The Hospital for Sick Children: Plastic and Reconstructive Surgery
PGY1 Resident Goals and Objectives
The Hospital for Sick Children rotations are 2 blocks (8 weeks) in duration at the level of PGY-1. The
division of plastic surgery covers the full scope of pediatric plastic and reconstructive surgery at a
tertiary and quaternary level. Due to the broad scope of practice in our Division the junior resident will
focus on more fundamental aspects of pediatric care (burns, hand trauma and congenital conditions,
pediatric skin lesions, primary cleft lip and palate care) and team collaboration /communication. There
will be opportunities to explore more complex areas of pediatric plastic surgery as a senior resident
(secondary lip and palate repair, brachial plexus, congenital hand and vascular lesions) when surgical
skills and knowledge are more developed.
Goals
This rotation emphasizes the development and evaluation of the Medical expert, Collaborator and
Professional CanMEDS roles.
The topics that the junior residents (PGY1) will focus on during this rotation include gaining familiarity in
pediatric plastic and reconstructive surgery with an emphasis on
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pediatric burn care
common pediatric skin and soft tissue pathology
basic pediatric trauma with an emphasis on the hand
introduction to cleft lip/palate
This rotation has been placed early in the training (PGY1) as many aspects of this pediatric rotation
require developing skills working with, and effectively communicating with, teams of care providers and
family members. Communication and collaboration skills are an essential part of residency training and
are applicable for the entire residency program.
These skills will be taught and evaluated primarily in the ambulatory clinics, emergency room, inpatient
services and the consult service.
Medical Expert
By the end of the rotation the junior plastic surgery resident will be able to:
1. Investigate and provide initial management for common pediatric plastic surgery problems,
including: Burns, Hand fractures, Skin and soft tissue pathology (including wound healing),
Fingertip injuries, Scars, Primary Cleft Lip and Palate
2. List and identify benign pediatric skin lesions and describe their treatment (e.g. spitz nevus,
pilomatrixoma, nevus, hemangioma, pyogenic granuloma and nevus sebaceous)
3. Classify vascular lesions and outline basic diagnostic workup
4. Diagnose and list potential treatments for hypertrophic and keloid scars
5. Diagnose and excise a dermoid cyst
6. Interpret hand x-rays (hand fractures) correctly and demonstrate competence in local
anesthesia and sedative techniques to perform closed reduction procedures
7. Perform a closed reduction of a hand fracture and manage a fingertip injury
8. Describe the anatomy of the hand relevant to pediatric traumatic injury
9. Diagnose and conduct the intraoperative planning for nevus excision and reconstruction
10. Discuss all basic aspects of pediatric burn injury, demonstrating knowledge of the principles
of pediatric burn management.
11. Classify burn injury, perform an admission with orders for pediatric burn, including pain
management and fluid resuscitation
12. Perform a burn dressing change, including making the most appropriate choice of dressing
for wound,
13. Describe the pathophysiology, embryology and anatomy of the unilateral and bilateral cleft
lip and palate
14. Diagnose and triage most pediatric hand trauma.
15. Diagnose and treat common pediatric soft tissue tumors and skin conditions
16. Demonstrate knowledge of the surgical techniques used for primary cleft lip and palate
repair.
Communicator
By the end of the rotation the junior plastic surgery resident will:
1) Exhibit effective and timely verbal and written communication skills, including: communicating
with both patients and families.
2) Establish a therapeutic relationship with patients and communicate well with the family.
3) Provide clear and thorough explanations of diagnosis, investigations and management in a
professional manner.
4) Demonstrate empathy.
5) Obtain informed consent, providing sufficient information of the risks and benefits of the
proposed procedure.
6) Write written orders, progress notes and consult notes are well organized and timely.
Collaborator
By the end of the rotation the junior plastic surgery resident will:
1) Participate effectively and appropriately in an inter-professional health care team, including
personnel on the ward, clinic, emergency and operating room environments.
2) Recognize and demonstrates the use of the team members for the care and treatment of cleft
lip and palate patients (cleft lip and palate coordinators), craniofacial (nurse coordinators) and
burn care (nurse practitioner)
3) Consult and work effectively with other medical specialists, particularly the pediatric associates
service and the emergency room physicians
4) Communicate well with the interprofessional staff that treat the children
5) Provide clear verbal presentations to health care team members (physicians, nurses, social
work, therapists, speech pathology etc.)
6) Communicate with the health care team members concerning plans of care, including inpatient
plans of care, follow up care and consultant services
Manager
By the end of the rotation the junior plastic surgery resident will:
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Effectively contribute to the health care team.
Delegate and distribute tasks fairly
Use time wisely.
Utilize information technology
Effectively organize medical students during rotation
Health Advocate
By the end of the rotation the junior plastic surgery resident will:
1) Support the health of patients/families by providing appropriate referrals, support and
information on health maintenance, as well as community/home resources.
2) Demonstrate an understanding of the use of the SCAN team as it relates to pediatric patients
3) Arrange appropriate follow up, including the use of telemedicine consultations for pediatric
patients encountered in the emergency room
Scholar
By the end of the rotation the junior plastic surgery resident will:
1) Maintain and enhance professional activities through ongoing learning.
2) Demonstrate knowledge of the content of the most recent plastic surgery seminars relevant to
the topics of burns, cleft lip and palate, embryology of the head and neck, pediatric skin lesions
Professional
The junior plastic surgery resident will:
1) Demonstrate a commitment to patients and their families, as well as to their profession and to
society, through ethical practice.
2) Maintain and complete a procedural case log that accurately reflects the resident’s surgical
experience.