Evaluation of Commitment to Equity, Diversity, and Inclusion on Canadian Plastic Surgery Residency Program Websites.

Abstract: The present study designs a new classification scheme of neighbourhood ethnic transition and uses this scheme to examine the residential patterns of visible minorities in Canada's three largest metropolitan areas. Based on 1986 and 1996 census tract profile data, this study finds that the conventional invasion-succession process of neighbourhood ethnic transition is generally not applicable to major visible minority groups in large Canadian cities. However, divergent patterns of ethnic transition have emerged among visible minority groups. Blacks tend both to live in, and move into, neighbourhoods with low socio-economic status (SES). South Asians also tend to live in neighbourhoods with low SES, but they do not become further concentrated in such neighbourhoods. In contrast, the Chinese population increases more rapidly in neighbourhoods with higher SES. Resume: La presente etude propose un nouveau plan de classification des transitions ethniques dans les quartiers, qui sert a examiner les modeles de repartition residentielle des minorites visibles dans les trois regions metropolitaines les plus importantes du Canada. A. partir des donnees des profils de secteurs de recensement pour 1986 et 1996, l'etude a pennis de determiner que le processus conventionnel d'invasion/succession pour ce qui est des transitions ethniques dans les quartiers ne s'applique generalement pas aux principaux groupes de minorities visibles clans les grandes villes canadiennes. Toutefois, des modeles divergents de transitions ethniques so sont manifestes parmi des groupes de minorities visibles. Les personnes de race noire out tendance a vivre et a after s'installer dans des quartiers ou le statut socioeconomique (SSE) est faible. Los Sud-Asiatiques oat aussi tendance a vivre dans des quartiers ou le SSE est faible, mais n'ont pas tendance a s'y concentrer davantage. Par contre, la population chinoise augmente plus rapidement dans les quartiers dont le SSE est eleve. ********** Since the 1970s, the visible minority population has bean dramatically increasing in Canada's three largest metropolitan areas that have accommodated most of Canada's new immigrants. This increase in the visible minority population through immigration is profoundly affecting the racial make-up of urban neighbourhoods. Changes in neighbourhood ethnic composition often transform the physical and social characteristics of neighbourhoods, affect the 'way of life' established by long-term residents, and frequently generate tensions within local space (Ray et al., 1997). It is therefore of important social significance to examine neighbourhood ethnic transition and its relationship with neighbourhood socio-economic status under the condition of rapid increases in visible minority populations. The present study investigates the residential patterns of visible minority populations in Canada's three largest metropolitan areas. Specifically, has the substantial increase in the visible minority population led to increased co-residence of visible and white populations within neighbourhoods or has it created more racially concentrated neighbourhoods? In addition, is transition in neighbourhood racial composition closely related to neighbourhood socioeconomic status? Ethnic Transition Among Neighbourhoods: A Literature Review Many studies on neighbourhood ethnic transition in the US have been centred on the compositional stability of racially mixed neighbourhoods. In their pioneering analysis of neighbourhood racial transition in the city of Chicago in the 1940s, Duncan and Duncan (1957) propose an invasion-succession model of neighbourhood racial transition. This model suggests an inevitability of white-to-black change in racially mixed neighbourhoods. Once blacks penetrate an area inhabited exclusively by whites, the number and proportion of blacks in the neighbourhood would continuously increase, while the white population would continuously decrease until a complete turnover of population from white to black occupancy takes place (Duncan and Duncan, 1957). …

Mission Mania

75th Anniversary: Taking CME to the Next Level of Excellence in Plastic and Reconstructive Surgery.

IntroductionThis study examines the integration of community engagement and community-engaged scholarship at all accredited US and Canadian medical schools in order to better understand and assess their current state of engagement.MethodsA 32-question data abstraction instrument measured the role of community engagement and community-engaged scholarship as represented on the Web sites of all accredited US and Canadian medical schools. The instrument targeted a medical school’s mission and vision statements, institutional structure, student and faculty awards and honors, and faculty tenure and promotion guidelines.ResultsMedical school Web sites demonstrate little evidence that schools incorporate community engagement in their mission or vision statements or their promotion and tenure guidelines. The majority of medical schools do not include community service terms and/or descriptive language in their mission statements, and only 8.5% of medical schools incorporate community service and engagement as a primary or major criterion in promotion and tenure guidelines.DiscussionThis research highlights significant gaps in the integration of community engagement or community-engaged scholarship into medical school mission and vision statements, promotion and tenure guidelines, and service administrative structures.

