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Plastic Surgery Residency »  About the Program »  Clinical Rotations

Clinical Rotations

Curriculum


Intern Year

Our interns spend five months in plastic surgery, covering Parnassus, VA, and two months of ZSFG. At all of these rotations, opportunities to assist in the operating room are plentiful.  At ZSFG, the minor procedures clinic is the intern’s opportunity to perform bedside procedures, often excisions of skin lesions, under the direction of an attending.

We spend a month on the orthopedic service at ZSFG, which features an 2-3 operative days a month and opportunities to assist in hand clinic.

There is a month in Oral and Maxillofacial Surgery, where you have opportunities to experience facial trauma call, perform dental extractions, and become comfortable with intra-oral blocks. 

The remaining five months of the year include general surgery rotations including VA general surgery with one operative day a week, Kaiser general surgery with at least one week as the OR intern, trauma with one operative day a week, vascular surgery with one operative day a week, and neurosurgery.

 


2nd Year

Our residents spend two months in plastic surgery at ZSFG where they serve as the consult resident taking hand and face call, while also enjoying a robust trauma operative experience. We also spend a month at Parnassus to assist with high-volume operative cases

We do one month as the sole resident at the St. Francis Both in Burn Center, the only burn center in SF county, where we learn ICU burn care and the surgical management of burn patients. 

The general surgery experience in the second year is rich with operative opportunities and growth as the consult resident for trauma surgery at ZSFG and a robust experience in pediatric surgery. On vascular surgery, you begin doing vascular anastomoses as the resident covering dialysis access and using your new loupes (gifted by the department!) General surgery at the VA is full of opportunities for bread and butter surgery. In addition, this is first opportunity where you are the surgeon of record and have the privilege of dictating operative notes on your patients. You also learn about transplant through caring for liver transplant patients.

 


3rd Year

Our residents spend a total of 7 months on plastics as third years! (This may differ from what is seen on the website currently as many changes have been made to increase exposure to plastic surgery earlier on).  R3s again spend two months in plastic surgery at ZSFG, where they serve as the consult resident but with more autonomy given their experience from the previous year.  Again, there is a robust operative experience in hand, transgender surgery, and facial trauma. 
They then spend 1 month on Pediatric Plastic surgery as a junior resident, getting early exposure to cleft, craniofacial, and pediatric hand anomalies at Mission Bay. They also spend 2 months at Parnassus on Plastics for high volume operative experience.
Finally they are chief at VA plastics for 2 months, their first opportunity as the chief of a plastics service and most senior resident in a variety of hand, reconstructive head and neck, and free flap cases with our VA attending.
The remaining general surgery this year continue to increase skills with purely operative rotations such as trauma surgery. Vascular surgery involves fun cases involving open aortic and limb salvage procedures and you continue to be the resident for dialysis access cases. Lastly, the favorite rotation of our general surgery years is the Kidney Transplant service, where you get to perform kidney transplants as the first assist with the transplant attendings. This is an unparalleled opportunity to perform a fun surgery with multiple anastomoses and the instant feedback of the kidney starting to produce urine within minutes of having blood supply!

 


4th Year

Two months are spent as a float resident helping with a multitude of different cases across all campuses. Again, residents are also sent to Mission Bay in order to gain experience seeing pediatric craniofacial patients and performing craniofacial cases along with general reconstruction.
Two months are spent at the VA, where we perform most hand cases as well as general reconstruction. Minor procedures are also performed in clinic.
Four months are spent at ZSFG, where residents take the lead in caring for patients at our county hospital. Most of our hand and facial trauma experience comes here, along with some transgender surgery as well. We have a robust experience fixing hand and face fractures. Elective cases are booked through our clinics, where residents have the opportunity to make diagnoses, formulate an operative plan, and take the patient to the OR.
Four months are spent as at Parnassus campus, where most of our microsurgical reconstruction is performed, along with transgender facial feminization cases as well as general reconstruction. Patients we are consulted on here tend to be amongst the most complex that we see and are often managed by multiple services.

 


5th Year

Residents again perform additional tours of duty at ZSFG (2 months). During the latter half of the year, they are the most senior resident at ZSFG and have wide latitude with both patient care decisions and OR scheduling. Another four months are spent at Parnassus, where they are again the senior resident on service. They also see cosmetic patients in the resident cosmetic clinic and perform cosmetic operations with volunteer staff from the community.
Two months are spent at Mission Bay, where residents are the most senior during this time and participate in more craniofacial operations such as cleft lips and palates, as well as cranial vault remodeling. We also help the colorectal and orthopedic services with general reconstructive cases.
We also spend two months at the Buncke clinic, a private practice group based at CPMC that specializes in microsurgery and hand surgery. In particular,  they are a high-volume replant center, and most of our experience with replants comes here. They are also uniquely a high-volume phalloplasty center and acknowledged as having one of the largest experiences in the world performing these operations.

 


6th Year

Another two months are spent as the senior resident at Mission Bay performing pediatric craniofacial operations; two months at Parnassus for general reconstruction, microsurgery, and transgender surgery; and two months at ZSFG for trauma. 
The year wraps up with two months of outpatient breast at Mission Bay, two months of cosmetics, and one month each of dermatology and oculoplastics. Our cosmetic rotation this year involves visiting our clinical faculty in the community to observe and occasionally participate in their private practice operations. During our dermatology and oculoplastics rotations, we have the opportunity to perform local flap reconstruction of face and eyelid wounds following tumor resection.

 

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