Academic careers in plastic surgery

The diverse nature of the specialty provides the opportunity to pursue a wide range of clinical, laboratory and education research.

Blending clinical and academic activities can be very rewarding. Academic surgery offers the chance to participate in the broader scientific community, develop a field of expertise and make contributions to the leading edge of patient care.

The integrated academic training (IAT) pathway outlined below is for those trainees wishing to become independent researchers. However, research is valuable for all surgical trainees and there are ample opportunities to gain experience outside of the IAT

The integrated academic training pathway
In 2005, the Joint Academic Careers Subcommittee of the UK Clinical Research Collaboration (UKCRC) and Modernising Medical Careers (MMC) published the ‘Walport' report, recommending an integrated academic training pathway that combined research and education with a clinical career

Image below- Current integrated academic training pathway for plastic surgery. The stars mark the points where the BAPRAS Research Committee recommends a higher research degree is best undertaken. In general, this is either before commencing core training or following the award of a national training numberTraining Pathways








Academic Foundation Programme

The academic foundation programme offers newly qualified doctors the chance to gain experience in a broad range of education and research topics. The two-year programme varies greatly between regions. In some the academic component is a discrete block and in others is runs concurrently with clinical training. Completing an AFP is not a prerequisite for gaining an academic clinical fellowship (ACF). Visit the Foundation Programme website.

Academic Clinical Fellowships
Academic Clinical Fellowships follow the Foundation Programme and last a maximum of three years. During this period of core surgical training a specialty interest and research area is identified. There is a time allocation of 25% for research activity. Ideally a project proposal is assembled during this time and external funding sought for  a doctorate.

Plastic surgery Academic Clinical Fellowships and Academic Clinical Lectureships currently appointed in England and Wales 


Academic Posts


1 Clinical Lecturer


3 Clinical Lecturers


2 Clinical Lecturers


1 Academic Clinical Fellow, 1 Clinical Lecturer

Northern Ireland

1 Clinical Lecturer


1 Clinical Lecturer

2 Welsh Clinical Academic Trainees

There are no ACF/CAL posts currently available in Scotland. Three non-training grade posts with ACF equivilent academic/clinical division are available at the Canniesburn Unit.

Higher research degree
The degree of choice for the IAT pathway is a PhD. It is recognised internationally and provides formal research training that sets the trainee on the path to becoming an independent researcher.

Those outside of the IAT can still choose to pursue a higher degree. The website Postgraduate Search has a comprehensive listing of MSc courses.

MSc CourseUniversity 
Musculoskeletal scienceUniversity of Oxford 
Plastic, reconstructive surgery and burns

University College London

Surgical Research University of Manchester
Surgical ScienceImperial College London
University of Edinburgh
University College London
Surgical Technology Imperial College London
Surgical Skills and ScienceQueen Mary, University of London
Trauma Surgery Swansea University 

Out of Training Research Experience
Undertaking a higher degree will necessitate a period of out-of-training time. Although there are diplomas and some Masters degrees that can be followed as distance learning or part time activities, formal research training within a Masters or Doctorate programme will require full time commitment. The present competitive selection for appointment to higher specialist training at ST3 is based on a number of criteria of which research is just one of many. Credit is certainly given for a one-year research Masters degree but little extra credit is awarded for PhD, MD or ChM degrees. The extra investment in time to complete such degrees does not guarantee ST3 selection. Those aspiring to become academic surgeons must appreciate that they will need to train and become fully competent in the two separate fields of surgery and science. Achievements in the latter may not have a positive value in surgical promotion. The best time to undertake a PhD is either early, (intercalated with undergraduate studies or before or after the foundation programme), or after a higher specialist training number has been secured. During core training the major focus should be on acquiring clinical competencies and gaining a National Training Number. Interrupting this progression by embarking on doctoral research carries the risk of reaching a career ‘dead end’ if a training number is not subsequently secured. The present training structure points towards there being a benefit to most trainees of a one year Masters degree. Perhaps 10% of trainees should do a PhD, at the times advised, not as a means of advancing a surgical career, but as a formal research training to work closely with scientists from other disciplines and develop an academic career. The lesson of history is that only a small committed minority of consultant surgeons will continue to be research-science-active, although we are entering an era where most will admit patients to clinical trials. For those aspiring to become surgeon scientists a PhD is recommended rather than an MD as this is internationally recognised and carries greater weight amongst the scientific community.

