Rotation Educational Objectives
St. Michael’s Hospital – Senior Resident
(Reviewed May1, 2015)
St. Michael’s Hospital Plastic Surgery
CanMeds Goals and Objectives – Senior Residents
Medical Expert
By the end of the rotation the resident will be able to
General Plastic Surgery
1. Take a relevant, appropriately detailed history from a patient,
2. Perform a detailed and thorough physical examination
3. Identify possible preoperative and postoperative risk factors
4. Use all of the pertinent information to arrive at complete and accurate clinical decisions;
orders appropriate investigations and develops a therapeutic plan that reflects current
standards of practice
5. Obtain informed consent, providing sufficient information of the risks and benefits of the
proposed procedure
6. Select the most appropriate suture materials and demonstrates expertise in wound closure
7. Recognize and manage both common and less common postoperative complications
8. Recognize and appropriately manage patients with plastic surgical problems and multisystem disease
9. Recognize and manage emergency conditions resulting in prompt an appropriate
treatment
10. Demonstrate proficiency in pre-operative and post-operative patient management.
11. Generally recognize and manage post-op complications
12. Demonstrate proficiency in technical and procedural skills. Handles instruments and
tissues carefully.
13. Perform techniques including gentle tissue handling, recognition of important skin lines
and landmarks, and understands the blood supply to the skin and other tissues
14. Demonstrate an understanding of the concept, the goals and the approach to the operation
as well as the potential complications and performs the operation proficiently with
supervision
Area of Focus – Wound
Discuss general wound reconstruction – Wound Assessment and Treatment Options
Demonstrate an approach to the surgical management of acute and chronic wounds
Demonstrate expertise in surgical debridement
Demonstrate expert knowledge in the principles of flaps – anatomy, physiology, surgical
application and techniques; can apply this knowledge to different anatomical areas
5. Discuss and order the most appropriate adjuvant treatment which can assist in wound
healing – i.e. tissue expansion
6. Carry out specific surgical procedures for the management of complex wounds.
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Areas of Focus - Hand
1. Demonstrate an expert knowledge base in all aspects of tendon injury, nerve injury,
fractures, vascular injuries and nerve compression syndromes.
2. Demonstrate knowledge of, and can perform under supervision, tendon transfers
3. Manage acute and chronic fingertip injuries
4. Manage hand tendonopathy and arthropathies
5. Diagnose, investigate, and treat various hand tumours
6. Demonstrate expertise in Specific Procedures
o Closed reduction of fractures and dislocations
o Open reduction of fractures and dislocations
o Carpal tunnel release
o Peripheral Nerve repair
o Finger amputation
7. Order appropriate physiotherapy for the following conditions:
o Tendon repair
o Nerve injury
o Hand fractures
Areas of Focus - Diagnosis and Treatment of Facial Fractures
1. Apply facial anatomy and correctly classify facial fractures
2. Interpret radiologic investigations appropriately
3. Perform rigid fixation of facial fractures
4. Restore facial aesthetics and dental occlusion
5. Apply the detailed examination and investigation of a patient with a craniomaxillofacial
injury acutely and perform the required surgical treatment under supervision
Areas of Focus - Breast Surgery
1. Classify both congenital and acquired defects of the breast
2. Perform an appropriate examination of the breast
3. Appropriately investigate and recommend management options for the various plastic
surgical conditions of the breast
4. Demonstrate a detailed knowledge of various breast and nipple-areolar reconstructive
techniques, including both alloplastic and autogenous options
5. Demonstrate an understanding of the blood supply to the breast and nipple-areolar
complex and is able to perform various techniques for breast reduction
6. Diagnose, work up and manage gynecomastia appropriately
7. Diagnose and recommend treatment options for various defects of the breast, including
congenital and post-surgical defects
8. Perform specific procedures
o Breast reduction
o Breast augmentation
o Breast reconstruction
o Tissue expansion
o Pedicled flap reconstruction
o Free flap reconstruction
o Nipple reconstruction
COMMUNICATOR
By the end of the rotation the resident will be able to
1. Develop rapport, trust and ethical relationships with patients and families.
2. Accurately elicit and synthesize relevant information and perspectives of patients
families, colleagues and other professionals
3. Accurately convey relevant information and explanations to patients and family,
colleagues and other professionals, obtain informed consent (providing sufficient
information of the risks and benefits of the proposed procedure)
4. Dictate concise and clear description of operation
5. Write clear and consultation notes and discharge summaries and clinic notes
6. Prepare and present rounds in an organized manner
7. Participate actively in scheduled rounds
8. Explain surgical interventions, options and expected morbidity and prognosis to patients
and families
COLLABORATOR
By the end of the rotation the resident will be able to
1. Participate effectively and appropriately in an interprofessional health care team
2. Effectively work with other health professionals to prevent, negotiate and resolve
interpersonal conflict
3. Work with ambulatory, inpatient and operating room nurses to manage patients
appropriately
4. Identify social, rehabilitative, dietetic concerns with patients and consults appropriate to
allied health professionals
5. Consult and work with medical specialists appropriately
6. Assist allied health professionals through active participation in their training and
educational rounds
MANAGER
By the end of the rotation the resident will be able to
1. Participate in activities that contribute to the effectiveness of healthcare organizations and
systems
2. Manage the plastic surgical service and delegate tasks appropriately
HEALTH CARE ADVOCATE
By the end of the rotation the resident will be able to
1. Demonstrate an understanding of the data supporting prevention of primary and
secondary illness and morbidity in plastic surgery patients and upgrading.
2. Support the health of patients/families by providing appropriate referrals, support and
information on prevention, as well as appropriate community/home resources.
3. Book patients appropriately on the urgent waiting list, demonstrating an understanding of
the rationale and how patients are upgraded
4. Treat the individual as a whole person, acknowledging cultural, social, economic, family
and personal influences on their psychosocial make-up and on their health and illness
5. Assesse all patients for risk factors for a variety of plastic surgical conditions and advise
appropriate interventions
6. Utilize preventative measures correctly
7. Develop and support constructive relationships with hospital administrators, regional,
provincial and federal government agencies and representatives
8. Support activity of local and national organizations promoting health advocacy
SCHOLAR
By the end of the rotation the resident will be able to
1. Maintain and enhance professional activities through ongoing learning
2. Teach fellow professionals, including junior house staff, effectively.
PROFESSIONAL
During the rotation the resident will
1. Demonstrate a commitment to their patients, profession and society through ethical
practice
2. Deliver care with integrity honesty and compassion
3. Exhibit appropriate personal and inter-personal professional behaviors
4. At all times function professionally
5. Be sensitive to, and respond appropriately to, different patients of different social status,
ethnic groups, age and gender