PLAstic Surgery Teaching In the Undergraduate Curriculum of Medical Students-United Kingdom (PLASTICS-UK): A UK national collaborative survey of plastic surgery in the undergraduate medical curriculum

Abstract

Objective: To undertake a United Kingdom national medical student survey investigating undergraduate plastic surgery exposure and specialty perceptions.

Background: Plastic surgery incorporates all anatomical regions, age groups and tissue types; clinical challenges vary from trauma and burns to congenital defects and cancer and although around 50% of the workload is trauma, it is often misperceived to revolve around cosmetic surgery.

Method: Following ethical approval, a national survey was conducted across 27 included UK medical schools (31/03/23-07/07/23). Trends were analysed, with comparisons made between surgical and non-surgical aspirants.

Results: Data were included from 2513 students; 29.2% had surgical career aspirations. Students perceived plastic surgery as challenging, competitive, and impacting quality of life; however, most had no formal teaching (56.3%); merely 6.2% had clinical exposure and 30.4% had an undergraduate plastic surgery placement available. Breast reconstruction was the most frequently correctly identified surgery (91.8%), with head and neck cancer surgery the least (35.9%). Surgical aspirants were less likely to overestimate private practice (p < 0.001) but demonstrated greater self-confidence in plastic surgery understanding (p < 0.001) and their future ability to make plastic surgery referrals (p < 0.001), being more likely to pursue it (p < 0.001). Surgical aspirants were 17.3% more likely to obtain non-curricular plastic surgery experience (p < 0.001), and 5.6% more self-confident dressing basic wounds (p < 0.001).

Conclusion: A greater need for undergraduate plastic surgery teaching was determined. Significant heterogeneity across medical schools was identified. Formation of a national undergraduate plastic surgery curriculum, led by professional bodies, may tackle disparities among medical schools, improve accessibility and facilitate knowledge acquisition.

Keywords: Collaborative research; Medical education; Plastic surgery; Undergraduate curriculum.