Communication and education for the plastic surgeon after Y2K William P Graham III MD 1 , Donald R Mackay MD 1 , Paul J Gorman MD 1 , Lawrence L Ketch MD 2 1 Penn State Geisinger Health System, The MS Hershey Medical Center, Section of Plastic & Reconstructive Surgery, Hershey, Pennsylvania; 2 University of Colorado Health Sciences Center, Denver Colorado, USA W ith the new millennium, how plastic surgeons educate their trainees and themselves, and communicate with each other is radically changing. With the advent of the com- puter and the Internet, the ways in which these processes are approached will never be the same. For communication and education, there is an obligation to multiple constituencies (Table 1). Each has its own needs, and interaction with these groups varies depending on how they interface with estab- lished plastic surgeons and leaders within academic centres. Such relationships will not be limited to the academician. As access to knowledge expands, the demands on the commu- nity surgeon will increase. A greater awareness of new devel- opments, safer treatments, novel techniques and ways of sharing such information will be expected. What do we owe our medical students and what may be gleaned from their education? They are the source of future trainees, and for those who choose other fields in which to practice, a potential source of referrals. For residents and fellows, training must become relative and task oriented rather than time based. They must learn in- tellectual and technical competence, and be prepared for the certification process with a sound ethical foundation. With greater clinical demands placed on their faculty and greater cost of animal models, they will enter the world of virtual re- ality for surgical simulation. The landscape of education and training, and the issues relative to it are shifting from the 20th to the 21st century. The role of the physician is changing from that of a self-con- tained entity to that of a knowledge manager. The inability to assess competency will be replaced with a variety of interac- tive programs, from didactics to patient management and to virtual reality through surgical simulation. There are implica- tions across the board for training, certification and credenti- aling. To start the 21st century, there are abundant resources cur- rently operational for use in training and continuing educa- tion (Table 2). Audio visual interactive multimedia allows a graduated training situation. The degree of difficulty is matched to the user’s ability, and assessment and feedback are immediately available. Advance distribution learning makes available a variety of sources, with geographic restric- tions. As a cost efficient modality, it lends itself to CD rom or a website. Video teletraining delivers real time learning with Can J Plast Surg Vol 8 No 1 January/February 2000 13 EDITORIAL This article was presented as a Guest Lecture at the 53rd Annual Meeting of the Canadian Society of Plastic Surgeons, June 26, 1999, Montreal, Quebec Correspondence and reprints: Dr William P Graham, Penn State Geisinger Health System, The MS Hershey Medical Center, Section of Plastic & Reconstructive Surgery, PO Box 850, MC-H071, Hershey, Pennsylvania 17033, USA. Telephone 717-531-8372, fax 717-531-4339 TABLE 1 Areas of communication for plastic surgery Students Residents and fellows Colleagues Plastic surgeons Nonplastic surgeons Patients Media TABLE 2 Twenty-first century technologies available to plastic surgeons Audiovisual interactive multimedia Advance distribution learning Video teletraining Virtual surgery