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Implementation of a Competency-Based, Time-Variable Residency Education Program in Plastic Surgery
Elizabeth A. Moroni, MD MHA1; Anne E. Glenney, BA2; Joseph Mocharnuk, BA2; Francesco Egro, MD1; Jesse A. Goldstein, MD2; Joseph E. Losee, MD2; Vu Nguyen, MD1
UPMC
2023-01-31
Presenter: Elizabeth A. Moroni, MD MHA
Affidavit:
Vu Nguyen
Director Name: Vu Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction: In 2018, our institution adopted a Competency-Based, Time-Variable (CBTV) model for resident training, the first of its kind in surgical training in the U.S. This educational model emphasizes performance and skill mastery, rather than time-based benchmarks, as the measure by which residents are evaluated. We present our experience and highlight opportunities and challenges of this approach to GME.
Methods: Each integrated resident is evaluated regularly via oral board-style Milestone Modular Examinations to assess their knowledge of plastic surgery principles and patient management. Self-assessment of technical and operative competency is directly compared to faculty assessment using the Zwisch Rating Scale. Ultimately, the Clinical Competency Committee is responsible for assessing resident progression along an individualized competency pathway.
Results: Our first residents matched into the CBTV model in 2018. Two of these three residents (66%) were deemed clinically competent for graduation after five years. One defered graduation until after six years due to fellowship application timing constraints; the other dedicated a year to research but graduated after five clinical years of training. Thus, CBTV training allowed for customized experiences based on specific interests and educational needs. To accommodate the changing educational paradigm, PGY5s now act as service chiefs, while PGY6s, depending on their interests and needs, explore unique training opportunities both at our institution and around the world.
Conclusion: The CBTV approach to resident training is a viable and important step forward. By sharing our program's experience, we hope to promote the establishment of similar programs in plastic surgery around the country.
