Pediatric Plastic and Oral surgery

Credits: 4.00 CREDITS (Clinical Elective)
Directors: Labow, Brian Ian; Meara, John Gerard
Prerequisites: HMS Principal Clinical Experience (Core Clinical Clerkships) or equivalent
Offered: Full time every month.
Open to Exclerks: Yes (may be restricted for international students)
The independent study in Pediatric Plastic surgery provides clinical exposure to the multi-faceted field of plastic and reconstructive surgery. The student will be exposed to peri-operative and surgical management of a wide variety of deformities that affect the pediatric population such as cleft lip and palate, vascular anomalies, craniosynostosis, and upper limb congenital defects. During this four-week rotation in the Department of Plastic Surgery at Children’s Hospital, the student will work under the mentorship of 4 residents and 8 faculty members and participate as a member of the service. Student activities include patient evaluation, assisting in the operating room, teaching conferences and rounds. The educational material and programs involved will include three formal one hour lectures and conferences on Monday, Wednesday, and Friday which are currently part of the resident program. The student will attain greater understanding of the principles of plastic surgery as they apply to the pediatric age group, gaining an understanding of the etiologies, pathogenesis as well as surgical approaches to a wide array of disorders, as well as the postoperative care, family interaction and follow-up that is unique to the care of pediatric patients.
Learning Goals:
The student will obtain familiarity with the principles of pediatric surgical wound management both in the operating room as well as in the emergency room.
The student will become familiar with the embryological basis for the common pediatric plastic disorders such as cleft lip and palate, craniosynostosis, syndactyly and polydactyly.
The student will understand the timeline for the major cleft procedures, reasons for timing and issues/variations in treatment algorithms. Become familiar with cephalometric analysis (major angles, landmarks, and planes) and orthognathic treatment planning as well as the dental, orthodontic, and oral and maxillofacial issues involved in caring for cleft patients.
The student will become familiar with the broad classification scheme for vascular anomalies and be able to distinguish between common vascular malformations and tumors.
Incorporation of Basic Science Content and Evidence-Based Medicine:
At the outset of the rotation, each student will be provided a syllabus containing references and articles authored primarily by the faculty on clinical and basic scientific articles germane to pediatric plastic surgery.
By participating in the multi-disciplinary craniofacial and vascular anomalies clinic, the student will gain insight into the genetic basis and genotype-phenotype correlations in these rare patient populations. These unusual cases will provide insight into the fundamental principles of craniofacial embryology and vascular biology.
At each of the 3 one-hour conferences per week that the student will attend, basic scientific articles as well as clinical articles on a variety of topics will be presented and discussed.
The evidence-based rationale behind the clinical management of common pediatric problems such as wound management and minor hand trauma will be presented to the student as part of the treatment team in the emergency room and operating room.
The student will present a case study at the oral and maxillofacial conference to Plastic and Oral Surgery faculty and residents. The presentation should manifest the consistent achievement expected in professional work and should represent a substantial amount of effort and knowledge on the subject. This will be graded with an evaluation form.

The student will also be evaluated based on their performance during their month assisting in the operating room, clinic, and on research projects. The student will need to prove their acquired knowledge on the subjects and topics presented around him.
Grade Criteria:
High Honors:
The student was able to contribute knowledge to the case he will be presenting as well as show a substantial amount of effort during his rotation.
The student obtained a core of knowledge of pediatric plastic and oral surgery and presented but did not provide a personal contribution to cases and topics discussed.
The student was merely an observer and did not show extensive thought and effort in his clinical approach and the presentation lacked insight and detail.
The student was unable to grasp the topics and cases presented around them and their presentation was hastily and carelessly constructed.
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