Current surgical residency programs are notable for a specific timeframe required for training, unique to each specialty. However, graduate medical education is on the brink of a paradigm shift in educating the next generation of physicians, with an emphasis on the skills gained rather than the time spent training. There is a growing body of evidence that competency-based, as opposed to time-based, medical education is this century’s Flexnerian revolution. By using a more developmental, integrated, and programmatic approach to curriculum and assessment, it is thought that we can educate our trainees more effectively and efficiently, provide much needed accountability to our patients and to the public, and establish a long-lasting model of self-motivated, lifelong learning.
Here at Pitt Plastic Surgery, we have embarked upon a longitudinal, integrated curricular and assessment innovation pilot to study different models of time-variable, competency-based plastic surgery resident education via a consortium of four plastic surgery programs. In essence, the milestones for educational progress are valued more than just the length of time of spent in the program. Of course, all residents must achieve the required competencies in order to graduate and there is already a precedent in US plastic surgery programs for residents to spend extra time in a program if skills need to be further developed. What is new in the CBPST program is that a resident who reaches specific milestones ahead of schedule will be graduated at the end of 5 clinical years, rather than 6.