Trillium Health Partners
Reconstructive & Plastic Surgery Rotation
Educational Objectives
Medical Expert:
By the end of the rotation the resident will be able to:
Take a focused and appropriate history from a patient
Perform an appropriate physical examination
Recognize all major significant findings
Identify possible peri-operative risk factors
Develop a differential diagnosis based on the history and physical
Arrange and interpret appropriate diagnostic tests and investigations
Identify the diagnosis and recommend appropriate management of plastic
surgical problems
8. Perform techniques, including gentle tissue handling, recognition of important
skin lines and landmarks, and demonstrate an understanding of the blood
supply to the skin and other tissues
9. Select the most appropriate suture materials and utilize the most appropriate wound closure
techniques
10. Use all of the pertinent information to arrive at complete and accurate clinical decisions; order
the appropriate investigations and develop an appropriate therapeutic plan that reflects
current standards of practice for patients in the pre and post-operative settings.
11. Recognize and recommend appropriate postoperative rehabilitation
12. Recognize and manage postoperative complications
13. Recognize and manage patients appropriately with complex problems and/or multi-system
disease.
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Skin Pathology and Wound Healing:
By the end of the rotation the resident will be able to:
1. Demonstrate an in depth knowledge of the physiology, and anatomy of the skin
2. Demonstrate an understanding of the principles and pathology of wound healing
3. Demonstrate an understanding of factors affecting scar formation and
can recommend appropriate treatment for both prevention and
treatment of scars
4. Recommend the most appropriate clinical options to modify wound healing
5. Utilize the most appropriate basic techniques for wound closure
6. Demonstrate an in depth knowledge of skin lesions, both benign and malignant
7. Demonstrate an understanding of the surgical, non-surgical, and
adjuvant treatment regimes for various skin malignancies
8. Demonstrate an understanding of the theory, design, and indications for
local skin flaps and can use this knowledge to execute appropriately
chosen flaps
9. Demonstrate an understanding of the pathology of thermal injuries
10. Diagnose, classify, and appropriately manage burns and frostbite
11. Diagnose and appropriately treat injection and extravasation injuries
12. Proficiently perform the grafting of skin and other tissues
13. Demonstrate a detailed knowledge of various wound care regimens,
dressings, and topical antimicrobials
14. Demonstrate knowledge regarding cellulitis and necrotizing infections of the soft tissues
15. Diagnose, properly investigate and recommend appropriate treatment,
both surgical and non-surgical, for cellulitis and necrotizing infections of the
soft tissue
Hand:
Area of Focus:
Demonstrate an in depth knowledge of functional anatomy of the hand and upper extremity.
Interpret radiologic investigations appropriately
Execute microsurgical nerve repairs
Execute tendon repairs
Demonstrate an understanding of the pathophysiology, anatomy and treatment of Dupuytren’s
disease
6. Demonstrate an understanding of the principles of bone healing
7. Manage acute hand fractures, both closed and open reductions
8. Demonstrate the basics of extremity soft tissue injuries and soft tissue cover
9. Diagnose, classify and appropriately manage various hand infections
10. Demonstrate an understanding of the anatomy and pathogenesis of nerve
compression syndromes and be able to formulate and execute a
management plan, both surgically and non-surgically
11. Demonstrate an understanding of the anatomy, pathogenesis, non-surgical
and surgical management of tendon entrapment syndromes
12. Demonstrate knowledge of the principles of tendon transfers and tendon
transfer options and make appropriate recommendations.
13. Demonstrate knowledge of, and manage appropriately acute and chronic
fingertip injuries. Perform a fingertip revision.
