Curriculum of plastic surgery

Contents:
I. General topics
II. General principles of plastic surgery.
III. Head and neck.
IV. Breast.
V. Trunk.
VI. Lower extremity.
VII. Upper limb.
VIII. Pediatric plastic surgery
Ix. Oncological aspect.
x. Optional courses

I.General topics
1)Imaging modalities.
a.Unit Objective
At the completion of this unit, the candidate can request the appropriate
imaging modality based upon the differential diagnosis developed
from the history and physical examination.
b.Learner Objectives
Upon completion of this unit, the candidate:
I. Understands current diagnostic and therapeutic imaging modalities and
techniques available.
ii. Understands appropriate indications for each imaging modality and their
limitations, as well as their variations.
iii. Can interpret imaging result reports and integrate that information into
patient management
c.Contents
i.Plain x-rays/Panorama.
ii.CT Scan with/without contrast
iii.Diagnostic ultrasound
iv.MRI scan with/without contrast
v.CT
i.f. Angiography/embolization
i.g. Doppler and duplex

d.Clinical Skills
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During the training period, the resident:
i. Develops the ability to request appropriate imaging studies to assess the
underlying pathology
ii. Demonstrates the ability to identify and describe normal radiographic
anatomy
iv. able to interpret different radiographic reports.

2)Pharmacology:

a.UNIT OBJECTIVE:
At the end of this unit, the candidate understands the pharmacology of
drugs commonly used in plastic surgical practice including antibiotics,
anti-inflammatory agents, analgesics and steroids, and effectively
utilizes such drugs in a wide variety of settings.

b.LEARNER OBJECTIVES:
Upon completion of the unit, the candidate:
1.Knows the common pathogens producing infections of the skin, head and
neck structures, breast and hand.
2.Knows the special pathogens related to infections caused by human and
animal bites and infections.
3.Understands the indications and proper antibiotics and antimicrobials for
treatment of the problems noted in #1 and #2 above.
4.knows the principles of use (including dosage and complications) of
common analgesics (oral and parenteral).
5.Understands the pharmacology and clinical use of steroids in plastic
surgery patients (including scar treatment, hand problems, steroid-
dependent patients).
6.Is familiar with the pharmacology of the major types of antibiotics and
the indications for their use.
7.Is familiar with the commonly used anti-inflammatory agents including
dosage and mechanism of action.
8.Is familiar with the pharmacology, complications and clinical use of
common chemotherapeutic agents for treatment of skin and head and
neck malignancies.
9.Understands the principles of management of extravasation injuries
involving chemotherapeutic agents and other drugs.

c.CONTENTS:
1.Pharmacology and clinical use of:
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a. antibiotics
b. analgesics
c. anti-inflammatory agents
d. steroids
e. chemotherapeutic agents applicable in plastic surgery
1) complications and their management
f. topical antimicrobials
g. Anticoagulants

2.Bacteriology of wounds
a. skin infections
b. breast infections
c. surgical wound infections
d. hand infections
e. special problems
1) Animal bites
2) Human bites
3) Farm injuries

d.CLINICAL skills:
During the course of the training program, the candidate:

1.Diagnoses and treats patients with surgical wound infections.

2.Evaluates and treats patients with infections of the head and neck, breast,
skin and hand.
3.Prescribes analgesics for postoperative care and for pain management.
4.Prescribes anti-inflammatory agents for appropriate cases.
5.Utilizes steroids for treatment of a variety of plastic surgical problems
and in the postoperative care of steroid-dependent patients.
6.Participates in the management of patients undergoing chemotherapy for
head and neck and/or skin malignancies.
7.Manages patients with localized extravasations injuries.

3)Critical care, fluid and electrolyte, acid-base balance and

nutritional support:
a)Unite objectives:
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 At the completion of this unit, the candidate:
i.Understands the proper medical evaluation of the fluid and electrolyte,
acid-base and nutritional status
ii.Understands the various methods of correcting fluid and electrolytes
disturbances, acid base imbalance and the malnourished patients.
b)Learners objectives:
. Upon completion of this unit, the candidate can:
i. Describe the scheme used for assessing nutritional status
accurately predict and diagnose electrolytes and acid base disturbances
ii. Describe the methods used for correction of such disturbances.

c)Contents:
i. Critical care management/emergency management of burn and trauma
patients:
a. initial care
b. diagnosis
c. preparation for the operating room

ii.ICU patients
a. monitoring
b. respiratory management
c.cardiovascular management
d. fluid management
e. management of infection and sepsis
iii.management of nutrition

iv.Postoperative patient management

1)respiratory failure
2)cardiovascular problems (arrhythmia, DVT, PE)
3)sepsis
4)bleeding
5)hematoma

d)Clinical skills:
The candidate should be able to design and adequately execute a plane for
correction electrolyte and acid base disturbances correct a
malnourished status and provide a plane for per operative nutritional
support

