SINGAPORE ASSOCIATION OF PLASTIC SURGEONS
SINGAPORE SOCIETY FOR COSMETIC (AESTHETIC) SURGEONS

 

Plastic Surgery-Training Requirements and Certification

1. Plastic Surgery - Specialty Training And Certification

1.1 Basic Qualifications

      M.Med (Surg) 
      FRCS (Edin, Eng, Glas, Ire)

1.2 Existing Specialty Qualificatons

FRACS (Plastic and Reconstructive Surgery)       
FRCSC (Plastic Surgery) 
Diplomate, American Board of Plastic Surgery
FAMS (Plastic Surgery)
FRCS (Plastic Surgery)

1.3 Basic Training

      The requirements for basic training are similar to those for M.Med (Surg) or its equivalent.

a. Basic Surgical Sciences

All trainees will be selected for the Advanced Training Programme only after completing their Basic Surgical Training, which is at least 3 years after their housemanship. During this period the trainee should acquire a sound knowledge of the theory and practice of surgery in general. The trainee should sit and pass the Part I FRCS or Part I FRACS examination in order to gain a satisfactory understanding of the basic surgical sciences.

b. Clinical Postings 

During this period before or after the Part I examination, the trainee should spend at least 12 months in General Surgery, 6 months in Plastic Surgery, (Singapore General Hospital or a recognised center) and a 6-month appointment in the preferred Departments of Otolaryngology, Hand Surgery, Paediatric Surgery, Neurosurgery or Orthopaedic Surgery, or a research appointment in the Basic Medical Sciences. This is to allow him to gain a satisfactory understanding of the practice and principles of surgery in general. The trainee must sit and pass the M. Med (Surg) or the FRCS (Edin, Eng, Glas, Ire) examination at the end of his Basic Surgical Training before winning a place in an advance Specialty Training Programme.

1.4 Advanced Specialty Training

1.4.1 Duration

4 years of which 3 years should be spent in a Department of Plastic Surgery and 1 year preferably in recognised centres of training aboard.

1.4.2 Content

The Advanced Trainee must be familiar with the basic techniques and fundamental aspects of Plastic Surgery. He should have sound and practical knowledge in the following areas at the completion of his clinical training:

  1. Historical aspects of the specialty
  2. Wound healing and dressing technique
  3. Principles and practice of tissue culture and transplantation
  4. Skin graft and other types of free grafts
  5. Principles of various types of flaps
  6. Management of soft tissue injuries
  7. Microsurgery - basic techniques and applications
  8. Excisional and reparative surgery involved in treatment of skin cancers and tumours of the face, neck and intraoral region
  9. Management of maxillo-facial trauma including the mandible
  10. Management of burns and their complications
  11. Management of pressure sores and chronic ulcers
  12. Hand surgery - management of acute hand injuries, elective and reconstructive surgery and hand rehabilitation
  13. All aspects of amputation
  14. Management of lymphoedema and post-irradiation problems
  15. Block dissection of lymph nodes, radical neck dissection
  16. Management of head/neck cancers including aspects of resection and reconstruction
  17. Reconstructive surgery of the breast
  18. Cleft lip/palate and craniofacial anomalies All aspects of management including surgery, orthodontics, dental and speech therapy
  19. Management of congenital and acquired deformities of the urogenital system, spinal cord, upper and lower limbs
  20. Principles of tissue expansion and their clinical applications
  21. Principles of laser surgery and their clinical applications
  22. All aspects of aesthetic surgery
  23. All the basic sciences related to the above topics including embryology, surgical anatomy and physiology

He is further encouraged to continue his research activities during this period of advanced training.

1st Year The Advanced Trainee will assist in operations and perform simple operations under supervision. He will commence training in microsurgery in the microsurgical laboratory. In research, the Advanced Trainee will be given a clinical/basic anatomical dissection project. The Advanced Trainee will be involved in Journal Clubs and all other teaching activities of the unit. He should attend all outpatient specialty clinics in the Department. Training in the 1st Year emphasises a solid grounding in basic plastic surgery techniques and their clinical applications.

2nd Year The Advanced Trainee will receive further training in the sub-specialty areas like Head and Neck Cancer, Cleft Lip/Palate, Burns, Aesthetic Surgery and Reconstructive Surgery in all aspects.