14. Demonstrate an understanding of the principles of, and manage
appropriately, hand arthropathies
15. Demonstrate an understanding of the principles of, and manage
appropriately, the burned hand
16. Diagnose and recommend treatment for various hand tumours
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Aesthetic Surgery:
Area of Focus:
1. Demonstrate familiarity with the principles and ranges of aesthetic procedures
(abdominoplasty, breast augmentation, botox and filler injections)
2. Demonstrate an understanding of the concepts of appropriate patient selection
3. Take an appropriate history and carry out a proper physical examination of the aesthetic
patient
4. Recommend an appropriate approach to rejuvenation, including both surgical and nonsurgical options
5. Demonstrate an understanding of the risks, complications and principles of liposuction
6. Perform portions of various aesthetic procures under direct supervision
7. Demonstrate an understanding of various filler and their indications.
8. Demonstrates an understanding of Botox and its indications.
9. Obtain informed consent, providing sufficient information regarding risks and benefits of treatment
alternatives
10. Demonstrate a practical and logical approach to clinical problem solving
Communicator:
By the end of the rotation the resident will be able to:
1. Develop rapport, trust and ethical therapeutic relationships with patients and families.
2. Obtain and synthesize a relevant history from patients and their families
3. Communicate effectively with patients and families. Use voice, body language, translators to
good effect.
4. Demonstrate skills in working and patients to overcome communication challenges including
anger, confusion, sensory or cognitive impairment, socio-economic or ethno-cultural differences
5. Write and dictate clear and timely reports in patients charts
6. Inform patients and their families about their conditions in an empathetic and understandable
fashion
7. Obtains informed consent, providing sufficient information regarding risks and benefits of
treatment alternativesAccurately and appropriately explain surgical interventions, alternatives
and expected morbidity and prognosis
8. Demonstrate empathy and sensitivity to racial, gender and cultural issues.
9. Discuss the patient's beliefs, concerns, illness experience and specifically focuses on the
patient's expectations in terms of pain relief, improved function or appearance.
10. Develop a common understanding on issues, problems and plans with patients and familiesto
develop a shared plan of care.
Collaborator:
By the end of the rotation the resident will be able to:
1. Work effectively with ward, clinic, emergency and operating room nurses
2. Notify attending physician of consults and admissions in a timely manner
3. Recognize social, rehabilitative and potential nutritional concerns of patients
and consult colleagues appropriately
4. Assist allied health professionals through active participation in their training
and educational rounds
5. Consult and work effectively with other medical specialists
Manager/Leader:
By the end of the rotation the resident will be able to:
1. Demonstrate an understanding of the importance of, and mechanisms to,
safely utilizing resources in a cost effective manner to benefit all
2. Organize and prepare the call schedule
3. Effectively organize junior residents and medical students
4. Demonstrate an understanding of the basic organization of an office.
5. Manage practice and career effectively
6. Participate in activities that contribute to the effectiveness of their healthcare organizations and
systems.
7. Serve in administration and leadership roles, as appropriate.
Health Care Advocate:
By the end of the rotation the resident will be able to:
1. Demonstrate familiarity with the importance of various determinants of health affecting
plastic surgery patients and their clinical problem
2. Treat individuals as whole people, acknowledging possible cultural, social, economic and
personal influences
3. Demonstrate an understanding of the principles and data supporting preventative
medicine and assist in the prevention of primary and secondary illness and morbidity
4. Utilize various preventive strategies effectively and appropriately
5. Assess patients for various health risk factors
6. Demonstrate an understanding of the triage waitlist system for surgery and cancer care
7. Develop and support constructive relationships with management and administrators of
the hospital
8. Participate in systemic quality process evaluation and improvement, such as patient safety
initiatives.
Scholar:
By the end of the rotation the resident will be able to:
1. Demonstrate an understanding of the value of outcomes research for surgical procedures
2. Recognize gaps in his or her own knowledge and rectify this by self-study as well as
consulting various knowledgeable peers and attending staff
3. Utilize information technology to optimize lifelong learning
4. Demonstrate an understanding of the principles and practice of basic and applied research
5. Effectively read around clinical cases
6. Prepare and present organized rounds in a clear and concise manner
7. Actively participate in journal clubs
8. Participate effectively at teaching junior residents and medical students
Professional:
The resident will:
1. Deliver care with integrity, honesty and compassion
2. Demonstrate an understanding of the professional, ethical and legal codes by which
physicians practice
3. Exhibit appropriate personal and inter-personal professional behaviours
4. Answer pages and respond to other staff in a timely fashion
5. Arrive in a timely fashion to rounds, clinics and the operating room
6. Be sensitive to, and respond appropriately to, patients of different social status, ethnic groups,
age and gender