: Simulation tools continue to play an important part in surgical education, particularly allowing junior trainees an opportunity to familiarize themselves with various procedures that they either have not been exposed to or have not had enough repetition to feel confident enough to execute. It is particularly relevant when surgical training is interrupted due to unforeseen circumstances (i.e., coronavirus disease 2019, also called COVID-19) or to personal reasons (i.e., pregnancy, leave of absence). The ability to remotely work on technical skills has tremendous value and is certainly one of the reasons that we have continued to develop new surgical simulation tools, particularly in the field of plastic surgery. A review of the major surgical simulation and anatomy software tools available within the various subdivisions of plastic surgery such as craniofacial, microsurgery, aesthetic, hand/upper extremity and burn was performed. We also reviewed some of the simulation tools available in other surgical specialties and evaluated them for fit and utility in plastic and reconstructive surgery (PRS) surgical education. Our study shows that while various surgical simulators have been developed in PRS over the years, there remains a gap in terms of the ability for residents and trainees to acquire real-life skills remotely along with the capability to receive live feedback from faculty. This review shows that further tools need to be developed to optimize the acquisition and maintenance of surgical skills in a remote fashion. Taken together, it provides an overview of the evolution of surgical simulation education within plastic surgery.

Much of this complex history comes from Europe, with contributions and advances from dentists, otolaryngologists, and general surgeons. Prior to World War I there wasnospecificplasticsurgeryspecialty.For example, Sir Harold Gillies, an otolaryngologist, learned many dental skills and techniques from Charles Auguste Valadier, a rogue French practitioner of dentistry and maxillofacial surgery. (Valadier is said to have treated most of his patients in an automotive vehicle described as a “traveling dental parlour” around 1900.) Gillies,extraordinarilyinnovative,technically superb, and politically adept, was called by some the “father of plastic surgery,” although such a descriptor probablydoesnotpayproperhomageandcredit to his many European predecessors. Gillies drew heavily from these surgeons and teachers in Britain and continental Europe,astheythemselveshadadvancedtheir own training and expertise.

Introduction: This study investigated the visibility and accessibility of mission, vision, and values statements on websites of entry-level allied health care programs (occupational therapy, physical therapy, and speech-language pathology). The primary objective was to determine the ease of locating these statements on program websites and how their visibility varies by program characteristics. Methods: A cross-sectional analysis was conducted on 300 randomly selected accredited programs (100 per profession) across the United States. Each program’s website was evaluated to determine the visibility and accessibility of its mission, vision, and values statements, defined by their presence within two clicks of the homepage. Data were collected using a standardized form and analyzed using Fisher’s exact test and Cramer’s V to assess associations between visibility and program characteristics, including program type, institutional affiliation, region, and delivery modality. Results: Findings revealed significant variability in statement visibility. Mission statements were most frequently located, followed by vision, and then values statements. Significant differences in mission statement visibility were observed between program types and between public and private institutions. Regional differences in vision statement visibility were significant only for speech-language pathology programs. Discussion: Mission, vision, and values statements are crucial for communicating program identity and purpose to stakeholders, including prospective students, faculty, and the broader community. This study highlighted the need for improved transparency and accessibility of these core principles within allied health education. Findings may inform program website design, accreditation standards, and stakeholder engagement strategies, ultimately enhancing student experience and professional preparation in the health care workforce.

Are Teachers Born or Do They Develop over Time?

