A survey of microsurgery training among UK plastic surgery and maxillofacial surgery trainees

Microsurgery continues to be a fundamental technique in many surgical subspecialties. It is an integral part of several specialty programs, such as plastic surgery, vascular surgery, maxillofacial, and ENT surgery. The ultimate goal of every surgical training program is to produce competent professionals capable of meeting the healthcare needs of society. Our aim in this survey was to compare microsurgical experience among the two surgical subspecialty programs deemed to have the highest microvascular workloads; plastic and maxillofacial surgery. An online survey was developed, compromising 13 questions on microsurgery training, experience, and satisfaction. The survey was disseminated online through national trainee organizations and at trainee days. All trainees of all levels in all the deaneries (training regions) of the UK and Ireland were asked to complete the survey. Trainees not in a training program and junior trainees, such as core surgical trainees, were excluded. In this study, where the answers were for the number of procedures, the choices given were in categories; 1–3, 4–7, 8–10, 11–13, 14–17, 18–20, and more than 20 (Table 1). Seventy-seven responses were received. One trainee in a nontraining program and two others in the core surgery training program where excluded. Of the included 74 trainees, 34 (46%) were plastic surgery trainees and 40 (54%) were maxillofacial trainees. Forty-seven percentage of the plastic trainees and 50% of the maxillofacial trainees were in the first 3 years of their training (ST 3–5). All the trainees have attended at least one microsurgical training course before or during their training period. Nine plastic surgery and six maxillofacial surgery trainees did not answer the question regarding happiness with their training program. Of the trainees who answered this question 15 of the plastic surgery group (60%) and nine (26%) of maxillofacial group were unhappy with the microsurgery training they are receiving. Overall 79% of the plastic surgery trainees and 75% of the maxillofacial surgery trainees said that they have assisted in more than 20 free flaps procedures (Table 1). The results also show that 59% of the plastic surgery trainees and 50% of the maxillofacial surgery trainees have assisted in microsurgery anastomosis. However, only 20% of the plastic surgery group and 27% of the maxillofacial group has actually performed microsurgical anastomosis. The commonest free flaps encountered during the period of plastic microsurgery training program are deep inferior epigastric perforator flap and transverse rectus abdominus myocutaneous flaps. Following this are the free radial forearm flap (RFF), anterolateral thigh (ALT) flap, and the free Latissimus Dorsi flap. These differ to maxillofacial training experience in this cohort who most commonly were exposed to RFF, fibular flap and the ALT Flap. Both plastic and maxillofacial surgery trainees felt they were competent raising the RFF (Table 2). Only 13 (38%) of the 34 plastic surgery trainees and 16 (40%) of the 40 maxillofacial surgery trainees feel *Correspondence to: Ammar Allouni, MB.Bch, M.Sc., MRCS, Department of Plastic Surgery, University Hospital of North Durham, North Road, Durham DH1 5TW, UK. E-mail: Allouni@hotmail.com Received 13 February 2014; Revision accepted 9 March 2014; Accepted 11 March 2014 Published online 24 March 2014 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/micr.22251