The Chang Gung Memorial Hospital Microsurgery Fellowship: A Review of 1 Year of Experience

The Department of Plastic and Reconstruc-tive Surgery offers a 1-year fellowship in microsurgery. The fellowship setup, diversity and number of cases, and high success rate make it a sought target for training. In this article , I share my personal experience from a 1-year fellowship as a guide tool for those considering microsurgery training at this prestigious institution. This fellowship is provided by the Division of Micro-surgery at the Department of Plastic and Reconstructive Surgery. In total, 6 to 8 fellows are selected annually for duration of 1 year. Different areas of reconstruction are covered during the fellowship, and rotations can be cus-tomized based on the need and interest of the fellows, and these areas include head and neck reconstruction, breast reconstruction and lymphedema surgery, upper limb reconstruction, lower limb and trauma reconstruction , peripheral nerve, and facial reanimation. The fellowship is based on the principle of mentorship, and the year is composed of six 2-month rotations, where in each rotation, the team is composed of the professor, the fellow , and 1 resident. The fellow is engaged actively in the clinical and operative activity including the preoperative planning and postoperative care. There is no assigned on-call schedule for the fellow; however, he/she is expected to be in any flap takeback for the team as part of the learning experience. Table 1 summarizes the structure of the fellowship. EDUCATION Activities that emphasize educational value to enrich the theoretical knowledge and surgical judgment skills are as follows: 1. Biweekly plastic surgery grand rounds: Valuable review of topics in plastic surgery, updates, and new researches are discussed. 2. Weekly microsurgery teaching rounds: During this meeting, a review of scientific microsurgery articles, book chapters, and all cases mandates exploration during that week. Thirty-four scientific articles and 8 book chapters were reviewed this year. 3. Operative education: Formal teaching about surgical cases is done at the day of surgery where there will be a full presentation of the cases followed by relevant literature review. There was an average of 3 operative days, with 2 rooms running simultaneously, and 1½ clinic days each week. The cases included microsurgical cases (free flaps, peripheral nerve surgery, and lymphatic surgery), pedicle flap, and secondary revision for all procedures. I was involved in a total of 164 cases: 101 microsurgical cases, 4 pedicled flaps, and 59 nonmicro-surgical cases. Table 2 summarizes the areas and flaps for reconstruction. Length of …