4)Anesthesia and pain relief.:

a)Unit Objective:
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 At the end of this unit the candidate should:

i.Understands the medical evaluation necessary to assess co morbidity for

patients undergoing general anesthesia and the appropriate specialty
or subspecialty evaluations necessary to assess per operative risk and
to optimize the patients medical condition prior to the proposed
procedure
ii.Understands the various methods of airway management and indications
for endotracheal intubation, laryngeal mask anesthesia, emergency
tracheostomy, cricothyrotomy.
iii.Understands the mode of action of commonly used local anesthetics for
topical application and local infiltration, mode of action, dose ranges,
untoward effects, treatment of toxic reactions, and role of
vasoconstrictors
iv.understands different strategies for pain relief
b)Learner Objective s
a. Upon completion of this unit, the resident can:
i. Describe the schema used for assessing anesthetic risk based on
comorbidity
ii. Describe the methods for safe tracheal intubation based on the patients
normal or abnormal anatomy and the options available.
iii. Describe the commonly used local anesthetics, dose range for adults
and children, common side effects and their management.
iv. Demonstrate regional blocks for different areas of the body.
c)Contents
a. Review the current risk assessment schema for general anesthesia
including techniques of tracheal intubation: nasotracheal,
endotracheal, tracheotomy, cricothyrotomy, laryngeal mask
anesthesia.
b. Pharmacology of commonly used local and topical anesthetics.
d)Clinical Skills
a. At the completion of this unit, the resident understands:
i. Various methods of tracheal intubation, including fiberoptic and LMA.
ii. Topical application of local anesthetics for various procedures.
iii. Successful local anesthetic administration and regional nerve blocks.

II. General principles of plastic surgery

1)Medico legal and Psychiatric Aspects of Plastic Surgery.
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a)UNIT OBJECTIVE:
At the end of the unit, the resident has a clear understanding of medico
legal and psychiatric aspects of plastic surgery practice, regularly
obtains informed consent from patients, and carries out an effective
basic psychological evaluation upon them when appropriate.

b)LEARNER OBJECTIVES:
Upon completion of the unit, the candidate:

1.understands the medical and legal perspectives of the contractual

agreement between a physician and his/her patient.
2.Understands the concepts of informed consent and implied guarantee.
3.Understands the role of the medical record as a legal document.
4.Understands the impact physical deformity can have on patients and their
families.
5.Knows techniques to explore the motivations of patients seeking
cosmetic surgery, and how to distinguish acceptable, unacceptable,
and pathological motivations.
6.Knows legal and ethical ways to sever the physician/patient relationship.
7.Understands the various types of malpractice insurance.
8.Recognizes the basic principles of risk management.
9.Understands psychiatric and psychological treatment options for patients
with physical deformities and their families.

c)CONTENTS:
1.Principles of informed consent.
2.The medical record.
3.Psychiatric aspects of plastic surgery.
4.evaluation of the patient for aesthetic surgery.
5.The psychology of deformity.
6.Management of the dissatisfied patient.

d)CLINICAL skills:
During the course of the training program, the candidate:
1.Obtains informed consent from all patients; effectively documents the
consent agreement.
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2.Evaluates patients for aesthetic surgery from a physical and
psychological perspective.
3.Contributes effectively and accurately to the medical record of both
inpatients and outpatients.
4.Treats patients with physical deformity and explores the psychological
aspects of their care.
5.Manages problem patients, including angry patients, dissatisfied patients,
doctor shoppers, drug seekers, etc.

2.Photography and plastic surgery.

a)Unit Objective
At the completion of this unit, the resident understands the essentials of
medical photography
b)Learner Objective s
Upon completion of this unit, the resident understands:
i. The importance of quality and consistent photography.
ii. Standard views for different specific procedures.
iii. Basic aspects of equipment and technology.
c)Contents
a. Standard views
b. Equipment
c. Imaging Computer
d)Clinical Skills
During the training period, the candidate uses these skills to accurately
document clinical cases.

3.Wound healing.
a)Unit Objective
At the completion of this unit, the candidate understands the basic
physiology of normal wound healing and the pathology of abnormal
wound healing.
b)Learner Objective s
a. Upon completion of this unit, the candidate understands:
i. Normal wound healing, to include scar formation and wound
mechanisms
ii. Abnormal wound healing
iii. Hypertrophic scars and keloids

c)Contents
a. Phases and histology
b. Collagen formation
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c. Biochemistry/cytokines
d. Bacteriology of wounds
A. skin infections
B. breast infections
C. surgical wound infections
D. hand infections
E. special problems
1) Animal bites
2) Human bites
3) Farm injuries

d)Clinical Skills
a. During the training period, the resident:
i. Interprets abnormal wound healing
ii. Initiates pharmacologic or other interventions
iii. Manage different wound healing problems

4.Skin repair, grafting, tissue expansion and flap surgery.

a)Unite and learners objectives:
By the completion of this unit the candidate should understand:
1) The normal physiology and the abnormal pathology of skin healing
2) Different methods of skin repair.
3) Different methods of skin grafting.
4) Principles of flap surgery
5) Principles of tissue expansion

b)Contents:
1.Normal physiology of skin healing
2.Pathological skin healing
3.Types of skin grafts
4.Various methods of skin repair
5.Principles of flap surgery
6.Different types of flaps
7.Vascular territories of the body.
8.Principles of microvascular surgery.
9.Principles of tissue expansion

c)Clinical skills:
By the end if this unit the candidate should be able to perform different
methods of skin repair, grafting and different types of flaps.

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5.Repair, grafting and healing of tendons.
a)Unite and learners objectives:
By the completion of this unit the candidate should understand:
1) The normal physiology and the abnormal pathology of tendon healing.
2) Different methods of tendon repair and grafting.

b)Contents:
1.Normal physiology of tendon healing.
2.Pathological tendon healing.
3.Types of tendon grafts.
4.Various methods of tendon repair.
c)Clinical skills:
By the end if this unit the candidate should be able to perform different
methods of tendon repair and grafting.

6.Repair, grafting and healing of muscle

a)Unite and learners objectives:
By the completion of this unit the candidate should understand:
1) The normal physiology and the abnormal pathology of muscle healing.
2) Different methods of muscle repair and grafting.

b)Contents:
1.Normal physiology of muscle healing.
2.Pathological muscle healing.
3.Various methods of muscle repair and grafting.
c)Clinical skills:
By the end if this unit the candidate should be able to perform different
methods of muscle repair and grafting.

