The Evolution and Expansion of the Johns Hopkins Residency Program

Just as the department has expanded in size over its five years of existence, so has its residency program. Now host to 29 physicians—one of the largest plastic surgery residency programs in the country—the program has also expanded in breadth, depth and technological innovation.

By combining forces with several university and local hospitals and community practices, the program gives residents experiences across the state of Maryland and the national capital region to offer them the broadest perspective possible. In addition to placements throughout the Johns Hopkins Health System and University of Maryland Medical System, the program has long offered opportunities at Union Memorial’s Curtis Hand Center, Suburban Hospital and Walter Reed National Medical Center. More recent additions include St. Agnes Hospital and the Dellon Institute, and All Children’s Hospital in St. Petersburg, Florida, will soon join that list.

“One of the things we pride ourselves on is that we’re able to give our residents the full scope of experience in anything interesting in plastic surgery happening statewide,” says Scott Lifchez, director of the residency program.

The program is also one of just a few in the country offering a full spectrum of cutting-edge research opportunities. Physicians in the Integrated Residency Program spend their third year in the lab performing basic science research in areas related to plastic surgery, such as transplantation, tissue engineering, immunology and cancer biology.

At the same time, the residency program is committed to maintaining the coherence and intimacy physicians depend on to develop the professional and personal networks that will follow them throughout their careers.

“These are your peers who will be your friends and colleagues going forward. We make sure we ensure cohesion among our large group of residents,” Lifchez says.

Day-to-Day, Comprehensive Assessment of Our Residents                                                   

When the Accreditation Council for Graduate Medical Education established its residency milestone system— a set of accomplishments each trainee must meet along the way—two years ago, the department decided to implement the system with a day-to-day assessment. After every procedure, attending physicians use an evaluation tool that department faculty members designed to rate residents with numerical scores grouped by body area. Residents benefit by receiving immediate feedback on their knowledge and technique. Attendings benefit by having 100 or more data points on each trainee in hand when the time comes to measure the residents against the official milestones every six months, helping them to complete a fair and representative assessment in just 8.25 minutes on average, down from more than an hour per trainee without the system. Residents can also use the database to track their progress over time and compare their performance to their peers’.

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Now the department has employed a $100,000 grant from the Maryland Innovation Initiative to create a user-friendly, cloud-based version of the assessment system so that other institutions that learned about the department’s system during national meetings can apply it with their residents. The database is also adaptable to other specialties.

Lifchez says the system has the potential to help residency programs meet ACGME requirements without distraction from their primary mission. “It allows you to do what your real job as a surgeon is to do—take care of patients and teach residents as you do it,” he says.