The concept of shortening the traditional plastic surgery residency evolved approximately ten years ago. Plastic surgery, as a specialty, was becoming increasingly complex, and at the same time, general surgery was becoming more fragmented and specialized. General surgery was no longer "general" but was increasingly a specialty focused on abdominal surgery, with the other areas of general surgery having become fragmented into specialties themselves. Nevertheless, we feel that general surgery is still the best background for training prior to entering plastic surgery. It provides the broadest scope of training, especially if the various sub-specialties of surgery can be tailored to fit the special needs of a plastic surgeon's subsequent training. Because of decreasing funding for general surgery residencies, and thus decreasing numbers of general surgery residents in a given residency, the need for the service commitments of residency has tightened. Therefore, tailoring of individual pre-plastic surgery training needs continues to be a problem. In spite of this, the independent residency represents what we believe to be the pathway for the future. This program shortens what has traditionally been a five or six year general surgery residency followed by two years of plastic surgery residency into a three plus three year plan, for a total six years of specialized training. A year of research is an option for the independent plastic surgery residency, after completion of training.
At present, ours is one of a growing number of independent coordinated programs in the country and has been cited as a role model. Seven years ago, we began the independent coordinated plastic surgery program in what is historically one of the oldest plastic surgery training programs in the country.