Arrangements will be made for the Advanced Trainee to be posted to the Department of Hand Surgery for 3 - 6 months. During this period, the Advanced Trainee will be exposed to all aspects of Hand Surgery like Emergency Hand Problems, Reconstructive Hand Surgery, Free Tissue Transfers and Rehabilitation of the Hand.

Further arrangements will be made with the Dental Department for some exposure in Orthodontics, Dental Prosthetics and pre-operative planning in Orthognathic Surgery for the correction of maxillary and mandibular deformities. The Advanced Trainees will also be exposed to preoperative treatment of cleft patients undergoing alveolar bone grafts and orthognathic surgery.

The Advanced Trainee will continue to assist in operations and operate under supervision but will be allowed to perform more operations independently. When the Advanced Trainee has become competent in microsurgery, he will be allowed to carry out some microsurgical procedures.

The Advanced Trainee will continue his research activities and will present a basic research paper at a meeting. The Advanced Trainee will continue to teach the nurses and junior staff and be involved in Journal Club and inter-departmental lecturers. The Advanced Trainee will be encouraged to be involved in the organisation of workshops and conferences.

3rd Year The Advanced Trainee will be able to handle most of the acute problems like maxillofacial injuries, acute soft tissue trauma and emergency hand surgery. He is able to operate independently most of the time and be able to supervise medical officers during ward rounds and operations. He will co-ordinate most of the teaching activities in the Department.

The Advanced Trainee will continue both clinical and basic research. He will present papers at meetings and publish at least one paper during the year.

At the end of this period, The Advanced Trainee should be ready to sit for his Fellowship examinations in Plastic Surgery and seek certification in the specialty with the Academy of Medicine.

4th Year It is important for the Advanced Trainee to go overseas for one year to broaden the scope of his training and also for interaction with fellow trainees. It will be a time to see and learn new surgical techniques, different approaches to surgical problems and various concepts in basic and clinical research. The Advanced Trainee will attend appropriate meetings and seminars abroad and present his work there. This is also a year of consolidation of his knowledge, surgical skills and research ability.

1.4.3 Advanced Training Posts

These should be advanced training posts in accredited government, restructured and university hospitals.

1.4.4 Supervision of Training

Heads of Departments or Consultants should supervise training.

The Advanced Trainee should communicate freely with supervisors who will assess his progress at regular intervals.

All types of surgery performed will be decided by the supervisors and pre-operative discussion conducted either in the departmental rounds, outpatient clinic or with the supervisors. All Advanced Trainees are required to discuss the patients with their supervisors before listing them for operation.

All cases will be recorded and if there are complications or deaths, they must be reported and discussed with the supervisors.

1.4.5 Log Book

The Advanced Trainee must maintain a log book to record the following:

a. Minor and major surgery performed either under supervision or alone and where he is       
    supervising and teaching junior doctors 
b. Research projects and publications 
c. Journal club activities 
d. Attendance at local, regional and international meetings 
e. Participation in the organisations of local or regional conferences 
f. Teaching contributions

Advanced Trainees must submit log books to their supervisors every month and to heads of department every 6 months for certification.

1.4.6 Practical Training

Practical training involves learning all the skills as detailed in the syllabus.

1.4.7 Research

The Advanced Trainee is required to embark on at least 1 research project during his training period and publish the results.

1.4.8 Courses, Seminars and Lecturers

Attendance at courses, seminars and continuing medical education lectures is mandatory. The Advanced Trainees is required to participate actively in these activities.

1.4.9 Teaching Commitments

The Advanced Trainees will be involved in the teaching medical students and nurses.

1.4.10 Publications and Papers Presented in the Meetings

The Advanced Trainee must publish at least 1 paper in a refereed journal for which he is first author. He should read papers at local, regional and international conferences.

1.5 ANY OTHER SPECIAL REQUIREMENTS FOR THE SPECIALTY

At the end of his training, the Advanced Trainee is encouraged to sit for and pass the UK Intercollegiate Specialty Examination in Plastic Surgery or the FRACS (Plastic & Reconstructive Surgery). He should be eligible to apply for membership of the Academy of Medicine, Singapore and seek certification in the specialty of Plastic Surgery after completion of the Advanced Specialty Training Programme.

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