Plastic surgery and the undergraduate medical school curriculum

Abstract

Context and setting It has been acknowledged that the image of plastic surgery as portrayed by the media is of concern to all plastic surgeons. Television shows such as Nip/Tuck have outraged plastic surgeons and have strengthened further the stereotype that plastic surgeons do little but perform cosmetic surgery. This stereotype is widespread among the general public. Unfortunately, medical students are also unable to understand fully the diversity of the speciality and may share similar beliefs. Why the idea was necessary The undergraduate curriculum is currently very crowded. Most undergraduate deaneries treat plastic surgery as a speciality offering either very complex reconstructive procedures or cosmetic procedures. Subsequently, plastic surgery has been excluded almost universally from the undergraduate curriculum. This loss of teaching can only exacerbate the situation and damage the credibility of the speciality. Studies have shown that medical students do not feel sufficiently prepared for clinical practice. The transition from medical student to clinician often causes problems. Most students perceive a difficulty in applying theoretical knowledge to clinical practice. We aimed to show that by conducting teaching in plastic surgery we could change student's perceptions of what the speciality entailed. By teaching them the basics we also hoped to assist them prepare for clinical practice as a doctor. What was done An extensive teaching programme in plastic surgery was designed for final-year medical students. A total of 100 students were given a questionnaire to complete prior to the teaching. Students were asked to list 5 conditions treated by plastic surgeons. We established how useful they considered plastic surgery to be as part of their training and whether they felt it would benefit them as clinicians. This was performed using a scale graded from 1 to 7. A score of 1 suggested that plastic surgery was irrelevant and would not assist them as clinicians. A score of 7 suggested that plastic surgery was relevant and would be of benefit. The scores were then calculated; the students completed the same questionnaire after the teaching programme. Evaluation of the results and impact Prior to the teaching sessions 85% of the students could not list 5 conditions treated by plastic surgeons; 93% felt that cosmetic surgery was the core component of the speciality. The speciality was felt to be irrelevant to training, which was reflected by a score of 226 of 700. On completion of the teaching 100% of the students could list 5 conditions treated by plastic surgeons; 100% realised that cosmetic surgery was a small subspeciality of plastic surgery. The speciality was felt to be very relevant to training and scored 613 of 700. Our data suggest that medical students have serious misconceptions of what the speciality offers. It is thus essential that plastic surgery maintains its links with undergraduates. It is important that students have an early working knowledge of the scope and the limitations of plastic and reconstructive surgery. This will give them a clear picture of what plastic surgery entails as well as the ability to apply this knowledge in their future practice.