Clinical Lectureships (CL)
NIHR Clinical Lectureships are appointed after admission to higher specialist training and generally after graduation from a PhD programme. There may need to be a period of dedicated clinical trianing between completing a doctorate and applying for a clinical lectureship. Such posts enable trainees to split their time. Fifty percent is spent on clinical training and 50% on research or educational development at a postdoctoral level. The lectureship has a maximum duration of four years or until the certificate of completion of training is achieved. Clinical lectureships are not awarded to a specialty but to a University that will then generate its internal mechanism for selection of candidates and specialty areas to support

Exit from training
Substantive academic surgery posts remain few and far between in plastic surgery in the UK. In fact the majority of academic plastic surgeons hold honorary or single session academic positions and future appointments at professional level are likely to be based on personal achievements rather than continuation of established posts.
Ideally a joint appointment would be developed between an NHS Trust and a university research department. This would provide support and infrastructure required to be competitive for grant applications and to make the transition to setting up a research group comprising basic scientists and trainee surgeon-scientists.

Further Reading
Jain A, Nanchahal J. Research options for plastic surgical trainees. Br J Plast Surg 2002;55(5):427-9

Ansell J, Beamish A J, Warren N, Donnelly P, Torkington J. A guide to pursuing a higher degree in surgery. Ann R Coll Surg Engl (Suppl) 2012; 94:280-282.

Chan J K, Shaloub J, Gardiner M D, Suleman-Verjee L, Nanchahal J. Strategies to secure surgical research funding: fellowship and grants. Ann R Coll Surg Engl In press.

Rhodes M. How to undertake a research project and write a scientific paper. Ann R Coll Surg Engl 2012; 94:297-299

Jalali M, Davies P S E, Winterton R I S. The UK plastic surgery trainee. J Plast Reconstr Aesthet Surg. 2011 Dec;64(12):1716-7


