PLASTIC SURGERY PROFILE

GENERAL INFORMATION (Source: Pathway Evaluation Program and Royal College) Plastic surgery includes the management of major burns, reconstruction of congenital malformations, cosmetic surgery and other minor surgical procedures. Although many plastic surgeons concentrate on cosmetic procedures, there is a great opportunity for major reconstructive surgery that can be done with an understanding of the principles of wound healing, skin flaps, and skin grafting. There is ample opportunity for innovation and synthesis of new approaches (e.g., craniofacial surgery, microsurgery, fat transfers and artificial skin). Plastic surgeons treat a wide variety of clinical disorders including congenital and developmental problems, trauma, cancer and degenerative diseases. Often their goal is not only to improve appearances but also to restore function. Depending on the type of practice, many procedures are done under local anesthetic on an outpatient basis. Practitioners characterize plastic surgery as a highly creative specialty, requiring good aesthetic sense, the ability to think in three-dimension and appreciation of detail.

Upon completion of medical school, to become certified in plastic surgery requires an additional 5 years of Royal College-approved residency training. This training includes: • a minimum of 2 years of foundational training in the core aspects of surgery related to

plastic surgery, including rotations in: plastic surgery; general surgery; orthopedic surgery; critical care; otorhinolaryngology; vascular surgery; neurosurgery; pediatric surgery; surgical ophthalmology; surgical oncology; oral surgery; and urology;

• 3 years of progressive senior residency training in plastic surgery, which must incorporate the principle of graded increasing responsibility. This period includes rotations as a senior or chief resident, research or elective time. It must also include exposure to burn surgery, hand surgery, aesthetic surgery, craniofacial trauma surgery, and reconstructive surgery of the breast, trunk, head and neck, lower limb and upper limb, and pediatric plastic surgery.

For further training requirements go to: http://www.royalcollege.ca/portal/page/portal/rc/credentials/start/routes/traditional_route

The Canadian Society of Plastic Surgeons www.plasticsurgery.ca

PLASTIC SURGERY PROFILE

Number of physicians and physicians/100,000 population in Plastic Surgery in Canada, 2015

Source: 2015 CMA Masterfile

Province/Territory Physicians Phys/100k pop'n

Newfoundland/Labrador 5 0.9

Prince Edward Island 2 1.4

Nova Scotia 18 1.9

New Brunswick 13 1.7

Quebec 148 1.8

Ontario 219 1.6

Manitoba 17 1.3

Saskatchewan 15 1.3

Alberta 65 1.6

British Columbia 97 2.1

Territories 0 0.0

CANADA 599 1.7

Physicians/100,000 population in Plastic Surgery in Canada, 1995 to 2015

Source: CMA Masterfile

1.2

1.3

1.4

1.5

1.6

1.7

1.8

1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015

Plastic Surgeons by gender and year in Canada, 1995 to 2015

0

100

200

300

400

500

600

700

1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015

Total Males Females

Source: CMA Masterfile

Plastic Surgeons by age and gender in Canada, 2015

Source: 2015 CMA Masterfile

Female 21%

Male 79%

Gender

34 and under 6%

35 - 44 28%

45 - 54 24%

55 - 64 26%

65 and over 16%

Age Group

Plastic Surgeons by age and gender in Canada, 2015

Source: 2015 CMA Masterfile

13

54

27

19

7

20

107

109

132

88

34 and Under

35-44

45-54

55-64

65 and over

Female Male

Main work setting of Plastic Surgeons in Canada, 2014

Source: 2014 National Physician Survey. CFPC, CMA, Royal College

45%

33%

15%

3%

2%

1%

1%

Private Office/Clinic

Academic Health Sciences Centre

Community Hospital

Community Clinic/Health-centre

Admin/Corp office

Non-AHSC Teaching Hospital

Free-standing Lab/Diag Clinic

Practice organization for Plastic Surgeons in Canada, 2014

Source: 2014 National Physician Survey. CFPC, CMA, Royal College

56%

4%

1%

39% Solo Practice

Group Practice

Interprofessional Practice

Hospital-based Practice

NR

Hours worked per week (excluding on-call) by Plastic Surgeons in Canada, 2014

Source: 2014 National Physician Survey. CFPC, CMA, Royal College

Activity Hours worked per week

Direct patient care without teaching component 27.6

Direct patient care with teaching component 10.2

Teaching without patient care 3.0

Indirect patient care 6.4

Health facility committees 0.7

Administration 2.3

Research 0.8

Managing practice 3.6

Continued professional development 3.0

Other 1.2

TOTAL HOURS PER WEEK 58.8

Time spent on call in direct patient care = 45 hrs./month

On-call duty hours spent per month by Plastic Surgeons in Canada, 2014

Source: 2014 National Physician Survey. CFPC, CMA, Royal College

41%

27%

11%

19%

2%

Up to 120 hrs/month

More than 120, up to 180 hrs/month

More than 180, up to 240 hrs/month

More than 240 hrs/month

No response

Remuneration for Plastic Surgeons in Canada

78%

1%

2% 11%

8%

Primary payment method1 in 2013

90% + fee-for-service 90% + salary

90% + other* Blended

NR

* Other includes capitation, sessional, contract and other methods

Average gross clinical earnings for Plastic Surgeons in 2013/14 (those earning at least $60,000) = $362,6182