“Spotlight in Plastic Surgery” provides a quarterly overview of articles from non–plastic surgery high-impact journals and Plastic and Reconstructive Surgery Global Open. This month, we will review key articles of relevance to plastic surgeons from The Lancet, New England Journal of Medicine, Annals of Surgery, Journal of the American Medical Association, JAMA Surgery, in addition to Plastic and Reconstructive Surgery Global Open. Our goal is to enlighten Plastic and Reconstructive Surgery readers with relevant literature of our specialty that they otherwise may not read. We thank the Plastic and Reconstructive Surgery resident advisors and Plastic and Reconstructive Surgery advisory board members who volunteer to help us identify these articles and provide a brief synopsis of the articles. Should any of our readers have specific suggestions of articles to review in recent issues of high-impact journals, please contact us by means of e-mail at [email protected]. We wish to remain responsive to the needs of our readers in keeping all of us up to date as to key developments relative to plastic surgery.ARTICLES Implant Based Breast Reconstruction with Acellular Dermal Matrix: Safety Data from an Open-Label, Multicenter, Randomized, Controlled Trial in the Setting of Breast Cancer Treatment. By Lohmander F, Lagergren J, Roy PG, et al. Ann Surg. 2019;269:836–841.1 The authors present 6-month safety data from a randomized controlled trial comparing implant-based breast reconstruction with acellular dermal matrix and partial muscle coverage against implant-based breast reconstruction with complete submuscular coverage. Endpoints included unplanned reoperations, surgical complications, quality of life, aesthetics, and cost-analysis. With 6-month follow-up for all participants, the incidence of surgical complications was higher in the acellular dermal matrix group; however, the difference was not statistically significant. There was no statistical difference between the two groups regarding reconstructive failure. This is the first randomized controlled trial to prospectively assess clinical outcomes of using acellular dermal matrix in implant-based breast reconstruction and will continue to provide useful outcomes data to plastic surgeons as the study progresses. Michael V. Chiodo, M.D. New York University Langone Health New York, N.Y. Inappropriate Opioid Prescription after Surgery. By Neuman MD, Bateman BT, Wunsch H. Lancet 2019;393:1547–1557.2 In this review article, the authors discuss the current trend on opioid prescription, risk factors with prolonged opioid use, and strategies to minimize inappropriate opioid prescription after surgery. The authors state that male sex, age 50 years or older, type of surgery, early postoperative opioid use, preoperative opioid use, and high dosage of prescriptions are risk factors. They recommend preoperative patient education, using nonopioids, psychiatric support, counseling on the disposal of leftover opioids, and using procedure-specific upper limits for opioid prescription. This comprehensive review can assist plastic surgeons in appropriate opioid prescription after surgery and prevent overprescription. Min-Jeong Cho, M.D. University of Texas Southwestern Medical Center Dallas, Texas Oral versus Intravenous Antibiotics for Bone and Joint Infection. By Li HK, Rombach I, Zambellas R, et al. N Engl J Med. 2019;360:425–436.3 In this prospective, randomized, multicenter trial, the authors compared oral versus intravenous antibiotic therapy used during the first 6 weeks for bone, joint, and hardware infections. At 1 year and in 1015 patients, the authors found that oral therapy (13.2 percent failure) was not inferior to intravenous therapy (14.6 percent failure), whereas intravenous therapy had more catheter complications (9.4 percent versus 1.0 percent) and longer hospital stays. This study could encourage a paradigm shift in the treatment algorithm of plastic surgery patients with osteomyelitis and hardware infections, particularly in a safety-net hospital setting or uninsured population where resources for 6 weeks of intravenous antibiotics are limited. Austin S. Hembd, M.D. University of Texas Southwestern Medical Center Dallas, Texas Chlorhexidine versus Routine Bathing to Prevent Multidrug-Resistant Organisms and All-Cause Bloodstream Infections in General Medical and Surgical Units (ABATE Infection Trial): A Cluster-Randomised Trial. By Huang SS, Septimus E, Kleinman K, et al. Lancet 2019;393:1205–1215.4 In this large randomized controlled trial, Huang et al. examined the benefit of decolonization protocols compared to routine nursing care of 194 nonintensive care units in 53 hospital in the United States. Interestingly, decolonization with chlorhexidine and targeted mupirocin for methicillin-resistant Staphylococcus aureus carriers did not significantly reduce bloodstream-related infections. A post hoc analysis showed, however, that decolonization decreased the rate of infection with methicillin-resistant S. aureus and vancomycin-resistant Enterococcus by 32 to 37 percent in patients with medical devices. Would our plastic surgery patients with implants and other prosthetic devices benefit from such decolonization strategies? This is an intriguing question worth studying in the future. Christopher Homsy, M.D. Tulane University New Orleans, La. Adjunctive Intermittent Pneumatic Compression for Venous Thromboprophylaxis. By Arabi YM, Al-Hameed F, Burns KEA, et al. N Engl J Med. 2019;380:1305–1315.5 The purpose of this study was to evaluate whether adjunctive intermittent pneumatic compression in critically ill patients receiving pharmacologic thromboprophylaxis would result in a lower incidence of proximal lower limb deep venous thrombosis compared to