Our Program
The Harvard Plastic Surgery Residency Training Program was originally a result of a merger of three pre-existing Harvard affiliated plastic surgery residency training programs in 1999. Those three programs, based at Beth Israel Deaconess Medical Center, Brigham & Women's Hospital/Children's Hospital, and Massachusetts General Hospital, were fully accredited and independent training programs prior to the merger. Current residents in the Harvard Mass General Brigham program rotate among Boston’s finest teaching hospitals: Brigham and Women’s Hospital, Boston Children’s Hospital, Massachusetts General Hospital, Shriners Hospitals for Children, and Massachusetts Eye and Ear Infirmary. These teaching hospitals have over 2,000 cumulative inpatient beds and faculty members who serve as leaders in their respective fields. The diverse case mix covers the breadth of aesthetic, breast, craniofacial, cleft lip and palate, hand and upper extremity, lower extremity reconstruction, oncologic reconstruction of the head and neck, and microsurgery.
Program Mission
The mission of the Harvard Plastic Surgery Training Program is to provide the highest quality plastic surgical care to patients in need, to provide the most comprehensive level of education, and best training program for residents, students, and fellows in plastic surgery. It is the aim of the program to also further the science of plastic surgery through research. Our residency program trains residents in the art and science of plastic surgery through a comprehensive and well-rounded balance of structured education, research, and clinical experience. The ultimate goal is to produce excellent, ethical plastic surgeons capable of managing a wide spectrum of problems and surgeons who can function at a superior level of competence throughout their careers, become leaders in our field, and further the course of our specialty.
Independent Program (3 years)
An independent three-year program is available to applicants who will have completed prerequisite general surgery or other surgical specialty training in an ACGME accredited program prior to entering this program at the PGY-4 level. Maintaining an independent or advanced track allows the program to attract excellent candidates from diverse backgrounds that have decided to pursue further training in the field of plastic surgery. Approved pathways to plastic surgery training include completion of residency training in general surgery, oral surgery, otorhinolaryngology, urology, neurosurgery, and orthopedic surgery.
Integrated Program (6 years)
An integrated six-year program is open to applicants who have completed medical school. This program was initiated in 1999, and currently three residents are selected through the NRMP each year. During the first two years of the program residents will complete the prerequisite general surgery training, as well as have exposure to basic concepts in plastic surgery through Harvard affiliated teaching hospitals (Brigham and Women’s Hospital and Massachussetts General Hospital). Upon completion of the first two years, the residency training during the PGY-3 through PGY-6 years will focus solely on plastic surgical residency training.
In addition to rotations through the various General Surgery services at the respective hospitals, integrated residents also rotate through a variety of ancillary services including anesthesia, neurosurgery, orthopedic surgery, dermatology, oculoplastic surgery, facial plastic surgery, and oral/maxillofacial surgery. During the first two years of training, integrated residents also spend a significant number of months rotating through the divisions of plastic surgery at each respective teaching hospital in order to establish early exposure to the field, and to establish early and lasting mentoring relationships with the faculty and more senior residents.
There is no distinction made between the integrated residents in their final three years of training and the independent residents. The PGY 3-6 rotations take place at all the teaching hospitals and the residents work with all faculty within the Harvard program.
Operative Experience
Resident operative experience across the services within the Harvard Plastic Surgery Residency Program is tremendous. There are over 30 core faculty members in the Harvard plastic surgery teaching services. Members of our faculty have unique, specialized, clinical and research interests and provide a valuable resource in and out of the operating room for the comprehensive training of residents in the full breadth of plastic and reconstructive surgery. Residents track their cases on the ACGME online operative log system, and these logs are reviewed regularly by the Program Director to ensure that each resident’s operative experience is adequate in terms of number and diversity. Residents in the Harvard program graduate with caselog numbers that easily exceed the minimum number of required cases for board eligibility.
History
A formal plastic surgery training program was not available in Boston until 1967, when the first residency was established by Joseph E. Murray at the Peter Bent Brigham Hospital and Children's Hospital. Nonetheless, reconstructive surgery at Harvard has a long and notable history within the disciplines of general surgery and dentistry. John Collins Warren (1778-1856) repaired palatal clefts at the Massachusetts General Hospital. His son, Jonathan Mason Warren (1811-1867), is remembered as Boston's first plastic surgeon. He brought the techniques of reconstructive surgery from Europe to America and wrote about skin grafts, cleft lip/palate repair, syndactyly release, and flap reconstruction of nose, lip, and eyelid defects. He published his account of the first rhinoplasty in America in the Boston Medical and Surgical Journal on March 8, 1837. In addition to being an accomplished sculptor, George H. Monks (1853-1933) specialized in the care of patients suffering from disfiguring facial injuries and published the first report of the application of an axially-supplied temporalis flap for eyelid reconstruction. He was the founder and first president of the Boston Surgical Society.
