What to Expect in Residency
Congratulations on choosing and joining the plastic surgery community! Here is a general overview of what to expect in residency. Please keep in mind that there will be variability in the expectations for each year of training pending the specific program resident complement and curriculum.
Surgical Internship: For many, this is one of the most rewarding yet toughest years of residency. You spend the year learning the basics of patient clinical management and fundamental surgical techniques. You will generally spend the majority of your time in subsets of general surgery, however, you may also experience other specialties including anesthesia, orthopedic surgery, otolaryngology and emergency medicine. Despite not working directly on plastic surgery services, use this as an opportunity to network and get to know many of the providers in these different departments as you will cross paths with them many times in the future. It will help you tremendously to have established rapport with those in the ER when taking plastics calls in the future, as well as the anesthesia colleagues with your increasing involvement in operative procedures.
Junior Residency: This year is highly variable in structure and is largely institutional-dependent. In general, residency programs are requiring residents to complete less general surgery and more plastic surgery in their earlier years of training, though many programs still require 2 (or even 3) full years of general surgery training. By and large, the PGY2 job can be tough; you'll likely be seeing consults and have increasing autonomy to manage patients on the floor. You will also transition to taking on more roles in the OR and participating directly in the operations. At this level, you are generally taking plastics calls by yourself and will become quite fluent with managing simple and complex lacerations at the bedside, as well as understanding interpretation of imaging and deciding what is and is not operative.
Junior Residency: This is similar to the second year of training, but with far fewer non-plastics requirements. At this time, you may be the senior on a certain service. Expectations are higher at this level, with continued graduated autonomy both on the floor as well as in the OR. Depending on your program and resident complement, there may be many opportunities where you are taking the lead role in more complex operations.
Some programs require taking 1-2 years during residency to pursue a scholarly endeavor (research, MPH/MBA degree, etc.). However, this is not mandatory nor offered at all programs. Most likely, your program will encourage scholarly activity throughout your training, leaving your level of research investment strictly up to you. At this point, you may already have an idea of whether or not you would like to pursue a fellowship and may consider directing your research in your particular subspecialty of interest.
Senior Residency: You will be operating every day and be responsible for essentially running the service. At this point in training, expectations include taking the lead on larger cases and showing proficiency in a wide range of plastic surgery cases. You should identify areas where you feel you excel as well as those that need more focus so you can fine-tune your skillset as you prepare to exit residency and proceed either to fellowship training or directly into a practice.