pharmacologic thromboprophylaxis alone. The investigators conducted a multicenter, randomized, controlled trial and found no statistically significant difference in lower leg deep venous thrombosis in patients with both intermittent pneumatic compression devices and chemical prophylaxis (3.9 percent) compared to those with chemical prophylaxis alone (4.2 percent). These findings demonstrate that postoperative plastic surgery patients with prolonged intensive care unit stays may not require pneumatic compression devices if already receiving chemical thromboprophylaxis. Karan Mehta, M.D. Montefiore Medical Center Bronx, N.Y. Migraine Surgery: An All or Nothing Phenomenon? Prospective Evaluation of Surgical Outcomes. By Gfrerer L, Hulsen JH, McLeod MD, Wright EJ, Austen WG Jr. Ann Surg. 2019;269:994–999.6 Migraine headaches represent a heterogenous group of disorders. With peripheral nerve compression, it has not been established whether the migraine is secondary to a combination of central and peripheral pathways, or peripheral compression alone. In a single-institution, single-surgeon, prospective study of 85 patients who underwent surgery for refractory migraines, the authors found a binary response to surgery, with 69 percent (n = 57) demonstrating greater than 80 percent improvement and 14 percent (n = 12) demonstrating less than 5 percent improvement. The authors conclude that the binary response supports the peripheral compression–alone cause, suggesting that surgical release when indicated has the potential to provide substantial benefits to patients. Lily R. Mundy, M.D. Duke University Hospital Durham, N.C. Association of Overlapping Surgery with Perioperative Outcomes. By Sun E, Mello MM, Rishel CA, et al. JAMA 2019;321:762–772.7 In this retrospective cohort study, the authors examined the effect of overlapping surgery, a common occurrence at teaching hospitals, on surgical outcomes. Sixty-six thousand four hundred thirty cases were examined across 8 years from eight hospitals in the United States and The Netherlands and analyzed using multivariate linear regression analysis. Overall, overlapping surgery was not associated with increased in-hospital mortality or complication rates, but was associated with increased operative time. Subgroup analysis found that for high-risk patients, overlapping surgery was associated with increased mortality and complications. These results set up future studies to examine patient subsets for overlapping surgery to optimize both surgical education and patient outcomes. Kashyap K. Tadisina, M.D. Saint Louis University School of Medicine St. Louis, Mo. Potential Consequences of Patient Complications for Surgeon Well-Being: A Systematic Review. By Srinivasa S, Gurney J, Koea J. JAMA Surg. 2019;154:451–457.8 In this systematic review, the authors examined how patient complications affect surgeon health. Results found that, contrary to prior studies, surgeons are consistently affected emotionally after adverse outcomes. Psychological consequences can be significant and longstanding, with surgeons typically coping in isolation because of perceived downstream personal and professional consequences. This study may help bring to light this occupational hazard and current barriers to effective support, and help create paths to prevent it. This is particularly relevant to plastic surgeons, whose surgical outcomes are often a qualitative judgment. Macarena Vizcay, M.D. Hospital Nacional Prof. A. Poasadas Buenos Aires, Argentina Evaluation of Long-Term Outcomes of Facial Sensation following Cranial Vault Reconstruction for Craniosynostosis. By Dengler J, Ho ES, Klar EL, Phillips JH, Forrest CR. Plast Reconstr Surg Glob Open 2019;7:e2135.9 The authors investigate the long-term sensory outcome of cranial vault reconstruction for craniosynostosis performed in infancy. The authors recalled 28 patients, now aged 6 years and older, and compared sensory findings in the face to 16 age-matched controls. They examined the sensory distribution of the supraorbital, supratrochlear, zygomaticofacial, and zygomaticotemporal nerves, and found no difference in sensation between groups. Criticism of the study is that the authors could not identify which patients with craniosynostosis had nerve injury during surgery. However, the study does indicate that if nerve injury occurred during initial surgery, this does not result in a long-term sensory deficit. Arun K. Gosain, M.D. Lurie Children’s Hospital Chicago, Ill. Routine Laser-Assisted Indocyanine Green Angiography in Immediate Breast Reconstruction: Is It Worth the Cost? By Mirhaidari S, Azouz V, Wagner DS. Plast Reconstr Surg Glob Open 2019;7:e2235.10 This study examined the cost-effectiveness of routine indocyanine green analysis of mastectomy skin flaps after immediate breast reconstruction in 206 breasts over a 1-year period. They retrospectively reviewed prospectively gathered data and compared them to historical controls. Patients analyzed with indocyanine green had a statistically significant decreased full-thickness necrosis, implant loss, and unexpected operation. Indocyanine green analysis decreased full-thickness necrosis by 6.4 percent. If the average cost of necrosis was $15,000, the break-even point would be 248 cases with an expected 6 percent decrease in necrosis. Limitations of this study are its retrospective nature, unmatched controls, and inclusion of other surgical applications that may further reduce the break-even point. Brett T. Phillips, M.D., M.B.A. Duke University Hospital Durham, N.C. Brett T. Phillips, M.D., M.B.A.Michael V. Chiodo, M.D.Min-Jeong Cho, M.D.Austin S. Hembd, M.D.Christopher Homsy, M.D.Karan Mehta, M.D.Lily R. Mundy, M.D.Kashyap K. Tadisina, M.D.Macarena Vizcay, M.D.Arun K. Gosain, M.D.

