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  • Friday, June 17, 2016
  • 0706-000805 RESIDENT EDUCATION CURRICULUM FOR GENDER CONFIRMATION SURGERY

    June 20, 2016 4:18 PM - June 20, 2016 4:30 PM

    IJ Room

    • Nikita Abhyankar, MD ;
    • Ervin Kocjancic, MD ;
    • Mimis Cohen, MD ;
    • Loren Schechter, MD

    Purpose

    Educational Philosophy: 

    The surgeon performing gender confirmation procedures should assume an active and integral role in the care of the transgendered patient.  In addition to the requisite technical knowledge and skill regarding specific surgical procedures, resident education and training should include exposure to the mental health evaluation and assessment, hormonal management, and pre- and post-operative care. 

    From a programmatic standpoint, continuing medical education (CME) should include participation in multi-disciplinary conferences which are both didactic and patient-care oriented.  Because the field of gender confirming medicine continues to evolve and change rapidly, CME specific to care of the transgendered individual should be encouraged.  This includes opportunities for cadaver dissections and focused educational seminars.  Additionally, research opportunities should be offered, including presentations at regional, national, and international conferences and publication in peer-reviewed journals. 

    Materials and Methods

    Multi-disciplinary Treatment Model:

    No single discipline can satisfy all of the treatment needs for the transgender individual.  Care is delivered in a collaborative fashion, utilizing a multidisciplinary approach.  At our institution, the plastic surgeon is part of a healthcare team that includes mental health professionals, primary care providers, endocrinologists, urologists, colorectal surgeons and midlevel practitioners.  Additional providers including speech therapists and ENT surgeons (voice surgeons) are also desirable.  Furthermore, administrative and support staff familiar with and sensitive to the needs of the transgender patient is also important.  

    Results

    Resident Education Model:

    A structure for resident education should include:

    1. Lecture series:  Lectures consisting of terminology, history, etiology, mental health assessment, hormonal management, surgical therapies, adolescent therapy, general medical care, and ongoing challenges and barriers to care should be offered.  These lectures should be consistent with the Standards of Care.
    2. Office-based experience:  Exposure to the pre- and post-operative care of the transgender patient should be offered. 
    3. Technical experience:  Training in surgical therapies for both transmen and transwomen should be offered.  This may be in conjunction with related surgical disciplines including urology, colorectal surgery, gynecology, and ENT. In addition, “hands-on” experience can be supplemented with instructional courses.  For example, cadaver courses are under development at our institution.
    4. Continuing medical education:  Participation in multi-disciplinary case conferences should be required.  This includes exposure to mental health and medical experts.
    5. Focused seminars:  ASPS-sponsored seminars on care of the transgendered patient should be developed
    6. Research:  Participation in outcome studies and other academic efforts should be available.  

    Conclusion

    A structured educational initiative is required to meet the needs of resident training.  These efforts require a comprehensive and ethical approach to the transgendered patient.




    Category: Medical Education