MS1 Interested in plastics, but concerned about gender reassignment surgeries.

[NamesMcree]

Hey everyone,

I'm an MS1 at a very liberal school and did not want to ask any faculty this - I am interested in plastic surgery but for moral reasons would not participate in any sort of gender reassignment, top surgery changing genders, or gender reassignment. I'm wondering how integral those surgeries would be for my training as a resident. Could I be asked to leave a residency program if I refuse to participate in these surgeries? Would this be the case for all residencies or just a few particular ones, or none at all? Another interest of mine is urology, so the same question applies to that specialty as well.

Thanks,
McCree

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[EvryDayImHustln]

Gender reassignment, though a hot topic in plastic surgery, is still relatively new and not heavily practiced nor prioritized in residencies. There are programs that have a small focus of it but it certainly isn’t the majority. Not even close. Some plastics programs have no exposure at all. I would keep an open mind. There are some things that I do that I swore I would never do. Everyone can be bought with a price…

 

[igap]

Hey everyone,

I'm an MS1 at a very liberal school and did not want to ask any faculty this - I am interested in plastic surgery but for moral reasons would not participate in any sort of gender reassignment, top surgery changing genders, or gender reassignment. I'm wondering how integral those surgeries would be for my training as a resident. Could I be asked to leave a residency program if I refuse to participate in these surgeries? Would this be the case for all residencies or just a few particular ones, or none at all? Another interest of mine is urology, so the same question applies to that specialty as well.

Thanks,
McCree

This is actually a great question. As an attending at an academic center who trains residents, the idea that a resident would make demands about which surgeries to scrub on is somewhat problematic. Just from the standpoint that it would create a precedent where residents could dictate the surgeries that they will/will not scrub on. For you it would be GRS, but for someone else it might be something else. This could be a headache for programs to deal with.

That said, gender reassignment is still somewhat niche and depending on the program there might not be much of it going on. But anecdotally, a lot of programs are looking to develop GRS programs so it may be difficult to avoid these cases going forward.

I suggest that you examine your reasons for not wanting to even scrub on GRS cases. It doesn't mean that you have to perform them in practice. But if you have such a deep-seated desire to avoid these cases, you might want to think about why that is. It may be that once you figure it out, it might not be such a big deal to scrub on the few cases in residency that you would be required to do.

 

[Fission Chips]

Agree with the above. As a resident, you are told what to do, not the other way around. You don't have to offer GRS in your practice, but a residency program probably could kick you out if you refused. Would they? Probably not, because plastics and urology are smaller communities and it would be difficult to replace a resident. But this may come up when it comes time for referrals for jobs or fellowships down the road... never know. You also would be missing out on a valuable experience... some of the techniques you develop during GRS can carry over to other surgeries you may offer (for example, orchiectomy, urethroplasty, buried penis repair). Your only real option to avoid this would be to only apply to programs that do not offer GRS. Given that both plastics and urology are highly competitive, you'd be limiting yourself. You program could also develop a GRS program by the time you are a PGY-4 and you may be stuck in those cases anyways.

 

[deleted314957]

Maybe you should put your patient’s best interests, concerns and needs before your own parochial views. What about the junkie pimp/human trafficker with a GSW? This business is not about you. This is only from my own 48 year perspective since I was an M1.

 

[Dunadan]

Hey everyone,

I'm an MS1 at a very liberal school and did not want to ask any faculty this - I am interested in plastic surgery but for moral reasons would not participate in any sort of gender reassignment, top surgery changing genders, or gender reassignment. I'm wondering how integral those surgeries would be for my training as a resident. Could I be asked to leave a residency program if I refuse to participate in these surgeries? Would this be the case for all residencies or just a few particular ones, or none at all? Another interest of mine is urology, so the same question applies to that specialty as well.

Thanks,
McCree

I'm an MS2 with similar moral inclinations. I worked in a plastic surgery clinic this Fall and had badge access to the plastic surgery ORs. After scrubbing into a top surgery I found I could separate the procedure from my moral views and I enjoyed how much I learned. I probably wouldn't perform them my career, but as a learner on the side-lines I thought they were fun.

FYI I saw general surgery and plastic surgery residents scrubbing into gender reassignment regularly at my program.