Changes in surgical education have caused concern over residents' preparedness for independent practice. As the field of otolaryngology requires such a wide breadth of expertise, ill preparation becomes especially costly. This study explores how the presence and participation of a postgraduate year 3 (PGY3) otolaryngology resident in surgery impacts revision rates and operating time as gauges for the resident competency and indirect training costs. A retrospective chart analysis of patients who underwent cosmetic plastic surgery at sites for PGY3 otolaryngology residents' facial plastic surgery rotations was conducted. Residents performed one side of bilateral procedures (eg, blepharoplasties) and approximately 50% of midline procedures (eg, rhinoplasties). Chi-squared testing and odds/risk ratios were done to assess the effect of resident involvement on revision rates. Operating time was compared using t tests. When a resident was involved in cosmetic surgery, the revision rate was 22.2% compared with 3.6% without. The likelihood of a future revision surgery was 7.57 times higher when a resident participated in the original operation. Resident involvement was not a statistically significant predictor of exceeding the allotted operating time. The revision rate of cosmetic surgery was much higher when a resident was involved. Otolaryngology residents would benefit from increased facial plastic and reconstructive surgery training. As a response to this analytical study, this clinical rotation was moved to be offered at a later stage of postgraduate surgical training to allow residents to gain more experience and be better set up for success in the rotation.

