ACGME | Accreditation Council for Graduate Medical Education

Residency Review Committee for Plastic Surgery
October 1, 2000

Definition of a Surgeon

Basic Principle: To be recorded as the surgeon, a resident must be present for all of the critical portions, and must perform the majority of the critical portions of the procedure. Involvement in the preoperative assessment and the postoperative management of that patient is an important element of that participation.

Clarifications:

If a plastic surgery resident completes one side of a bilateral procedure, the resident can count that as one case, surgeon. If a plastic surgery resident completes both sides of a bilateral procedure, this still counts as one case, surgeon. If two residents each do one side of a bilateral procedure, each resident can record the procedure as the surgeon, provided that each fulfills the stated criteria for performance as surgeon on one side.
In an operation which involves multiple procedures, more than one plastic surgery resident may be recorded as the surgeon, provided that the resident performs the majority of the critical portions of one or more of the procedures, e.g., tendon repair, vascular repair, nerve repair in a complex hand injury case. If there are multiples of the same procedure in one case,(i.e., tendon or nerve repair), and each resident performs to completion one or more of the repairs, each resident may claim that case as surgeon.
In the circumstances where a fellow, e.g., a hand fellow, oversees a plastic surgery resident in the performance of a procedure, both the fellow, as the teaching assistant, and the plastic surgery resident may be recorded as the surgeon.
If a senior plastic surgery resident oversees a junior plastic surgery resident on a particular case, both may be recorded as the surgeon, providing they meet the stated criteria above.

Disclaimer Statement

The stated minimum numbers of listed surgical procedures for plastic surgery residency education reflect the minimum clinical volume of these procedures which is acceptable per resident for program accreditation. A program complies with this requirement if each resident in the program achieves the minimum number of procedures for each listed procedure.

Achievement of the minimum number of listed procedures is not tantamount to achievement of competence of an individual resident in a particular listed procedure. A resident may need to perform an additional number of listed procedures before that resident can be deemed competent in each procedure by the program director. Moreover, the listed procedures represent only a fraction of the total operative experience of a resident within the designated program length. The intent is to establish a minimum number of listed procedures for accreditation purposes, without detracting from the latitude that the program director must have to blend the entire educational operative experience for each resident, taking into account each resident's particular abilities.

This requirement does not supplant the requirement that, upon the resident's completion of the program, the program director should verify that the resident has demonstrated sufficient professional ability to practice competently and independently.

original 5/10/00/revised 8/22/final 10/1/00