7.Repair, grafting and healing of cartilage.

a)Unite and learners objectives:
By the completion of this unit the candidate should understand:
1) The normal physiology and the abnormal pathology of cartilage healing.
2) Different methods of cartilage repair and grafting.

b)Contents:
a)Normal physiology of cartilage healing
b)Pathological cartilage healing
c)Types of cartilage grafts
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d)Various methods of cartilage repair
e)Clinical skills:
By the end if this unit the candidate should be able to perform different
methods of cartilage repair and grafting.

8.Repair, grafting and healing of nerves.

a)Unite and learners objectives:
By the completion of this unit the candidate should understand:
1) The normal physiology and the abnormal pathology of nerve healing
2) Different methods of nerve repair and grafting

b)Contents:
1.Normal physiology of nerve healing
2.Pathological nerve healing
3.Types of nerve grafts
4.Various methods of nerve repair
c)Clinical skills:
By the end if this unit the candidate should be able to perform different
methods of nerve repair and grafting.

9.Bone healing and grafting.

a)Unite and learners objectives:
By the completion of this unit the candidate should understand:
1) The normal physiology and the abnormal pathology of bone healing
2) Different methods of bone repair and grafting

b)Contents:
1.Normal physiology of bone healing
2.Pathological bone healing
3.Various methods of bone repair
4.Types of bone grafts
5.Principles of distraction lengthening.

c)Clinical skills:
By the end if this unit the candidate should be able to perform different
methods of hand and foot bone fixation and bone grafting.

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 10. Laser and plastic surgery.
a)Unit Objective
At the completion of this unit, the resident understands basic laser physics
and physiology, to
include laser selection for specific lesions
b)Learner Objective s
Upon completion of this unit, the resident understands:
i. Basic laser principles and terminology
ii. Principles of laser selection for specific clinical problems
iii. Principles of laser safety
c)Content
i.Laser biophysics
ii.Laser tissue interaction to include chromophores
iii.Laser characteristics
d)Clinical Skills
During the training period, the resident:
i.Selects the appropriate laser for a specific clinical problem
ii.Performs laser procedures safely

11. Burns, electric, radiation and cold injuries

a)UNIT OBJECTIVE:
At the end of the unit, the candidate understands the physiology of burns
and soft tissue injury, the principles of burn resuscitation, and the
techniques of burn wound repair and reconstruction, and performs
comprehensive, long-term management of burn and soft tissue
injuries.
b)LEARNER OBJECTIVES:
Upon completion of the unit, the candidate:

1.Understands normal skin anatomy, circulation and how it is impacted by

injury.
2.Understands the physiologic changes which occur with thermal injury
including the:
a. relationship between duration of exposure and temperature.
b.specific changes which occur in the zone of coagulation, stasis, and
hyperemia.
3.Recognizes the Rule of Nines, the use of more detailed body surface
charts, and the difference in relative body surface area comparing
children to adults.
4.Knows the parameters which define major, moderate and minor burns.
5.Knows the various factors in addition to body surface area which affect
prognosis of a patient with a thermal injury.
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6.Understands the pathophysiology and treatment of inhalation injuries and
carbon monoxide poisoning.
7.Understands the principles and techniques of fluid resuscitation,
including isotonic and hypertonic techniques, and the principles of
monitoring resuscitation.
8.Understands the pathophysiologic changes unique to chemical burns
including acid burns, alkali burns, chemotherapy extravasations,
hydrofluoric acid burns, etc.
9.Recognizes injuries and sequelae associated with electrical injuries
including cardiac dysrhythmias, central nervous system damage, intra-
abdominal injury, vascular injury, cataracts, etc.
10. Knows the anatomy and physiology pertinent to the excisional
treatment of burns and treatment by split thickness skin grafting.
11. Understands principles pertinent to burn rehabilitation and
reconstruction including aesthetic units of the face, tissue expansion,
hair transplantation, hand splinting, etc.
12. Understands the pharmacology and utilization of topical antibacterial
agents, analgesics and antibiotics in the treatment of burns.
13. Understands the basic theories pertaining to current flow, energy
disposition, and location and extent of injury associated with
conductive and arc injuries from electrical current.
14. Understands the pathophysiology of acute and chronic radiation
damage.
15. Understands the pathophysiology of frostbite and its natural history and
treatment.
c)CONTENTS:
1.Physiology of burn injuries including: thermal, electrical, chemical, etc.
2.Principles and techniques of burn resuscitation
3.Principles of nutritional management of the burn patient
4.Burn wound management
a. excisional techniques
b. grafting
5.Reconstruction of the burn patient
6.Rehabilitation of the burn patient
7.Radiation injury acute and chronic
a. physiology
b. treatment
8.Cold injury physiology and treatment
9.Extravasation injury

d)CLINICAL skills:
During the course of the training program, the resident:

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1.Evaluates patients with minor, moderate, and major burns of chemical,
electrical, and thermal origin.
2.Manages outpatient burns operatively and non-operatively.
3.Performs surgical treatment of acute burns including escharotomies,
fasciotomies, excision, grafting, etc.
4.Manages patients with burns of the hand including the operative
treatment, postoperative therapy and late reconstructive surgery.
5.Manages inpatients with major burns including resuscitation, nutrition,
treatment of inhalation injury, and rehabilitation.
6.Evaluates and treats patients with acute and chronic radiation injuries.
7.Manages patients with chemical burns including intravenous infusion
injuries.
8.Performs reconstructive surgery on burn patients including functional and
aesthetic procedures.
9.Manages patients with frostbite injuries.

