are involved in the pre-operative, intra-operative, and post-operative care of patients. Residents are involved in clinics at all of the hospitals, thus gaining pre-operative experience.   The residents will see patients both independently and with the attending physicians in the clinics. Discussions are held when appropriate to maximize the educational experience for the resident.  Post-operative experiences likewise are gained in these clinics with the attending supervising.  Faculty attend all surgical cases.  The resident assumes a level of responsibility appropriate to his or her knowledge and capabilities.

At each institution, the residents are responsible for making daily rounds on the patients before the beginning of the clinic or operative schedule.

The resident rotations are three months in duration and each resident rotates on all services each year.  The first year is designed to allow the resident to learn the basics of the service and to operate directly under the supervision of the staff.   The second year's rotations will allow concentration on more complex and more detailed facets of surgery and more independent operating.

Two residents are assigned to University Hospital. During these rotations, each resident spends two days in the clinic and three days in the operating room.  The operating rooms used for these rotations are those at University Hospital and those at the University Madsen Clinic.

While at Primary Children's Medical Center, the residents spend one to two days a week in Dr. Morales' private office and attend the clinic for the cleft lip and palate team.  The other three to four days are operative days at the same facility with the four pediatric plastic surgeons.  Dr. Rockwell conducts a pediatric hand clinic at Primary Children's Medical Center once per month. While at the VA Medical Center, clinics are held within that facility two days a week.

Shriners Hospital also maintains its own clinic within the hospital facility.  A plastic surgery clinic is held in that facility once per month. These clinics provide the residents with broad exposure to all aspects of pre- and post-operative plastic surgical care.  The residents are supervised at all times by the attending physicians.

All significant decisions and especially those regarding operative intervention are made in conjunction with the attending staff. Surgery is performed on an outpatient basis in all of these facilities.  The University Madsen Clinic is only available for outpatient surgical care.  The remainder of the facilities are available for both inpatient and outpatient care. The clinics at University Hospital and the VA have small procedure rooms appropriate for performing procedures under strictly local anesthesia.

In their rotations at the affiliated institutions, the residents gain a broad exposure to all facets of plastic surgery and to all twelve specific clinical areas described in the plastic surgery operative log. University Hospital provides the bulk of the exposure to trauma. It is a tertiary care facility.  This includes both hand and maxillofacial trauma.   A significant amount of adult reconstruction in both breast, upper and lower extremity, and trunk are provided by this facility.

The VA Medical Center provides the residents with a good opportunity to perform some cosmetic procedures as surgeon and provides a very broad experience in facial skin cancers and their reconstruction.  Primary Children's Medical Center and Shriners Hospital focus on pediatric problems.  Shriners Hospital provides some reconstruction as well as congenital hand experience and general pediatric plastic surgery.  It does not provide craniofacial work at present although discussions are underway to establish a cleft lip and palate clinic at Shriners Hospital.  Primary Children's Medical Center provides a broad and inclusive range of plastic surgical, craniofacial, and hand pediatric patients.  Pediatric maxillofacial trauma is also provided at PCMC.

Dr. Grant Fairbanks runs a busy cosmetic private practice.  While not part of a formal resident rotation, he gladly teaches residents when their assigned service has a slow day.  The residents are responsible to Dr. Fairbanks on assigned days.