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Introduction | Clinical
Areas of Strength
 Brown
University's residency in Plastic and Reconstructive Surgery,
established in 1963, is a fully accredited, six-year coordinated
program. Two residents are accepted each year, through the
internship matching program (NRMP) as 4th year medical students.
This program combines three years of general surgery, a transitional
elective year and two years of plastic surgery.
The first three years have a curriculum
providing special rotations appropriate for the plastic surgeon-to-be,
including a month on the Plastic Surgery service each year.
The resident is encouraged to pursue some investigative activity - lab or
clinical research - during those early years.
The transitional, elective year is meant
to offer some degree of flexibility to the resident, and could
be made up of anything from a year of strong clinical rotations
to a year of research, depending on the individual's strengths
and weaknesses, interests and career plans. By the year 2010, however, this year will be incorporated into the new requirements, forming a formal 3 general and 3 plastic surgery program. The plan is that this will transition to a fully integrated program by that time.
Finally, the resident spends two years
on the busy plastic surgery service, following which most
residents take an additional year of subspecialty fellowship.
The training program is based at the Rhode
Island Hospital, where both junior and senior plastic surgery
residents spend nine months of each year. The remaining three
months of each year are spent at the Providence Veterans'
Administration Medical Center.
The program offers a busy and diverse clinical experience,
with over 2,000 operating room cases per year. Four formal
didactic conferences occur weekly and supplement the busy
clinical program.
Four to six months of research is required
of trainees. Under the direction of Drs. Edstrom, Sullivan, Zienowicz, and Oh, residents
have presented the results of their clinical and laboratory
investigations at both local and national forums increasingly
over the last several years.
Plastic Surgery trainees graduate with
a well-rounded experience in the full range and scope of the
specialty, and have been regularly accepted in the best postgraduate
fellowships. They are well prepared to enter either private
practice, or academic plastic surgery.
PGY1: Kathryn Kent: UMD New Jersey
Tyler Street: Texas Tech University
PGY2: Ben Phillips: Brown University
Clinton Morrison: University of Louisvile School of Medicine
PGY3: Ben Christian: University of Massachusetts/Worcester
Johnny Chang: Tufts
PGY4: Reena Bhatt: Drexel
Erik Hoy: UMD New Jersey
PGY5: Josh Zuckerman: Finch/Chicago Med
Donovan Rosas: University of Rochester
PGY6 - Chief Residents: Nilton Medina: Dartmouth
Rachel Rich Sullivan: Washington University
 Breast
The development of techniques for delayed
or immediate reconstruction in breast surgery has been an
ongoing priority in the Plastic Surgery Department, and pioneering
work in tissue expansion has been done in this department.
A variety of methods have been successfully used by our staff,
ranging from tissue expansion, pioneered by former Chief,
Dr. Armand Versaci, to the use of TRAM traditional flaps and
microvascular free tissue transfers. Dr. Zienowicz has pioneered the use of abdominal advancement flaps (AMBRA) in breast reconstruction.
Aesthetic
All the surgeons in the Plastic Surgery Department do aesthetic
surgery. This gives the residents exposure to a variety of
ways to plan and perform cosmetic surgery, including the latest
endoscopic, liposuction, and laser techniques. A clinic population
provides residents with their own cosmetic surgery patients.
We continue to perfect techniques with ongoing research in
aesthetic surgery which has included primate studies and anatomic
human studies in the laboratory. This has provided plastic
surgery residents with an opportunity to learn techniques
and a scientific approach to challenging problems in aesthetic
surgery.
 Microvascular
Surgery
Microvascular Surgery has been strongly represented in the program
by Drs. Edstrom and Zienowicz.
With the addition of Drs. Schmidt and Oh to the staff
this already active area will become much more so. Dr. Edstrom
has been in the field since 1975, and Dr. Zienowicz offers
the perspectives and experience from his fellowship
training in Boston. With an emphasis on lower extremity reconstruction,
microvascular reconstruction is being performed in the head
and neck and the upper extremity as well, including replantation
surgery.
Microvascular TRAM flap reconstruction
has greatly enhanced our capabilities in breast reconstruction.
A microvascular laboratory is available to the residents for
perfecting technique, as well as research projects. Each resident
is expected to spend time in the laboratory before using the
microscope clinically.
 Hand
Surgery
Hand Surgery is very busy in the Department of Plastic Surgery,
both by trauma and elective reconstruction. Dr. Edstrom is
a past president of the American Association of Hand Surgeons and currently president of the New England Hand Society;
Dr. Zienowicz is a graduate of the Massachussetts General Hand and
Microvascular Fellowship; and Dr. Schmidt has recently completed a hand fellowship with Dr. Kirk Watson in Hartford, so the clinical activity is up-to-date
and sophisticated, with Drs. Bowen and Barrall also doing
significant volumes of hand surgery. Much activity
exists in the areas of acute trauma (from large amount of
light industry in the area), reconstruction after trauma,
congenital, burn reconstruction, nerve and tendon reconstruction,
and wrist surgery. A special unit for evaluation of industrial
hand injuries utilizes a computerized examination system,
for efficient documentation and data analysis. Excellent relations
exist with the Department of Orthopaedics, with whom we share
call in the emergency department, as well as two conferences each
week, providing beneficial cross-fertilization.
 Cleft
Palate/Craniofacial Center
The management of patients with facial abnormalities has been
a major part of the residency training program at Rhode Island
Hospital for over 30 years. In 1960 a Cleft Palate Clinic
was established where patients could be evaluated and treated
by a multidisciplinary group. Its purpose has been to make
available the highest quality care possible for the coordinated
treatment of infants, children, adolescents, and adults with
cleft and craniofacial anomalies. Spearheaded by Dr. Albert Oh, new this year from his fellowship at Boston Children's, adding to the experience and expertise of Dr. Patrick Sullivan, the Cleft and Craniofacial Center is responsible for coordinating the expertise
of all associated disciplines, including pediatrics, genetics,
hearing and speech, dentistry, orthodontics, nursing, neurosurgery,
otolaryngology, ophthalmology and psycho-social services.
Areas of clinical interest include cleft lip and palate, jaw
deformities, and other abnormalities of the first and second
branchial arches.
 Cranio/Maxillofacial
Hundreds of people with cranio/maxillofacial trauma are treated
every year by the plastic surgery service at Rhode Island
Hospital. In addition to this, patients with a variety of
congenital and developmental cranio/maxillofacial anomalies
are cared for by the combined cranio/maxillofacial service.
This service is directed by Dr. Albert Oh, and staffed
by members of the Plastic Surgery Department who have also
completed training in otolaryngology, dentistry or orthodontics.
All
intracranial and paracranial procedures are done in concert
with the neurosurgery service, and the plastic surgeons also
work closely with neurosurgery, otolaryngology, and ophthalmology
in providing craniofacial approaches for tumor extirpation
followed by plastic surgical reconstruction. The Plastic Surgery
Department has conducted both clinical and laboratory research
in cranio/maxillofacial surgery. This includes exciting intrauterine
cleft repair in goats. The plastic surgery residents have
been closely involved with the research and resulting publications.
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