12. Implants and biomaterials:

a)UNIT OBJECTIVE:
At the end of the unit, the resident is familiar with both the biology and the
surgical use of the various implant materials including bone, cartilage,
.and alloplasts

b)LEARNER OBJECTIVES:
Upon completion of the unit, the resident:
1.Knows the local wound factors which influence bone graft survival.
2.Recognizes the biologic differences between vascularized and non-
vascularized bone grafts.
3.Understands the influence of perichondrium and balanced cross
sectional area on the warping of cartilage grafts.
4.Recognizes the various types of breast implants and the factors involved
in implant choice including surfaced content characteristics; is aware
of the issues regarding silicone and is able to discuss these with a
patient.
5.Understands the effects of breast implant surface characteristics on
formation of capsular contracture.
6.Recognizes the various injectable materials for subcutaneous filling and
the principles of their use.
7.Understands the processes of bone repair: incorporation,
osteoconduction and osteoinduction.
8.Recognizes the difference in incorporation between cortical and
cancellous bone grafts and membranous and endochondral autografts.
9.Is familiar with the immunology of bone and cartilage transplantation.

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10. Understands the comparative characteristics of bone and cartilage
autografts, allografts and xenografts.
11. Knows the chemistry and biocompatibility of the commonly implanted
biomaterials including silicone, methyl methacrylate, hydroxyapatite,
tricalcium phospate and proplast.
12. Understands the factors involved in the choice of implant materials for
varying reconstructive problems.

c)CONTENTS:
1.Bone
a. autogenous graft repair
b. cancellous versus autogenous grafts
c. local wound factors in bone graft healing
1) bone inductive chemicals
d. common sources of non-vascularized bone autografts and their
characteristics
1) rib
2) iliac
3) cranial
e. common sources of vascularized autografts and their characteristics
1) periosteal
2) nutrient
f. immunology and antigenicity of bone
g. bone allografts
h. xenografts
i. clinical applications

2.Cartilage
a. autografts
b. allografts
c. xenografts
d. immunology
e. influences on warping
f. clinical application
g. resorption, incorporation

3.Alloplastic materials
a. biomaterials
1) silicone
2) methyl methacrylate
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 3) hydroxyapatite
4) tricalcium phosphate
5) proplast
6) other

4.Breast implants
a. types
b. physical characteristics
c. biologic characteristics
d. clinical choices

5.Injectable materials
a. collagen
1) bovine
2) human
b. fat
c. others

d)CLINICAL skills:
During the course of the training program, the resident:
1.Prepares methyl methacrylate prostheses.
2.Performs surgical procedures using solid implant materials including:
a. cranioplasty
b. silicone implantation to breasts, orbital floor, malar area, chin or joints
c. bone substitution for small defects, such as orthognathic advancements
d. non-vascularized bone grafts for a variety of defects:
1) cancellous (iliac)
2) cortical-cancellous (iliac, rib, scapula)
3) cortical (cranial, radius iliae)
e. vascularized bone grafts
f. carving procedures (nasal grafts, ear reconstruction) using rib cartilage
or other alloplastic materials

3.Performs soft tissue augmentation using injectable material.

III. Head and neck:

1)Anatomy/Physiology/Embryology.
A) Unit Objective

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At the completion of this unit, the resident understands the development
and general and systematic anatomy of the face and neck to include
skeletal, skin, fascia, motor and sensory innervation, lymphatics and
various patterns of vascular supply. The candidate should also
understand the detailed surgical anatomy of each region and the
relevant function and physiology.

B) Learner Objectives
Upon completion of this unit, the resident understands the bony and soft
tissue anatomy of the face and neck and the relationships of hard
tissue, soft tissue, vascular and neurological systems. The candidate
should also understands the functional anatomy of each regional area
and the surgical applications

C) Content
a. Facial Skeleton/hard tissue foundation
b. Skin and soft tissue
c. SMAS
d. Facial musculature
e. Facial nerve
f. Facial sensory innervation
g. Vascular patterns of the face
h. Lymphatics of the face
a. Hair and scalp
b. Forehead and brow
c. Eyelids, Orbit, lacrimal system
d. Nose
e. Ears
f. Oral cavity
g.Lips
h. Pharynx
i. Neck/cervical

D)Clinical Skills
At the completion of this unit, the candidate uses the anatomy to:
i. Diagnose and define problems
ii. Perform cosmetic and reconstructive procedures of the face and neck

2)Embryology and congenital disorders:

a)Unit Objective
a. At the completion of this unit, the candidate understands normal
embryology of the face and neck and disorders of development.
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 b)Learner Objective s
Upon completion of this unit, the candidate understands:
i. Normal development
ii. Abnormal development in common clinical syndromes
c)Content
a. General embryology of facial development
b. Detailed embryology of the ears, eyes, nose, and oral cavity to include
lips
d)Clinical Skills
a. During the training period, the resident:
i. Diagnoses and recognizes syndromes and abnormalities
ii. Performs a functional anatomical reconstruction

3)Diseases, disorders, conditions and reconstructions:

a)Unit Objective
At the completion of this unit, the candidate can recognize, assess,
diagnose and manage diseases, disorders and conditions of the face
and neck to include congenital, traumatic, neoplastic.
b)Learner Objective s
Upon completion of this unit, the candidate should be able to:
i.Recognizes the signs and symptoms of congenital, traumatic, neoplastic
and cosmetic diseases, disorders, and conditions of the face and neck
ii.Uses appropriate diagnostic tools to assess these diseases, disorders and
conditions
iii.c. Can develop a diagnosis of these dis eases, disorders and conditions
iv.Understands the nonsurgical and surgical management of congenital,
traumatic and neoplastic diseases, disorders and conditions of the face
and neck.
v.Select the most appropriate reconstructive tool for a particular head and
neck defect.

