J. Silvestre1, B. Chang1, J. M. Serletti1 1Perelman School Of Medicine,Division Of Plastic Surgery,Philadelphia, PA, USA
Introduction: The Accreditation Council for Graduate Medical Education defines medical knowledge as one of six clinical care domains in which residents should receive instruction and display competency. The Plastic Surgery In-Service Training Exam (PSITE) is a commonly used tool to assess this domain during plastic surgery residency. The purpose of this study was to analyze the breast curriculum of the PSITE for content and referenced material.
Methods: Digital syllabi of six consecutive PSITEs (2008 – 2013) were reviewed for breast content. Questions were characterized and breast topics were summarized via overlap with the content outline for the American Board of Plastic Surgeons written board exam. Answer references were categorized by source and relative year of publication.
Results: 136 breast questions were analyzed (136/1174, 12%). Questions tended to appear in the Breast and Cosmetic (75%) section over the Comprehensive (25%) section (p < 0.001). Vignettes were most often clinic-focused (64%) over the operating room (19%, p < 0.001). Question taxonomy was evenly distributed between recall (34%), interpretation (28%), and decision-making (37%, p > 0.05). Only 6% of questions required photographic evaluation. Breast topics focused on aesthetic problems (35%), traumatic deformities (22%), and tumors (21%). Answer references comprised 293 citations to 63 unique journals published a median of 6 years prior to PSITE administration. Plastic and Reconstructive Surgery (57%) was the most cited journal (p < 0.001).
Conclusions: The PSITE affords a breast curriculum that may inform health providers and the general public regarding plastic surgery training in cosmetic and reconstructive breast surgery. Additionally, these data may help establish a benchmark for improving didactic, clinical, and operative experiences during plastic surgery residency training.