PLASTIC SURGERY PROFILE

PLASTIC SURGERY PROFILE

(Source: Pathway Evaluation Program and Royal College)

Plastic surgery includes the management of major burns, reconstruction of congenital malformations, cosmetic surgery and other minor surgical procedures.

Although many plastic surgeons concentrate on cosmetic procedures, there is a great

opportunity for major reconstructive surgery that can be done with an understanding of the principles of wound healing, skin flaps, and skin grafting. There is ample opportunity for innovation and synthesis of new approaches (e.g., craniofacial surgery, microsurgery, fat transfers and artificial skin).

Plastic surgeons treat a wide variety of clinical disorders including congenital and

developmental problems, trauma, cancer and degenerative diseases. Often their goal is not only to improve appearances but also to restore function.

Depending on the type of practice, many procedures are done under local anesthetic on an outpatient basis.

Upon completion of medical school, to become certified in plastic surgery requires an additional 5 years of Royal College-approved residency training. This training includes: • a minimum of 2 years of foundational training in the core aspects of surgery related to

plastic surgery, including rotations in: plastic surgery; general surgery; orthopedic surgery; critical care; otorhinolaryngology; vascular surgery; neurosurgery; pediatric surgery; surgical ophthalmology; surgical oncology; oral surgery; and urology;

• 3 years of progressive senior residency training in plastic surgery, which must incorporate the principle of graded increasing responsibility. This period includes rotations as a senior or chief resident, research or elective time. It must also include exposure to burn surgery, hand surgery, aesthetic surgery, craniofacial trauma surgery, and reconstructive surgery of the breast, trunk, head and neck, lower limb and upper limb, and pediatric plastic surgery.

For further training requirements go to:

http://www.royalcollege.ca/portal/page/portal/rc/credentials/start/routes/traditional_route

The Canadian Society of Plastic Surgeons

www.plasticsurgery.ca

Number of physicians and physicians/100,000 population

in Plastic Surgery in Canada, 2015

Source: 2015 CMA Masterfile

Province/Territory

Physicians

Phys/100k pop'n

Newfoundland/Labrador 5 0.9

Prince Edward Island 2 1.4

Physicians/100,000 population in Plastic Surgery

in Canada, 1995 to 2015

Source: CMA Masterfile

Plastic Surgeons by gender and year in Canada, 1995

to 2015

Total

Males

Females

Plastic Surgeons by age and gender in Canada, 2015

Source: 2015 CMA Masterfile

Plastic Surgeons by age and gender in Canada, 2015

Source: 2015 CMA Masterfile

Main work setting of Plastic Surgeons in Canada, 2014

Source: 2014 National Physician Survey. CFPC, CMA, Royal College

45% 33% 15% 3% 2% 1% 1% Private Office/Clinic

Academic Health Sciences Centre

Community Hospital

Community Clinic/Health-centre

Admin/Corp office

Non-AHSC Teaching Hospital

Practice organization for Plastic Surgeons in Canada, 2014

Source: 2014 National Physician Survey. CFPC, CMA, Royal College

Hours worked per week (excluding on-call) by Plastic Surgeons

in Canada, 2014

Source: 2014 National Physician Survey. CFPC, CMA, Royal College

Activity

Hours worked per week

Direct patient care without teaching component 27.6

Direct patient care with teaching component 10.2

Teaching without patient care 3.0

Indirect patient care 6.4

Health facility committees 0.7

Administration 2.3

Research 0.8

Managing practice 3.6

Continued professional development 3.0

Other 1.2

Time spent on call in direct patient care = 45 hrs./month

On-call duty hours spent per month by Plastic Surgeons

in Canada, 2014

Source: 2014 National Physician Survey. CFPC, CMA, Royal College

41% 27% 11% 19% 2% Up to 120 hrs/month

More than 120, up to 180 hrs/month More than 180, up to 240 hrs/month More than 240 hrs/month

Remuneration for Plastic Surgeons in Canada

78% 1%

2% _11%

8%

Primary payment method

_{in 2013}

90% + fee-for-service 90% + salary 90% + other* Blended NR

* Other includes capitation, sessional, contract and other methods

Average gross clinical earnings

for Plastic Surgeons in 2013/14

(those earning at least $60,000) =

$362,618

Average percent overhead

reported by all surgeons

specialists in 2010 = 28.4%

1 _{National Physician Survey, 2013, CFPC, CMA, Royal College} 2 _{National Physician Database, 2013/14, CIHI}

Satisfaction among Plastic Surgeons in Canada, 2013

NR Very dissatisfied Dissatisfied Neutral Satisfied Very satisfied

Plastic Surgeons who are Royal College, CFPC or CMQ

certified in Canada, 2014

100%

16%

10%

Royal College

CFPC

CMQ

Outside Canada

Note: Subset of those who reported a certification. Physicians could indicate more than one certification body.

Number of Plastic Surgeons who retired during

the THREE year period of 2012 to 2014

Source: CMA Masterfile – year over year comparisons

Note: “Retired” is based on giving up licence and is therefore excludes those who have retired from clinical practice but are still licensed; it includes physicians who have temporarily given up their license but will return to practice at a later date.

Faculty of

Medicine

Ministry

funded

Total

Faculty of

Medicine

Ministry

funded

Total

Memorial U N&L

0

0

McMaster U

17

18

Dalhousie U

10

12

UWO

11

13

U Laval

2

2

NOSM

0

0

U Sherbrooke

2

3

U Manitoba

10

15

U Montréal

15

17

U Sask

0

0

McGill U

9

15

U Alberta

12

15

U Ottawa

10

10

U Calgary

10

10

Queens U

0

0

UBC

11

16

U Toronto

21

43

Canada

140

189

Total and Ministry funded postgraduate MD trainees in

2014/15 – Plastic Surgery

13

19

13

16

0

20

40

First year

Exits from

postgrad

Female

Male

26

33

2

0

20

40

First year

Postgrad

exits

IMG

GCMS

First year and exiting postgraduate-MD trainees in

2014/15 – Plastic Surgery

Source: 2014/15 Annual Census of Post-MD Trainees, CAPER

IMG – International Medical Graduates

• Total of 26 first year Plastic Surgery trainees

representing 19% of all Plastic Surgery trainees.

• Total of 140 Plastic Surgery trainees representing 1%

of all Ministry funded trainees.

• Total of 31 visa trainees in Plastic Surgery.

• Total of 35 Plastic Surgery trainees completed

postgraduate training in 2014.

Postgraduate-MD trainees in 2014/15 – Plastic Surgery

2

4

11

2

1

2

4

3

0

6

12

Location of 2013 Postgraduate-MD exits in 2015 – Plastic

Surgery

Of the 29 exits in 2013, 26 (90%) were known to be practising in Canada

Stress associated with finding employment at end of residency

6%

7%

20%

43%

50%

42%

25%

8%

Other spec res FM resident

NR/NA

Not stressful

Somewhat stressful

Very stressful

Links to the organizations supplying information for this document

National Physician Survey

http://www.nationalphysiciansurvey.ca

Canadian Medical Association

http://www.cma.ca/pdc

Association of Faculties of Medicine of Canada

http://www.caper.ca/

Royal College of Physicians and Surgeons of Canada

http://www.royalcollege.ca/portal/page/portal/rc/credentials/start/routes/traditional_route

College of Family Physicians of Canada

http://www.cfpc.ca

Canadian Institute for Health Information