c)Content
1.Soft tissue injuries of the face.
2.Facial fractures.
3.Reconstruction of scalp.
4.Alopecia.
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 5.Reconstruction of forehead.
6.Reconstruction of upper face.
7.Reconstruction of mid face.
8.Reconstruction of lower face.
9.Distraction osteogenesis of facial bones.
10. Reconstruction of neck.
11. Reconstruction of orbit and periorbital adnexia.
12. Reconstruction of nose.
13. Reconstruction of upper and lower lips.
14. Reconstruction of mandible.
15. Reconstruction of hypopharynx.
16. Reconstruction of esophagus.
17. Facial nerve paralysis.
18. Facial atrophy.

d)Clinical Skills
At the completion of this unit, the resident:
i.Has participated in and understands how to plan surgical strategies and
perform procedures to manage the mentioned diseases, disorders and
conditions of the head and neck.
ii.Has participated in and understands how to plan surgical strategies and
perform procedures to manage defectsof the head and neck.
iii.Can select the most appropriate surgical procedure to treat the mentioned
diseases, disorders and conditions and reconstruct the mentioned
defects of the head and neck.

4)Aesthetic head and neck surgery:

a)Unit Objective
At the completion of this unit the candidate should understand, diagnose
and treat different cosmetic condition of the head and neck.
b)Learner Objective s
At the completion of this unit the candidate should be able to:
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 a. Recognizes the signs and symptoms of cosmetic disorders and conditions
of the face and neck
b. Understands the nonsurgical and surgical management of cosmetic
disorders and conditions of the face and neck.
c. select the most appropriate surgical or non surgical tool for a particular
face and neck cosmetic disorder.
c)Content
1.Periorbital rejuvenation.
2.Rejuvenation of upper face.
3.Rejuvenation of midface.
4.Rejuvenation of lower face and neck.
5.Rhinoplasty
6.Otoplasty
7.Hair restoration.
d)Clinical Skills
At the completion of this unit, the resident:
i.Has participated in and understands how to plan surgical strategies and
perform procedures to manage cosmetic disorders of the face and
neck.
ii.Has participated in and understands how to plan surgical strategies and
perform procedures to manage cosmetic disorders of the face and
neck.
iii.Can select the most appropriate surgical procedure to treat the mentioned
cosmetic disorders.

IV. Breast:
1)Anatomy/Physiology/Embryology.
a)Unit Objective
At the completion of this unit, the resident understands the general and
systematic anatomy of the breast. The candidate should also

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 understand the detailed surgical anatomy of the breast and the relevant
function and physiology.
b)Learner Objective s
Upon completion of this unit, the resident understands the anatomy of the
breast. The candidate should also understands the functional anatomy
of the breast and the surgical applications
c)Content:
1)Anatomy of the breast soft tissue
2)Blood and nerve supply of the breast
3)Lymph drainage of the breast
d)Clinical Skills
At the completion of this unit, the resident uses the anatomy to:
i. Diagnose and define problems
ii. Perform cosmetic and reconstructive procedures of the breast.
iii.Anatomical and functional knowledge to diagnose specific clinical
problems
iv. Detailed anatomy to perform surgical procedures to correct these
problems.

2)Embryology and Congenital Disorders.

a)Unit Objective
At the completion of this unit, the resident understands normal
embryology of the breast and disorders of development.
b)Learner Objective s
Upon completion of this unit, the resident understands:
i. Normal development
ii. Abnormal development in common clinical syndromes
c)Content
a. Embryology of breast development
d)Clinical Skills
During the training period, the resident:
i. Diagnoses and recognizes syndromes and abnormalities
ii. Performs a functional anatomical reconstruction

3)Diagnosis and treatment of breast cancer and post

mastectomy reconstruction.

a)Unit Objective
At the completion of this unit, the candidate can recognize, assess,
diagnose and manage breast cancer and breast reconstruction
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 b)Learner Objective s
Upon completion of this unit, the candidate should be able to:
a. Recognizes the signs and symptoms of breast cancer
b. Uses appropriate diagnostic tools to assess breast cancer
d. Understands the management of breast cancer and select the most
appropriate plane for management
e. understand the rule of breast reconstruction
f. able to plane and execute procedures for breast reconstruction

c)Content:
1.Symptoms and signs of breast cancer.
2.Different diagnostic modalities of breast cancer.
3.Different and recent modalities to treat breast cancer
4.different methods of immediate and delayed breast reconstruction.

d)Clinical Skills
At the completion of this unit, the resident:
i.Has participated in and understands how to plan surgical strategies and
perform procedures to manage breast cancer.
ii.Can select the most appropriate surgical procedure to treat breast cancer.
iii.Able to plane and execute procedures for breast reconstruction.

4)Aesthetic breast surgery:

a)Unit Objective
At the completion of this unit the candidate should understand, diagnose
and treat different cosmetic condition of the breast.
b)Learner Objective s
At the completion of this unit the candidate should be able to:
a. Recognizes the signs and symptoms of cosmetic disorders and conditions
of the breast.
b. Understands the nonsurgical and surgical management of cosmetic
disorders and conditions of the breast.
c. select the most appropriate surgical or non surgical tool for a particular
breast cosmetic disorder.

c)Content:
1.Augmentation.
2.Mastopexy.
3.Reduction.
d)Clinical Skills
At the completion of this unit, the resident:

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 i.Has participated in and understands how to plan surgical strategies and
perform procedures to manage cosmetic disorders of the breast.
ii.Can select the most appropriate surgical procedure to treat the mentioned
cosmetic disorders.

