Plastic Surgery Resident Training Program
General Information
General information in brief about the entire
schooling of a plastic surgeon can be found here.
Since the establishment of the Division of Plastic, Reconstructive,
Maxillofacial and Oral Surgery more than 40 years ago, its growth has
paralleled that of the Medical Center. Currently, there are six plastic
surgeons, one oral surgeon, and a physiologist on the senior staff.
The Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery
interfaces with a number of other services in the Duke University Medical
Center and provides residents with additional experiences. Residents
participate on the Craniomaxillofacial Team in the evaluation and
treatment of patients who have sustained facial trauma. Residents also
participate with members of the Orthopaedic service, providing soft
tissue management for upper and lower extremity problems that are acute
or chronic. Residents are on call for neonatal units, newborn
nursery, intensive care nursery and for emergency services including the
trauma unit. Complex soft tissue injuries are evaluated and treated.
Independent Training Program
All trainees will have completed residencies in General Surgery,
Orthopaedic Surgery, Oral Surgery or Otolaryngology before acceptance into
the program. The training program is three years. This includes a six-month
rotation in hand surgery in Louisville, Kentucky, and a one-month optional
rotation in Taiwan for additional experience in general craniofacial
abnormalities.
A vigorous microsurgery service is an integral part of the Division.
Since 1974, approximately one thousand two hundred vascularized composite
tissue transplantations have been performed with an overall success rate
of more than 97 percent. Typically, two or three major microvascular cases
are performed each week either at Duke University Medical Center or at
the adjacent Durham Veterans Administration Medical Center. An active
microsurgery laboratory is available to medical students and surgical
residents for animal training in microsurgical technique.
During the first year of the program, in order to provide an initial
general and broad base exposure to plastic surgery, incoming residents
will have a three-month rotation at our associated Veterans
Administration Medical Center and a three-month rotation at Durham County
General Hospital. The residents are assigned to senior staff, who
provide residents with increasing responsibilities during the training
period. During the second year, after some experience in plastic
surgery, residents are absent for six-month intervals to participate in
the hand surgery rotation in Louisville, Kentucky. During the final year
of the training program, resident responsibilities are increased further,
and each resident has the opportunity of becoming a Chief Resident and
Instructor in the program.
Integrated Training Program
The Division has discontinued applications to the Integrated Training
Program.
Aims of Plastic Surgery Residency Training
To have residents acquire and be proficient in the relevant plastic
surgery skills.
To give a broad base of experience by providing access to a wide
spectrum of plastic surgery patients.
To have residents demonstrate increasing responsibility, skill and
knowledge as they progress through the residency.
To have residents work well with the faculty and benefit from
interactions.
To emphasize scholarship.
To emphasize research and/or scientific interests or productions.
To maintain an appropriate balance between clinical interests and
academic pursuits.
Research Laboratory
The Plastic Surgery Research Laboratory is a significant component of
the Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery. The
newly renovated laboratory, directed by a basic scientist, is housed in a
building that is contiguous with the Vivarium, including its state of
the art surgical wing, and is readily accessible to both Duke Hospital South
and North. These facilities are available for original research by
third-year medical students, plastic surgery residents and fellows.
Close collaboration (recent co-authorship) exists between the Plastic
Surgery Research Faculty and members of the Departments of Cell Biology,
Biomedical Engineering, Pharmacology, Biochemistry, Pathology, Radiation
Oncology, Anesthesiology, and Medicine.
Current projects include:
1. Wound healing in compromised tissues; especially mechanisms of
healing and their improvement in open fractures and ischemic tissue.
2. Tissue Engineering; including endothelial cell transplant to
microvascular prostheses, adipocyte transplant via hydrogel matrices, and
transformation of adipocytes for transplant to wounded tissues.
3. Regulation of the microcirculation in health and disease.
Special Features
Treatment of acutely injured patients is provided by the Trauma Service
and is a cooperative effort by both Plastic Surgery and General
Surgery.
The Division sponsors the Facial Rehabilitation Center which evaluates
and treats patients with a variety of congenital and acquired facial
defects using a multidisciplinary team approach. Several hundred
patients with cleft lip and/or palate are followed by the team on a
routine basis. More than 300 patients are seen each year. Many members
of this cleft lip-palate team are nationally recognized for their
clinical and research efforts.
Closely associated with the Division is the Center for Speech and Hearing
Disorders: Frank DeRuter, Ph.D., Director; Bruce A. Weber, Ph.D.,
Associate Professor; Karen Harkins, M.Ed.; Lou Anne Teague, M.A.; Lynn
Fox, M.A., M.Ed.; Diane Felton, M.A. The Speech and Hearing Center is a
unit of the Department of Surgery.
The Division has a significant commitment to reconstructive breast
surgery. A large number of post-mastectomy patients have undergone
reconstruction. The approach to breast reconstruction requires
collaboration by specialists in Pathology, Medicine, General Surgery and
Plastic Surgery.
Pioneering efforts in breast reconstruction utilizing the microsurgical
method have demonstrated excellent results and progress.
The provision of quality aesthetic surgery reflects a commitment to
excellence. The brand new Center for Human Appearance will open its
doors in Fall,1997. This center will be composed of multiple specialists
each with a special interest in facial rejuvenation and reconstruction.
Plastic Surgeons, Oral Surgeons, Prosthodontist, Mohs Dermatographic
Surgeons, and physicians who specialize in the laser treatment of
vascular malformations will work together to treat these problems.
A facial prosthetic service, under the direction of a maxillofacial
prosthodontist, is available to patients requiring prosthetic
reconstruction for deformities resulting from trauma or disease. A
facial prosthetic technician, with an art background, designs aesthetic
and functional prostheses for restoration. Physicians throughout the
East Coast have referred patients for restorative assistance. Patients
range in age from 5 to 85 years.
Maxillofacial and Oral Surgeons are available to treat a large number of
patients with congenital and acquired deformities of the jaw. Clinical
research and expertise are directed at temporomandibular joint
dysfunction, utilizing a team approach. Innovations in implant
technology and prosthetic dental reconstruction are now available. The
provision of outpatient general anesthesia supervised by an
anesthesiologist ensures the safety of all major reconstructive
maxillofacial and oral procedures.
Plastic Surgery Procedures Annually
Head/Neck Congenital 318
Head/Neck Neoplasms 750
Facial Trauma 549
Cosmetic Surgery 272
Breast Surgery 938
Hand/Upper Extremity 858
Lower Extremity 262
Trunk - genitalia 349
Burns
Acute/Reconstruction 87
Benign/Malignant/Skin/Soft tissue lesions 319
TOTAL NUMBER OF PROCEDURES ANNUALLY 4,702
Facial Prosthetics Jane Bahor, B.S., Prosthetics Technician
For more information, please write to:
L. Scott Levin, M.D., Chief
Division of Plastic, Reconstructive, Maxillofacial, and Oral Surgery
Box 3945, Duke University Medical Center
Durham, NC 27710
All applications for residency must be processed through the Plastic
Surgery Central Application Service at the following address:
Ms. June Kane
Greater Arizona Central Credentialing Program
Maricopa County Medical Society
326 E. Coronado Rd.
Phoenix,AZ 85004
phone 602-251-2394