Microsurgery Training in Latin America: A Survey of Residents’ Experiences

Objective: Health services in Latin America have witnessed continuous expansion, improving access for patients requiring treatment for trauma and cancer. However, while demand for complex reconstruction is on the rise, the number of trained microsurgeons remains limited. The aim of this study is to investigate current experiences of plastic surgery residents with regard to microsurgery. It also aims to find out ways through which the number of trained microsurgeons in the region can be increased for better medical care. Methods: A cross-sectional survey was designed to obtain information regarding the exposure and training that plastic surgery residents receive during residency in Latin American countries. We ensured that our procedure followed the data protection rules laid down in the General Data Protection Regulation (GDPR). Results: We requested 129 microsurgeons in Latin American countries to respond to our survey questions. A total of 93 survey responses were received, corresponding to a response rate of 72.1%. An analysis of the survey data showed that in terms of hands-on microsurgical training, 79.6% of the respondents had previous experience of being involved in performing a microsurgical procedure. However, 59.1% of the respondents mentioned that this was part of their formal training program. The majority of respondents (74%) reported that they would not be confident in performing a microsurgical procedure unsupervised. About half, or 48.4% of the respondents said that they would consider applying for a microsurgery fellowship. However, only 63.4% reported that they had access to a fellowship program in their home country. Conclusion: Few resident plastic surgeons in Latin America are able to attain the required level of experience so as to feel comfortable acting as independent microsurgeons. Both time and effort are required to address this problem. A powerful tool to change this situation is to gain access to international microsurgical fellowships. An influx of returning trained microsurgeons can provide two benefits: (a) increasing the caseload in the short run, and (b) improving the training of plastic surgeons for future generations of doctors.