V. Trunk:
1)Anatomy/Physiology.
a)Unit Objective
At the completion of this unit, the candidate understands the general and
systematic anatomy of the trunk to include skeletal, skin, fascia, motor
and sensory innervation, lymphatics and various patterns of vascular
supply. The candidate should also understand the detailed surgical
anatomy of each region and the relevant function and physiology.

b)Learner Objectives
Upon completion of this unit, the resident understands the bony and soft
tissue anatomy of the trunk and the relationships of hard tissue, soft
tissue, vascular and neurological systems. The candidate should also
understands the functional anatomy of each regional area and the
surgical applications.

c)Content
1.thoracic wall
2.osteologyof thorax
3.anterior abdominal wall
4.posterior abdominsl wall
5.gastrointestinal tract
6.male urogenital region
7.f emale urogenital region
8.lumber and sacral plexuses

d)Clinical Skills
At the completion of this unit, the candidate uses the anatomy to:
i. Diagnose and define problems
ii. Perform cosmetic and reconstructive procedures of the trunk
iii. Anatomical and functional knowledge to diagnose specific clinical
problems

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 iv. Detailed anatomy to perform surgical procedures to correct these
problems

2)embryology and congenital disorders:

a)Unit Objective
At the completion of this unit, the candidate understands normal
embryology of the trunk and disorders of development.
b)Learner Objective s
Upon completion of this unit, the resident understands:
i. Normal development
ii. Abnormal development in common clinical syndromes.
c)Content
General embryology of trunk development.
d)Clinical Skills
During the training period, the resident:
i. Diagnoses and recognizes syndromes and abnormalities
ii. Performs a functional anatomical reconstructio

3)diseases, disorders, conditions and reconstructions:

a)Unit Objective
At the completion of this unit, the candidate can recognize, assess,
diagnose and manage diseases, disorders and conditions of the trunk
to include congenital, traumatic, neoplastic.
b)Learner Objective s
Upon completion of this unit, the candidate should be able to:
i.Recognizes the signs and symptoms of congenital, traumatic, neoplastic
and cosmetic diseases, disorders, and conditions of the trunk
ii.Uses appropriate diagnostic tools to assess these diseases, disorders and
conditions
iii.Can develop a diagnosis of these diseases, disorders and conditions
iv.Understands the nonsurgical and surgical management of congenital,
traumatic and neoplastic diseases, disorders and conditions of trunk.
v.select the most appropriate reconstructive tool for a particular trunk defect

c)Content
1.Reconstruction of abdominal wall
2.Reconstruction of chest wall.
3.Reconstruction of back.
4.Reconstruction of male genital defects.
5.Reconstruction of female genital defects.
6.Gender identity disorders.
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 7.Pressure sores.

d)Clinical Skills
At the completion of this unit, the resident:
i.Has participated in and understands how to plan surgical strategies and
perform procedures to manage the mentioned diseases, disorders and
conditions of the trunk.
ii.Has participated in and understands how to plan surgical strategies and
perform procedures to manage defects of the trunk.
iii.Can select the most appropriate surgical procedure to treat the mentioned
diseases, disorders and conditions and reconstruct the mentioned
defects of the trunk.

4)Body contouring:
a)Unit Objective
At the completion of this unit the candidate should understand, diagnose
and treat different cosmetic condition related to body contouring
b)Learner Objective s
At the completion of this unit the candidate should be able to:
i.Recognizes the signs and symptoms of cosmetic disorders and conditions
related to body contouring
ii.Understands the management of cosmetic disorders and conditions related
to body contouring.
iii.select the most appropriate surgical or non surgical tool for a particular
body contouring disorder.

c)Content
1.Abdominoplasty and belt lipectomy.
2.Liposuction
3.Upper extremity contouring.
4.Lower extremity contouring.
5.Trunk contouring.

d)Clinical Skills
At the completion of this unit, the candidate:
i.Has participated in and understands how to plan surgical strategies and
perform procedures to manage body contouring.
ii.Can select the most appropriate surgical procedure to treat the mentioned
cosmetic disorders.

24
VI.Lower extremity:
1)Anatomy/Physiology.
a)Unit Objective
a.At the completion of this unit, the resident understands the general and
systematic anatomy of the lower limb to include skeletal, skin, fascia,
motor and sensory innervation, lymphatics and various patterns of
vascular supply. The candidate should also understand the detailed
surgical anatomy of each region and the relevant function and
physiology.

b)Learner Objective s
a.Upon completion of this unit, the resident understands the bony and soft
tissue anatomy of the lower extremity and the relationships of hard
tissue, soft tissue, vascular and neurological systems. The candidate
should also understands the functional anatomy of each regional area
and the surgical applications.

c)CONTENTS:
1)Osteolgy of the lower limb
2)The gluteal region
3)Anterior compartment of the thigh
4)Medial compartment of the thigh
5)posterior compartment of the thigh
6)popliteal fossa.
7)Anterior compartment of the leg
8)lateral compartment of the leg
9)posterior compartment of the leg
10) dorsum of the foot
11) sole of the foot
12) lower limb innervations
13) vessels of the lower limb.

d)Clinical Skills
At the completion of this unit, the candidate uses the anatomy to:
i. Diagnose and define problems
ii. Perform cosmetic and reconstructive procedures of the lower limb

2)Embryology and congenital disorders:

a)Unit Objective
25
 a.At the completion of this unit, the resident understands normal
embryology of the lower limb and disorders of development.

b)Learner Objective s
a. Upon completion of this unit, the resident understands:
i. Normal development
ii. Abnormal development in common clinical syndromes
c)Content
General embryology of lower limb development.
d)Clinical Skills
During the training period, the resident:
i. Diagnoses and recognizes syndromes and abnormalities
ii. Performs a functional anatomical reconstruction