Conditions that develop later in life due to accident or infection.
Lazy eye.
A preinvasive cancer involving the surface layer of the anus.
Before birth.
Rare and dangerous lesions that occur in the scalp, head and neck region. Often triggered by puberty, there is often a visible swelling in the skin which is blue in colour.
This is surgery to fuse a joint.
The procedure whereby liquid contents of a swelling can be removed with a needle.
Reconstruction of the ear using the patient’s own tissue.
This is the most common form of skin cancer. It grows locally and does not spread elsewhere in the body. It is usually cured by simple removal.
A colloquial term for prominent ears.
A condition caused by infection of by a reduced blood supply to the facial nerve.
A benign condition is one that is not usually serious or harmful.
When clefts occur on both sides of the mouth.
Microtia affecting both ears.
A biopsy is a medical test involving the removal of cells or tissues for examination.
A new surgical technique often used in the treatment of hemifacial microsomia. Developed from limb lengthening operations first described in Russia, this technique is based on the principle of pushing small pins into bone, and moving these pins apart by a connecting bar which incorporates a screw thread. As the pins are gradually stretched apart, the bone and surrounding soft tissue is also stretched.
The group of nerves located behind the collar bone which control feeling and movements in the arm.
An artificial implant that is under the skin.
The smallest blood vessels in the deep layer of skin.
Another term for a haemangioma or strawberry mark.
A condition caused by mechanical interference with the median nerve in the wrist. This large nerve provides feeling to the thumb, index and middle fingers and half of the ring finger. It also provides power to the small muscles at the base of the thumb. The median nerve enters the hand from the forearm, passing beneath a tough ligament (known as the carpal ligament) that runs across the wrist. This nerve can become squeezed, either because the contents of the tunnel beneath the ligament swell, or because the size of the tunnel decreases. This squeezing of the nerve causes tingling in the fingers, often accompanied by numbness. These sensations are usually worse at night, and often wake a patient from sleep. Pain can occur later on in the condition and can be felt in the hand, forearm or even in the upper arm and shoulder.
An acquired shriveling of the outer ear common in boxers and rugby players.
Another term for a haemangioma or strawberry mark.
Abnormal cells in the cervix that only involve the surface layer of the cervix.
The neck of the uterus or womb.
Saromas arising from cartilage
Split or separation.
Where the lip components fail to fuse and are split or separated.
A specialist nurse that works as part of the cleft lip and palate team.
Where the palate is split or separated. This occurs when the main components of the palate – the two palatal shelves in the roof of the mouth – fail to fuse properly.
A clinical expert in the delivery of evidence-based nursing interventions usually in one specific area of clinical practice.
Medical practitioner who specialises in cancer and its treatment.
Nose reshaping operation carried out from inside the nostrils.
The central piece at the bottom of the nose that divides the nostrils.
A whole side-cleft running up to the nose from the lip.
A complete cleft of the palate extends to the hard palate, the bony part at the front of the mouth.
A graft consisting of skin and other underlying tissues such as fat and cartilage.
The cartilage bowl of the ear.
Conditions present at birth.
A congenital condition in which the ear takes on a cup shape due to shortening of the outer circumference of the ear.
A situation where tissues or scars shorten and cause deformity.
A bone distraction procedure whereby a cut is made in the bone which is to be stretched. Pins are passed through the skin and into the bone on either side of the cut. These pins are then connected together by a distractor. In most cases, the distractor is opened by approximately one to two millimetres each day through the turning of a small screw. An average distraction length is likely to be in the region of two to two and half centimetres, which will probably take about three weeks to achieve. At the end of the period of distraction, the distractor is left in position for six to eight weeks while new bone fills the gaps which have been created. A second small operation is then required to remove the distractor.
Is the term used to describe a number of conditions which, like craniosynostosis, involve the overgrowth and undergrowth of the structures of the head and face.
A condition caused by the premature closure of the gaps between the bones of the cranium.
Cryptotia means ‘buried ear’. This is a relatively rare deformation in which the groove behind the ear is not fully formed. This is aesthetically displeasing and can cause difficulties in wearing glasses. This condition can occasionally be corrected using splints but more commonly is corrected surgically around the age of 5.
A colloquial term for constricted ears.
Cysts associated with the skin are very common. They appear as rubbery or firm lumps just beneath the skin and attached to it. Often a tendency to get cysts is inherited. If they grow large they can become unsightly, they can become infected.
Concerning the act of defaecation.
Flat head syndrome in newborn babies. This is asymmetry in a baby’s head caused by the positioning of the head during extended time spent in a neonatal unit, the birth process, the position in the womb, and most often, the infant's preferred sleeping position.
Deep layer of skin.