Lack of awareness of heart disease and stroke among Chinese Canadians: Results of a pilot study of the Chinese Canadian Cardiovascular Health Project

Plastic surgery residency comprises a significant portion of early adulthood. The difficulties of residency are well documented, particularly with the impact on wellness and risk of burnout. Structured wellness programs, mentorship, social support, and autonomy can decrease residency burnout. This study looked at how plastic surgery program websites and GME websites represent wellness and support programs between both integrated and independent plastic surgery residencies. A cross-sectional analysis of US plastic surgery residency programs was performed during the month of April 2024. The authors conducted a systematic content analysis on the available websites of these residency websites, GME websites, and associated programs' Instagram and X (formally Twitter) pages. Data points included (1) mention of wellness on the program website, (2) vacation time mentioned on the website, (3) protected time available, (4) spouse support options, (5) day care options, (6) connections with mentors, (7) images of social events on the website, and (8) images of social events on Instagram. Data were compiled and analyzed in JASP (JASP Team [2024]. JASP [version 0.18.3; computer software]) as well as Microsoft Excel. Categorical variables were compared using binomial tests and chi-squared tests. Statistical significance was defined a P value less than or equal to 0.05. The majority of plastic surgery residencies did not discuss or describe their wellness programs on their official website, regardless of program size. Similar results were displayed when searching for spousal support and daycare. GME websites were more comprehensive than the program websites but still showed significant discrepancies with vacation policies and day care. Mentorship was mentioned in under half of all plastic surgery residencies. Integrated programs were more likely to display social events on Instagram when compared with independent programs. Plastic surgery residencies do not provide evidence of existing wellness programs on their program websites. Although a lack of public information on wellness programs does not mean they do not exist, this could easily be mitigated by providing more comprehensive information on both GME and program websites.

While the broad diversity of procedures is a hallmark of plastic surgery that attracts many young trainees, the extensive breadth of the specialty can lead to dramatic misunderstandings about the scope of practice of plastic surgeons by both the public and medical professionals alike.1 As the field of plastic surgery is amid a national transition toward integrated residency programs, it is important now more than ever to expose medical students to plastic surgery early in their education. Medical schools have the unique and critical task of educating future physicians on the scope of surgical subspecialties. However, plastic surgery inclusion in medical education curricula is minimal to absent at most medical schools.2,3 We therefore recruited 31 medical students to participate in a 1-hour lecture and complete prelecture and postlecture questionnaires to determine their understanding of a career in plastic surgery and plastic surgery procedures. We found that a 1-hour educational course is effective in improving medical students’ knowledge of plastic surgery procedures. Before the intervention, students associated plastic surgery most highly with cosmetic procedures and reconstructive procedures of the breast. After the intervention, there was a statistically significant increase in students correctly identifying that “bread and butter” procedures, such as free flaps, carpal tunnel releases, orbital floor fractures, and hand tendon lacerations, are frequently treated by plastic surgeons (p < 0.05) (Fig. 1). There was also a 15.2 percent increase in participants who considered plastic surgery to be a “lifesaving” field of medicine (p < 0.05). In examining perceptions of a plastic surgery career, there was a 12.1 percent increase after the lecture in choosing lifestyle as an appealing aspect of the specialty (p < 0.05), while there were no significant changes in any of the negative perceptions studied (competitiveness, lack of relatable role models, demanding training, and so on) (Fig. 2). Despite these findings, there was no associated increase in interest in pursuing plastic surgery as a career after the event.Fig. 1.: Change in correctly identifying procedures and pathologies as related to plastic surgery.Fig. 2.: Change in perceptions of plastic surgery as career.Prior studies have attempted to quantify baseline plastic surgery medical student knowledge and provide education about the specialty via emailed surveys and 1-day courses that included presentations and surgical skills practice.4,5 Some of this work, although important, took place in the United Kingdom, where medical and surgical training is structured differently than in the United States.5 This 1-day format is likely not feasible to be incorporated into the already-dense U.S. medical school curriculum. Our study demonstrates the importance of establishing surgical subspecialty education early in medical school, especially given the trend toward integrated training programs. The lecture event provided adequate education about the procedures involved in plastic surgery, which will be valuable for all future physicians with regard to making appropriate referrals and consultations. However, a 1-hour event may fall short in recruiting medical students to plastic surgery careers. In our anecdotal experience, many plastic surgery departments or divisions host little more than an annual medical student interest group lecture in an effort to attract students to our field. To achieve this goal will likely require surgical subspecialties to be more inventive and creative in how they engage students and introduce them to their fields. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article.