3)diseases, disorders, conditions and reconstructions:

a)Unit Objective
At the completion of this unit, the candidate can recognize, assess,
diagnose and manage diseases, disorders and conditions of the upper
limb to include congenital, traumatic, neoplastic.

b)Learner Objectives
Upon completion of this unit, the candidate should be able to:
i.Recognizes the signs and symptoms of congenital, traumatic, neoplastic
and cosmetic diseases, disorders, and conditions of the upper limb
disorders and conditions.
ii.Can develop a diagnosis of these diseases, disorders and conditions
iii.Understands the nonsurgical and surgical management of congenital,
traumatic and neoplastic diseases, disorders and conditions of the
upper limb.
iv.Select the most appropriate reconstructive tool for a particular upper limb
defect.

c)Content
1.Lower extremity coverage
2.Foot reconstruction.
3.Lymph edema of lower limb
4.Peripheral nerve lesions of lower limb
5.Mangled lower limb.

d)Clinical Skills
26
At the completion of this unit, the resident:
a.Has participated in and understands how to plan surgical strategies and
perform procedures to manage the mentioned diseases, disorders and
conditions of the upper limb.
b.Has participated in and understands how to plan surgical strategies and
perform procedures to manage defects of the upper limbs.
c. Can select the most appropriate surgical procedure to treat the mentioned
diseases, disorders and conditions and reconstruct the mentioned
defects of the upper limb.

VII.Upper limb:
1)Anatomy/Physiology.
a)Unit Objective
At the completion of this unit, the resident understands the general and
systematic anatomy of the upper limb to include skeletal, skin, fascia,
motor and sensory innervation, lymphatics and various patterns of
vascular supply. The candidate should also understand the detailed
surgical anatomy of each region and the relevant function and
physiology.

b)Learner Objective s
Upon completion of this unit, the resident understands the bony and soft
tissue anatomy of the upper limb and the relationships of hard tissue,
soft tissue, vascular and neurological systems. The candidate should
also understands the functional anatomy of each regional area and the
surgical applications

c)Contents
1)Osteolgy of the upper limb.
2)Pectoral girdle.
3)Axilla.
4)Shoulder region
5)Anterior compartment of the arm.
6)Posterior compartment of the arm.
7)Anterior compartment of the forearm.
8)Posterior compartment of the forearm.
9)Wrist and hand
10) Nerve supply of the upper limb
11) Vessels of the upper limb.

d)Clinical Skills
a. At the completion of this unit, the candidate uses the anatomy to:
27
 i. Diagnose and define problems
ii. Perform cosmetic and reconstructive procedures of the upper limb

2)embryology and congenital disorders:

a)Unit Objective
At the completion of this unit, the resident understands normal
embryology of the upper limb and disorders of development.
b)Learner Objective s
Upon completion of this unit, the resident understands:
i. Normal development
ii. Abnormal development in common clinical syndromes
c)Content
General embryology of upper limb development.
d)Clinical Skills
During the training period, the resident:
i. Diagnoses and recognizes syndromes and abnormalities
ii. Performs a functional anatomical reconstruction
3)diseases, disorders, conditions and reconstructions:
a)Unit Objective
At the completion of this unit, the candidate can recognize, assess,
diagnose and manage diseases, disorders and conditions of the upper
limb to include congenital, traumatic, neoplastic.
b)Learner Objective s
Upon completion of this unit, the candidate should be able to:
i.Recognizes the signs and symptoms of congenital, traumatic, neoplastic
and cosmetic diseases, disorders, and conditions of the upper limb
ii.Uses appropriate diagnostic tools to assess these diseases, disorders and
conditions
iii.Can develop a diagnosis of these diseases, disorders and conditions
iv.Understands the nonsurgical and surgical management of congenital,
traumatic and neoplastic diseases, disorders and conditions of the
upper limb.
v.select the most appropriate reconstructive tool for a particular upper limb
defect.

c)Content
1.Acute hand infections.
2.Chronic hand infections.
3.Dupetryns contracture.
4.Extensor tendon injury
5.Flexor tendon injury.
6.Fractures of metacarpal bones and phalanges.
28
 7.The perionychium
8.Stiff finger joints
9.Arthrodesis.
10. Compression neuropathies.
11. Median nerve palsy
12. Ulnar nerve palsy
13. Radial nerve palsy.
14. Obstetric brachial plexus.
15. Traumatic brachial plexus.
16. Replantation and revascularization.
17. Mangled upper extremity.
18. Toe to hand transfer.
19. Thumb reconstruction.
20. Distraction lengthening of the hand.
21. Congenital hand anomalies.
22. Amputations.
23. Compartment syndrome.
24. Rheumatoid arthritis
25. Tenosynovitis.
26. Vascularised joint transfer.

d)Clinical Skills
At the completion of this unit, the resident:
i.Has participated in and understands how to plan surgical strategies and
perform procedures to manage the mentioned diseases, disorders and
conditions of the upper limb.
ii.Has participated in and understands how to plan surgical strategies and
perform procedures to manage defects of the upper limbs.
iii.Can select the most appropriate surgical procedure to treat the mentioned
diseases, disorders and conditions and reconstruct the mentioned
defects of the upper limb.