A healthy part of the body where skin is removed as part of a skin graft or flap procedure.
Bridge of the nose.
This affects the layer of gristle which lies beneath the skin on the palm of the hand, fastening the skin to bone, enabling us to clutch and grip. The disease first makes its appearance as a small lump in the pit of the palm. Over time, this lump may form a cord of tissue that runs from the palm to the finger. After a while, this cord begins to shrink, drawing the finger into a clawed position.
A treatment for arteriovenous malformations (AVM) with onyx. Designed to stop the blood-flow to the lesions.
A cut made in the posterior wall of the vagina during childbirth.
Surgical removal.
An operation to remove a diseased part of the body.
A balloon-like device inserted under the skin near the area to be repaired, which is then gradually filled with salt water, causing the skin to stretch and grow.
A procedure whereby the face is deliberately split vertically along the line of the nasal bridge during monobloc advancement, in order to bring the eyes closer together, expand the upper jaw and rotate the two halves of the face into a more normal position.
This refers to a paralysis of part of the face caused by a dysfunction of the facial nerve. The facial nerve controls the facial muscles, especially those around the eyes and mouth – for example, the muscles that lift the eyebrows, close the eyelids and raise the corners of the mouth to shape a smile. It is in these areas that patients with facial palsy most commonly experience problems.
When developing tissues fail to join up properly.
Between the tissues of the body are layers of connective tissue that separate them. These layers are known as fascia.
A flap including the fascia along with its blood supply.
Transfer of a living piece of tissue from one part of the body to another, along with the blood vessels that keep it alive. Unlike a skin graft, flaps carry with them their own blood supply. Flap surgery can restore form and function to areas of the body that have lost skin, fat, muscle movement, and/or skeletal support.
Flap reconstruction involves the transfer of a living piece of tissue from one part of the body to another, along with the blood vessel that keeps it alive. Unlike a skin graft, flaps carry with them their own blood supply. Flap surgery can restore form and function to areas of the body that have lost skin, fat, muscle movement, and/or skeletal support. There are two main types of flap. These are local flap and regional flap.
Flap reconstruction involves the transfer of a living piece of tissue from one part of the body to another, along with the blood vessel that keeps it alive. Unlike a skin graft, flaps carry with them their own blood supply. Flap surgery can restore form and function to areas of the body that have lost skin, fat, muscle movement, and/or skeletal support. There are two main types of flap. These are local flap and regional flap.
Asymmetry in a baby’s caused by the positioning of the baby’s head during extended time spent in a neonatal unit, the birth process, the position in the womb, and most often, the infant's preferred sleeping position.
Free flap reconstruction involves the transfer of living tissue from one part of the body to another, along with the blood vessels that keep it alive. Unlike other flap transfers, free flaps are entirely disconnected from their original blood supply and are reconnected using microsurgery in the recipient site. This procedure involves hooking up the tiny blood vessels of the flap with those in the new site, and is carried out with use of an operating microscope.
A graft consisting of all layers of the skin.
Ganglions are the most common type of swelling in the hand. They contain a thick clear liquid called synovial fluid. Although ganglions can arise from any joint or tendon tunnel, there are four common locations in the hand and wrist - in the middle of the back of the wrist; on the front of the wrist at the base of the thumb; at the base of a finger, and on the back of a finger end-joint. Ganglions occur when synovial fluid leaks out of a joint or tendon tunnel and forms a swelling under the skin, although the cause of these leaks is not known. In some cases ganglions are painful, in others they are not.
A clinical geneticist arranges tests and advises patients and families who suffer from inherited conditions.
The term used to describe any surgery to the chin which does not involve the tooth-bearing part of the lower jaw. These procedures may be used to move the chin forwards, backwards, upwards or downwards, and are usually done via an incision made inside the mouth where the lower lip joins the lower gum. The bone of the chin is cut horizontally below the level of the tooth roots, and is then moved into its new position and fixed there with wires or titanium screws. These remain in place and do not need to be removed. The incision is then closed with dissolving stitches.
The lower urinary and reproductive tract.
A drug used to treat GIST sarcomas.
A skin graft involves taking a healthy patch of skin from one area of the body, known as the donor site, and using it to cover another area where skin is missing or damaged. The piece of skin that is moved is entirely disconnected, and requires blood vessels to grow into it when placed in the recipient site.
Concerning cancers arising from the female genital tract.
Medical practitioner who deals with the health of the female reproductive system.
A benign overgrowth of blood vessels on the skin that appears as a soft, raised swelling. They are typically crimson red in colour with a slightly dimpled surface. They appear just after birth, largely around the head and neck but can appear anywhere on the body. Colloquially known as strawberry marks or birthmarks and medically also referred to as strawberry naevi, strawberry haemangiomas, capillary haemangiomas and cavernous haemangiomas.