At the Brigham, John Homans (1887-1954) used skin grafts in the treatment of ulcers of the extremities. William E. Ladd (1880-1967), the pioneer pediatric surgeon, devised plastic surgical techniques for congenital anomalies at Children's Hospital. Ladd was a founding member of the American Board of Plastic Surgery and of the American Association of Plastic Surgeons. Later, Donald MacCollum (1908-1987) concentrated on children with cleft lip and palate, and developed the plastic surgical clinic at Children's Hospital.
Varaztad H. Kazanjian (1879-1974) graduated from Harvard Dental School in 1905 and quickly became an authority on the management of mandibular fractures through his development of the intermaxillary wiring method of fixation. During World War I, he applied his dental expertise to the care of soldiers suffering from combat-related facial injuries. Upon returning to America, he completed his education at Harvard Medical School and afterward assumed leadership of the combined Plastic Surgery Clinic of the Massachusetts Eye and Ear Infirmary and the Massachusetts General Hospital. In 1941, he became the first Professor of Plastic Surgery at the Harvard Medical School and continued to make monumental contributions to the field of dental and maxillofacial surgery until the time of his death. Ernest Daland (1891-1981) devoted his active surgical career to the treatment of cancer, and refined plastic surgical procedures for the head and neck regions.
After World War II, Bradford Cannon (1907-2005) began to teach the principles and practice of plastic surgery to an entire generation of residents in general surgery, orthopedics and neurosurgery at the Massachusetts General Hospital. Drawing heavily on his prior experience in Saint Louis and Valley Forge, he quickly became an internationally recognized authority on the care of burn patients, most notably exemplified in his treatment of multiple victims of the devastating Cocoanut Grove fire in 1942. He began the first plastic surgical training program at the MGH as an apprentice system in the early 1960's that was ultimately integrated with the Department of Surgery as a formal division of Plastic Surgery in 1971. Dr. Cannon was the first chairman of the Plastic Surgery Residency Program at the MGH. He was succeeded by John Remensnyder (1931-2006) in 1973.
Contemporaneous with the contributions of Dr. Cannon were those of Dr. Murray. Having served with Dr. Cannon at Valley Forge, Dr. Murray left the military in 1947 in order to complete his training in general surgery and plastic surgery at the Peter Bent Brigham Hospital and New York & Memorial Hospitals. He quickly became enamored with the challenges of skin grafting and tissue transplantation and, upon returning to the Brigham in 1951, joined a team of researchers focused on these matters. In 1954, he performed the world's first successful organ transplantation between the identical Herrick twins at the Peter Bent Brigham Hospital, followed shortly by the world's first successful allograft (1959) and the world's first cadaveric renal transplantation (1962). In 1966, he performed the first midface advancement in the United States and subsequently established the craniofacial program at Children's Hospital. In 1990 he was awarded the Nobel Prize in Medicine for his contributions to organ and cell transplantation in the treatment of human disease.
In 1972, the third residency program in plastic surgery at Harvard Medical School was instituted at the Cambridge Hospital by Francis Wolfort (1932-2003). It was later centered at the Beth Israel/Deaconess Medical Center and included Dr. Robert Goldwyn and his staff. In 1999, the Harvard Plastic Surgery Training Program was formed by combining the programs at the Brigham/Children's, Beth Israel/Deaconess and Massachusetts General Hospitals. Dr. Julian Pribaz was the Program Director from its inception until July 2010 when Dr. Michael Yaremchuck was appointed.
Training Hospitals
Resident Rotations
At each of the hospitals, the residents are part of a team headed by the chief resident, a varying number of senior and junior residents, interns, medical students, and mid-level providers (PA/NP's). Each teaching hospital incorporates daily inpatient rounds, operating room experience and clinic exposure. There is a system of graded responsibility and appropriate independence in the operating room. In addition to the full time permanent faculty, there are also craniofacial and aesthetic fellows at MGH, and a research and pediatric/craniofacial fellow at CHB.