VIII. Pediatric plastic surgery:

a)Unite objectives:
At the completion of this unit, the candidate :
i. Understands Relative differences between adult and pediatric anatomy
ii.Understands pharmacology and fluid management and growth charts as
they relate to children
iii.Can identify potential child abuse
iv. understandsSpecific aspects of developmental disorders
29
 v. Understands The forecoming mentioned pediatric diseases and conditions

b)Learners objectives:

Upon completion of this unit, the resident:

i.Understands the significance of differences between adult and pediatric
anatomy
ii.Understands the normal and abnormal embryologic derivations of these
structures
iii.Knows the various conditions and circumstances that lead to abnormal
embryologic development as well as normal variances in anatomy
iv.Knows the operative corrections/approaches for these disorders
v.Understands the normal and abnormal physiology and psychologic aspects
of child development
vi.Accurately assesses good, poor and harmful parenting skills and can
advocate for children in need
vii.Uses appropriate diagnostic tools to assess these diseases, disorders and
conditions
viii.Can develop a diagnosis of these dis eases, disorders and conditions
ix.Understands the management of mentioned congenital, traumatic and
neoplastic diseases, disorders and conditions.
x.select the most appropriate reconstructive tool for a particular head and
neck defect.

c)Contents:
1.Cleft lip (unilateral and bilateral) and cleft lip-nose.
2.Secondary deformity of cleft lip nose.
3.Cleft palate and alveolar clefts
4.Velopharyngeal insufficiency.
5.Craniofacial syndromes.
6.Craniosynostosis.
7.Hypertelorism.
8.Craniofacial microsomia.
9.Craniofacial distraction.
30
 10. Congenital ear deformities.
11. Congenital eye lid deformities.
12. Congenital hand.

d)Clinical skills:
At the completion of this unit, the resident can:
i.Interview parents and children for history
ii.Can perform an accurate physical examination using advanced techniques
and equipment, and utilizes and synthesizes laboratory and imaging
data for evaluation and planning for the mentioned diseases, disorders
and conditions
iii.Can educate and train parents and other family members of the
significance, etiology, impact, origin of the abnormalities and the
options for correction, including the timing and staging of surgery
iv.Has participated in and understands how to plan surgical strategies and
perform procedures to manage the mentioned diseases, disorders and
conditions.
v.Can select the most appropriate surgical procedure to treat the mentioned
diseases, disorders and conditions .

IX.Oncological aspects:
a)Unite objectives:
i.At the completion of this unit, the candidate can obtain a clear
understanding of the patients symptoms, pertinent co-morbid
conditions, general state of health, previous treatments, nutritional
status, tumor status, probable management and expected outcome
ii.At the completion of this unit, the candidate has knowledge of biopsy
techniques and an ability to interpret surgical pathology reports
(tumor size, thickness, differentiation, pattern of invasion, margins of
resection, etc.) in order to make clinical decisions in the treatment of
head and neck tumors
31
iii.At the completion of this unit, the resident can request the appropriate
imaging modality based upon the differential diagnosis developed
from the history and physical examination
iv.At the completion of this unit, the resident understands treatment strategies
and procedures for the surgical management of diseases and disorders
of the head and neck region.

b)Learners objectives:
Upon completion of this unit, the resident:
i.Understands biopsy techniques and indications for each of the following
biopsies:
a) Fine needle aspiration
b) Punch
c) Incisional
d) Excisional
ii. Understands the interpretation of pathology reports
iii. Knows the indications for frozen sections, immunohistochemistry,
electron microscopy, flow cytometry and cytogenetics in the evaluation
of pathology specimens
iv. Understands the staging criteria for the mentioned malignancies
v. Can acquire data from clinical and radiographic examinations to
assign the appropriate stage for the mentioned malignancies based on the
staging rules
vi. Can describe the impact of stage on prognosis and treatment options
based on disease site and
stage
vii. Recognizes the signs and symptoms of diseases and disorders of the
mentioned diseases
viii. Uses the appropriate diagnostic tests to assess diseases and disorders
ix. Can develop a differential diagnosis of diseases and disorders
x. Understands the non-surgical and surgical management of diseases
and disorders
xi. Understands the surgical strategies necessary to treat the mentioned
diseases and disorders region.
xii. Can perform surgical strategies to treat the mentioned diseases and
disorders.

c)Contents:
1.Salivary gland tumors.
2.Tumors of lip and oral cavity.
3.Tumors of mandible and craniofacial skeleton.
4.Tumors upper aerodigestive tract
5.Benign and malignant skin tumors.
32
 6.Melanomas.

d)Clinical skills:
At the completion of this unit, the candidate:
i.Interprets pathology reports
ii.Knows indicators for special studies
iii.Develops the ability to request appropriate imaging studies to assess the
underlying pathology
iv.Identifies and delineates pathologic lymphadenopathy
v.At the completion of this unit, the resident demonstrates the ability to
collate physical examination with radiographic data to develop a
accurate stage and overall stage assignment for patients with the
mentioned malignancies.
vi.Has participated in and knows how to perform in the surgical strategies and
procedures to manage the mentioned diseases.
vii.. Can select the most appropriate surgical procedure in order to treat the
mentioned diseases and disorders.

Optional courses:
1)Day surgery.
2)General principles of immunology and transplantation
3)General principles of genetics.
4)History of plastic surgery.
5)Ethics and plastic surgery.
6)General principles of anastomoses
7)Statistics
8)Medical research
9)Evidence based medicine
10) Principles of tissue bioengineering
11) Aging skin and Ancillary techniques for the aging face:
33
a)Chemical peel
b)Dermabrasion
c)Injection of filling material
d)Laser resurfacing
e)Botulinum toxin
f)skin care products
g)Others

12) Cosmetic pharmacology: different drugs used in plastic surgery

including:
A.Sun screens.
B.Retinoids.
C.Moisturizing agents.
D.Depigmentary agents.
E.Antioxidants
F.Others

13) Principles of hair science and hair loss

34