Major injuries that have been sustained to the hand. This could range from burns and skin loss to loss of digits.
Bony palate at the front of the month.
A congenital condition involving underdevelopment of the face.
The human papilloma virus.
Defect of the urethra in baby boys.
Slight notch in the lip.
This involves either realignment of bones or ligament reconstruction using a tendon; suitable only for a minority of patients who have an unstable joint but little damage to the surfaces of the joints.
The external lips of the vagina.
The outer lips of the vagina.
The inner lips of the vagina.
A surgical procedure to reshape the inner lips of the vagina.
Operations to move the facial bones forward.
Sarcomas that grow out of smooth muscle.
A lesion is a medical name for a skin blemish of some sort. Skin lesions include moles, warts, cysts and lipomas.
A muscle in the middle of the eyelid.
Lipomas are fatty lumps under the skin. They usually grow slowly as painless swellings.
Uses a piece of skin and underlying tissue that lie near to the wound. The flap remains attached at one end so that it continues to be nourished by its original blood supply and is repositioned over the wounded area.
Local removal of a lesion with a cuff of normal tissue.
A colloquial term for constricted ears.
A clear fluid carried through a network of channels in the body known as the lymphatic system.
These are organs consisting of many types of cells, and are part of the lymphatic system. Lymph nodes are found all through the body, and act as filters or traps for foreign particles. They contain white blood cells and are important in the proper functioning of the immune system.
A vascular malformation. These involve the lymph system and are present at birth or develop up until the age of two. The do not shrink or fade. They vary from small blister-like marks on the skin to large swellings in the neck, limbs or face.
A network of channels in the body that carry a clear fluid called lymph.
Melanoma is the type of cancer that arises in pigment cells within the skin. It is less common than the other sorts, but can be more serious. The majority of patients are still cured by simple removal, but melanoma can come back after removal and spread elsewhere in the body. Over the past few decades, the incidence of melanoma has risen steadily throughout the world.
Facial surgery to correct abnormalities of the jaw.
Medical practitioner who specialises in cancer and its treatment.
Surgery carried out with use of a microscope.
Surgery carried out with use of a microscope.
Translated from the Greek, means ‘little ear’. It is the medical word used to describe a small or absent ear in newborn babies.
A technique to remove a skin cancer with a narrow margin. The edges are then mapped and carefully checked to ensure complete removal of the tumour. If the excision is incomplete the involved margin is re-excised. This process is repeated until the excision is confirmed to be complete at all the edges.
A mole is a clump of pigment cells in the skin. Moles usually appear as flat brown marks during childhood and early adult life. They gradually change as time goes by often becoming more raised and paler, some go away completely. Moles assume a wide variety of sizes and appearances, some grow hair, and some are rough on the surface.
A LeFort III type osteotomy which extends into the skull to move the forehead region forward at the same time.
The mound anterior to the vagina.
This is a team made up of specialists working together to make sure that the best possible treatment is given
The medical name for capillary malformations.
Basal cell cancer and squamous cell cancer are two types of non-melanoma skin cancer.
The cartilage that makes up the tip-support to the nose needs to be partly removed or reshaped. This is done through the nostril, or by making a small cut in the bit (columella) between the nostrils.
A dental specialist that treats dental displacement or facial growth abnormalities on an aesthetic or reconstructive basis.
Surgeons that carry out procedures concerning the musculoskeletal system.
This is the degeneration of a joint through wear and tear. It can cause aching, especially between thumb and the side of the index finger. The pain may lead to a sense of weakness when you pinch or grip. The base of the thumb may become swollen and may crunch audibly during certain movements. It may also become misshapen. It is this pain and disability that often encourages people to seek surgical interventions.
Sarcomas arising from bone.
Is the term used to describe the surgical correction of prominent ears.
A surgeon who diagnoses and treats conditions affecting the urinary tract and genital tract in children.
A medical specialist that deals with the illnesses and treatment of infants, children and adolescents.
The two parts of the roof of the mouth that form the palate.
When the cleft is partial, it affects only the soft palate at the back of the mouth.
Medical practitioner who diagnoses diseases via tissue or cell samples or via autopsy.
That portion of the external pelvic organs that includes the urinary tract, the genital tract and anus.
A professional who treats and manages patient with musculoskeletal problems using exercises and other forms of physical therapy.
The colloquial name for capillary malformations.
Surgical procedure whereby the vagina is separated from the rectum and the muscles pulled together to tighten the vaginal structures.
These affect people who are immobilised through sickness or disability. The sores themselves occur when skin overlying a bony prominence breaks down following prolonged contact with a surface, such as a mattress or a wheelchair seat.
