Background: Increasing demand for surgical services in Australasia has driven public pressure to expand medical school graduate throughput. This risks placing strain on postgraduate surgical training pathways, including plastic surgery. Comparison of plastic surgery training pathways from medical school to accreditation with international counterparts may identify additional system-level approaches to meet workforce demands. The United States, with a highly regulated and well-described training pathway, represents a useful comparator.
Methods: A narrative literature review was conducted using structured searches of MEDLINE and Embase, supplemented by targeted review policy documents from relevant plastic surgery accreditation bodies. Literature describing training pathways and curricula for pre-accreditation plastic surgery training in Australasia and the United States were included. Studies focusing on post-accreditation training, candidate selection, and clinical outcomes were excluded. Relevant literature was screened by multiple reviewers, with data extracted and synthesised narratively.
Results: This review identified key differences in plastic surgery training systems. The United States model exhibits a high degree of centralisation and standardisation, with structured residency pathways, early career specialisation, and significant involvement of regulatory and financial bodies. In contrast, the Australasian pathway is more decentralised, with greater variability in pre-vocational experience and less central oversight.
Conclusion: Comparison with the United States plastic surgery training pathway identifies opportunities to inform assessment, funding, and training structure across pre- and intra-vocational education, building on the strengths of the Australasian approach.