Average percent overhead reported by all surgeons specialists in 2010 = 28.4%3

1 National Physician Survey, 2013, CFPC, CMA, Royal College 2 National Physician Database, 2013/14, CIHI 3 National Physician Survey, 2010, CFPC, CMA, Royal College

Satisfaction among Plastic Surgeons in Canada, 2013

10%

8%

4%

8%

6%

25%

11%

15%

34%

27%

36%

17%

Currentprofessional life

Balance ofpersonal &

professionalcommitments

NR Very dissatisfied Dissatisfied Neutral Satisfied Very satisfied

Source: 2013 National Physician Survey. CFPC, CMA, Royal College

Plastic Surgeons who are Royal College, CFPC or CMQ certified in Canada, 2014

100%

16% 10%

Royal College CFPC CMQ Outside Canada

Note: Subset of those who reported a certification. Physicians could indicate more than one certification body.

Source: 2014 National Physician Survey. CFPC, CMA, Royal College

Number of Plastic Surgeons who retired during the THREE year period of 2012 to 2014

Source: CMA Masterfile – year over year comparisons Note: “Retired” is based on giving up licence and is therefore excludes those who have retired from clinical practice but are still licensed; it includes physicians who have temporarily given up their license but will return to practice at a later date.

1 2

17

20

< 35 35-44 45-54 55-64 65 + Total

Age Group

Males Females

Faculty of Medicine

Ministry funded

Total Faculty of Medicine

Ministry funded

Total

Memorial U N&L 0 0 McMaster U 17 18

Dalhousie U 10 12 UWO 11 13

U Laval 2 2 NOSM 0 0

U Sherbrooke 2 3 U Manitoba 10 15

U Montréal 15 17 U Sask 0 0

McGill U 9 15 U Alberta 12 15

U Ottawa 10 10 U Calgary 10 10

Queens U 0 0 UBC 11 16

U Toronto 21 43 Canada 140 189

Total and Ministry funded postgraduate MD trainees in 2014/15 – Plastic Surgery

Source: 2014/15 Annual Census of Post-MD Trainees, CAPER

13 19

13

16

0

20

40

First year Exits frompostgrad

Female

Male26

33

2

0

20

40

First year Postgradexits

IMG

GCMS

First year and exiting postgraduate-MD trainees in 2014/15 – Plastic Surgery

Source: 2014/15 Annual Census of Post-MD Trainees, CAPER

IMG – International Medical Graduates GCMS – Graduates of Canadian Medical Schools

• Total of 26 first year Plastic Surgery trainees representing 19% of all Plastic Surgery trainees.

• Total of 140 Plastic Surgery trainees representing 1% of all Ministry funded trainees.

• Total of 31 visa trainees in Plastic Surgery.

• Total of 35 Plastic Surgery trainees completed postgraduate training in 2014.

Postgraduate-MD trainees in 2014/15 – Plastic Surgery

Source: 2014/15 Annual Census of Post-MD Trainees, CAPER

2

4

11

2 1

2

4 3

0

6

12

Location of 2013 Postgraduate-MD exits in 2015 – Plastic Surgery

Of the 29 exits in 2013, 26 (90%) were known to be practising in Canada

Source: 2014/15 Annual Census of Post-MD Trainees, CAPER

Stress associated with finding employment at end of residency

6%

7%

20%

43%

50%

42%

25%

8%

Other spec res

FM resident

NR/NA Not stressful Somewhat stressful Very stressful

Source: 2012 National Physician Survey of residents. CFPC, CMA, Royal College

Links to the organizations supplying information for this document

National Physician Survey http://www.nationalphysiciansurvey.ca Canadian Medical Association http://www.cma.ca/pdc Association of Faculties of Medicine of Canada http://www.caper.ca/ Royal College of Physicians and Surgeons of Canada http://www.royalcollege.ca/portal/page/portal/rc/credentials/start/routes/traditional_route

College of Family Physicians of Canada http://www.cfpc.ca Canadian Institute for Health Information http://www.cihi.ca