A sarcoma affecting bone.
The problem is often inherited, and is caused by a lack of the usual cartilage folds in the ear.
Shaping and fitting a false ear to the side of the head.
Someone who fits a prosthesis.
Professionals who are concerned using psychological findings to help people live healthy and productive lives and resolve mental health problems.
Medical practitioner who uses radiation to treat disease, usually cancer.
Radiation treatment used to treat disease, usually Cancer.
An area of the body where skin is missing or damaged and to where tissue is transferred.
The lower part of the large bowel above the anus.
Uses a section of tissue that is attached by a specific blood vessel. When the flap is lifted, it needs only a very narrow attachment to the original site to receive its nourishing blood supply from the artery and vein.
Nose reshaping.
An acquired condition characterised by the deterioration of the skin and soft tissue of one half of the face (usually the left side). More common in females than males, this deterioration causes initial changes in the tissues above the upper jaw, or between the nose and the upper corner of the lip. It then progresses to the mouth, the area surrounding the eye, the brow, the ear and the neck. It may also affect the tongue, the soft palate, and the gums. The eye and cheek of the affected side may become sunken, and facial hair may turn white and fall out.
A cancer of the body’s connective tissues, such as bone, muscle, cartilage and fat.
The outer groove of the ear.
The central structure of the nose.
A skin graft involves taking a healthy patch of skin from one area of the body, known as the donor site, and using it to cover another area where skin is missing or damaged. The piece of skin that is moved is entirely disconnected, and requires blood vessels to grow into it when placed in the recipient site.
The soft, flexible portion of the Palate at the back of the mouth that is concerned with speech.
The role of a speech and language therapist is to assess and treat speech, language and communication problems in people of all ages to enable them to communicate to the best of their ability.
A muscular constriction at the entrance or exit to a cavity or body organ.
The use of splints or other external devices to correct deformity, maintain position and support structures.
A graft that uses only the layers of skin closest to the surface.
A bar of cartilage in the upper part of the ear causing an extra crease.
Another term for a haemangioma or strawberry mark.
Another term for a haemangioma or strawberry mark.
A thick, clear liquid that lubricates a joint or tendon. This fluid accumulates within a ganglion.
Where muscle is moved from the temple to the eyelids to restore strength is area and counter the effects of paralysis.
The major bone in the lower leg.
Tissue expansion is a procedure that enables the body to ‘grow’ extra skin by stretching surrounding tissue. A balloon-like device called an expander is inserted under the skin near the area to be repaired, and is then gradually filled with salt water, causing the skin to stretch and grow.
This involves the transfer of digits from the foot to the hand undertaken with use of a microscope. The absence of a finger does not usually have much effect on either the function or the appearance of the hand, but when the missing digit is a thumb, or when many digits are missing, surgery may be needed.
A tough ligament that runs across the wrist.
This involves the complete removal of the trapezium bone; recommended if the joint above or below this bone are affected by arthritis. Some surgeons fill the gap left by the bone, or the deficit with adjacent tissue.
This is performed if there are concerns that the thumb appears too slack to sit securely in the new joint created by the removal of the bone.
The main joint at the base of the thumb. This joint carries a lot of force when the thumb is used, yet allows for a complex range of movements, including rotation.
Trauma refers to any serious, body-altering injury sustained through accident or impact. Trauma injuries vary in type and severity, but most commonly involve burns, lacerations, fractures and crush. Plastic surgeons have always been involved in the treatment of trauma.
An inherited congenital condition with a genetic cause. It affects both sides of the face and is associated with alteration of the position of the eyes, deafness, underdeveloped low-set ears, and underdevelopment of the mid and lower face.
Microtia affecting one ear.
This refers to all structures from the fingertips to the neck, and also encompasses the group of nerves located behind the collar bone which control feeling in the arm.
The tube through which urine is passed.
Constriction or blockage of the vagina.
These cover a broad spectrum of skin lesions present at birth of shortly after birth.
One of the types of vascular anomalies. They are present at birth. They grow proportionately to a baby and are classified according to the dominant blood vessel type they contain.
The external female genitalia.
Changes that can occur in the skin that covers the vulva. If left untreated, it can develop into vulval cancer.
A wart is a rough patch of skin. The most common type is caused by a wart virus infection. There other types of wart with other causes.
This means not only removing a tumour but cutting out a fair amount of surrounding tissue also.
Procedure whereby the wound is cleared of dead or damaged soft tissue and bone.
A procedure to convert a straight incision or scar into a zigzag. This is used throughout plastic surgery in a number of situations such as to release a contracture, reposition features, deepen a web, and improve the appearance of a scar.