PGY 1-2
The first two years are spent rotating through a variety of specialties at MGH and BWH. Residents spend 3 months in each of their first two years on dedicated plastic surgery rotations. In addition, residents rotate through specific general surgery services such as surgical oncology, vascular, trauma, breast, emergency surgery, transplant, abdominal surgery, pediatric surgery, and surgical ICU. Residents also rotate through several plastic surgery-related rotations during the first two including dermatology, anesthesiology, oral and maxillofacial surgery, and hand surgery.
PGY 3
During the third year, residents transition to full time plastic surgery rotations and begin taking plastic surgery call. Rotations are divided into 4-month blocks through each of the major institutions.
Junior Residents (Integrated PGY 4/Independent PGY 1)
Fourth year residents continue to rotate through each of the major institutions with the addition of two-month rotations each at Shriner's Burn Hospital time and the world-renowned Massachusetts Eye and Ear Infirmary (MEEI). There is also a unique outpatient hand surgery rotation experience with combined orthopedics and plastic surgery services at both BWH and MGH.
Senior Residents (Integrated PGY 5/Independent PGY 2)
Fifth year residents spend time rotating through each of the major institutions. In addition, six months are spent as administrative chief residents at each of the major institutions, where "admin" PGY 5 residents are held responsible for daily service responsibilities and scheduling while also continuing their commitments to the operating room and clinic.
Chief Residents
The final year of residency offers the opportunity for each chief resident to spent 4.5 months on a dedicated "chief rotation" at MGH and BWH. The resident essentially functions as a member of the staff and has dedicated OR time as well as their own clinic time. An elective and cosmetic surgery rotation is also scheduled during the final year during which time many residents choose to focus on research interests or pursue a clinical opportunity outside of the Harvard-affiliated system.
Conferences & Core Curriculum
Multiple weekly educational meetings are held program-wide and provide residents with the most comprehensive plastic surgery education experience available.
The Harvard Plastic Surgery Residency Program holds weekly program-wide grand rounds conferences on Wednesdays that include lectures on a wide range of topics given by leaders in the field of plastic and reconstructive surgery. Following grand rounds a teaching conference for all residents is also held each Wednesday morning. The aim of this conference is to cover the core curriculum in plastic surgery based on guidelines put forth by the American Council of Academic Plastic Surgery (ACAPS). We utilize Board Exam questions to formulate the didactic style lectures and include essential topics in plastic surgery (breast, hand, craniofacial, microsurgery, lower extremity, cosmetic, and general reconstruction) presented by our faculty. Journal clubs are held monthly.
Each week following Core Curriculum lectures, there is a 45 minute resident-only review session during which In-Service Exam specific questions and topics are reviewed. These sessions are run by current chief residents on a rotating schedule. The goal is to prepare all residents for the In-Service Examination, and graduating chief residents for their Board Exams.
In addition to the program-wide grand rounds conferences and didactics there are institution-specific conferences held each week, which are attended by the site-specific resident teams rotating at the institution during that time. Topics at these meetings include surgical indications, morbidity & mortality (M&M) presentations, and additional journal clubs.
Research
The Harvard Plastic Surgery Residency Program and affiliated departments provide numerous opportunities to participate in clinical and/or basic science research work.
Given the close relationship between Harvard Medical School, each individual hospital, Harvard University, Massachusetts Institution of Technology (MIT), and numerous startups in Cambridge, MA area, residents have an abundance of resources to be productive. Each of the participating teaching hospitals in the Harvard Program has ongoing clinical investigations and nationally funded basic science research laboratories. All residents are encouraged to submit their work for presentation at regional and national meetings. In addition, each resident is given time and financial support to attend one national meeting in plastic surgery each year. The chief resident class attends the senior resident conference at ASPS The Meeting. Additional time and support for travel may be provided for residents that are presenting a paper at a specific meeting. Residents and faculty also participate in Quality Improvement & Patient Safety projects that are required by the ACGME on a yearly basis. For those interested in dedicated research time it is suggested to contact primary investigators directly.
Research Links
City of Boston
A city of nearly 560,000 residents, Boston is a vibrant and exciting place to call home. With over 50 colleges and universities, thousands of restaurants, countless museums and theaters and several championship athletic teams, it truly offers something to everyone. Its close proximity to the mountains of New Hampshire and Vermont, as well as to the pristine beaches of the Cape and Islands, provides ample opportunity for weekend getaways. Potential applicants are encouraged to explore the links below in order to discover the city's unique offerings.
www.boston.com
www.visitboston.org
www.boston.citysearch.com
www.ci.boston.ma.us