Despite the significant reform medical education has witnessed over the past decade,1,2 the coronavirus disease of 2019 (COVID-19) pandemic has kindled change that will persist for generations to come.3 Recommendations recently made by the Association of American Medical Colleges have advocated for the withdrawal of medical students from all clinical rotations at the height of the COVID-19 pandemic, and, more recently, for the cancellation of all in-person visiting rotations.3,4 In response, plastic surgeons have continued to innovate and address these educational challenges. The American Society of Plastic Surgeons now provides interested medical students with free access to its online Education Network, a program that offers over 90 educational modules on an array of essential plastic surgery topics.3 A recent report in the Journal describes the development of virtual plastic surgery subinternships for senior medical students unable to complete in-person rotations, with objectives that remain in line with Accreditation Council for Graduate Medical Education core competencies.4 However, and despite these notable efforts, there remains a paucity of attention targeted toward the continuity of medical education in surgical anatomy, a topic that remains particularly relevant as an essential competency for senior medical students before beginning postgraduate training in plastic surgery. To address this educational disparity, our group developed and implemented an online virtual anatomy teaching curriculum designed to help keep medical students up to date, prepared, and on-track for surgical rotations ahead. Topics covered thus far include the thorax, brachial plexus, forearm, hand, anterior abdominal wall, back, and lower extremity, with upcoming sessions scheduled for head and neck, craniofacial, intraabdominal, and pelvic anatomy. These sessions were designed not to replace core anatomy teaching, but rather to help reinforce essential concepts and discuss different surgical techniques, medical abnormalities, and clinically relevant variations, thus simulating and complementing intraoperative and clinical learning. [See Video (online), which shows a short segment from a breast anatomy lecture (image courtesy of Jad Abi-Rafeh).] Our initiative has so far amassed interest from 227 medical students; the majority of them (80 percent) are in their second and third years of medical training. Most recently, 68 percent of participants attended from our local institution, with the remainder representing local and international trainees from the United States, Canada, Mexico, Colombia, Indonesia, and The Netherlands. With the support of Plastic and Reconstructive Surgery’s social medial channels, interest from international attendees continues to grow. Through before-and-after tests administered to participants, a significant improvement in average test scores was observed following virtual learning (from 46 percent to 76 percent; p < 0.05), with retention of knowledge subsequently established at 2-week follow-up. All sessions are recorded in real time and remain available for future reference by all participants. {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video.","caption":"This video shows a short segment from a breast anatomy lecture (image courtesy of Jad Abi-Rafeh).","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_syjxjg45"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]} The role of virtual teaching resources in plastic surgery education continues to grow, with notable advantages established for both trainees and educators alike.3 Advancements in the field of simulation and virtual teaching in plastic surgery have complemented timely transitions to competency-based training curricula.5 Plastic surgeons must continue innovating and responding to evolving educational challenges to help foster excellence in our field. Thus, it is the authors’ wish that through this correspondence, the validity, efficacy, and reliability of virtual training platforms in surgical education is demonstrated, to help address evolving educational challenges and training the next generation of surgeons, during the time of the COVID-19 pandemic, and beyond. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article. No funding was received for this work. Jad Abi-Rafeh, M.Sc.Faculty of Medicine Tyler Safran, M.D.Mirko S. Gilardino, M.D., M.Sc.Division of Plastic and Reconstructive SurgeryMcGill UniversityMontreal, Quebec, Canada

There are little published data about curricula of physician assistant (PA) postprofessional doctoral programs. This study examined current mission statements and learning outcomes for common and emerging themes aligned with the PA professional competencies. This qualitative study examined postprofessional doctoral programs that matriculated PAs as of December 2023. Program web sites were analyzed for mission or purpose statements and learning outcomes. Open coding of the PA professional competencies generated a final code list. Mission and purpose statements and learning outcomes were uploaded into ATLAS.ti and compared with the code list for common and emerging themes. Investigator triangulation confirmed themes. Twenty-two programs had mission statements on their websites. The most identified competency theme was the development of leadership skills (64%). Sixteen programs had learning outcomes for 30 concentrations. The most common competency themes in the concentrations' learning outcomes included knowledge/evidence (50%), leadership (40%), and communication (37%). Emerging themes comprised engaging in scholarly activity (29%) and performing research (37%). Because leadership was the most common theme in mission or purpose statements and learning outcomes, additional leadership training appears to be an area of focus for postprofessional PA programs. Despite common themes across the programs, there appears to be diversity in the areas of content focused on meeting the program's prospective students' needs more than alignment with the competencies. Including research and scholarly activity within postprofessional doctoral programs raises the question of whether this is an emerging area of focus that should be included in the PA professional competencies.