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*Corresponding Author:
Kieran W
Clinical Director of BMJ Learning, BMJ, BMA House, London, UK



Dear Sir,
Denadai and Raposo-Amaral have presented an interesting account of undergraduate plastic surgery education and the challenges associated with it.[1] They have outlined a comprehensive program to ensure that medical students get a much deeper understanding of the activities of plastic surgeons. The idea is that this should disabuse medical students of any misunderstandings that they might have regarding the role of plastic surgeons. However, it is uncertain whether their ideas will succeed. First impressions tend to last, and if young people’s first impression of plastic surgeons is that they spend much of their time doing cosmetic surgery then this is a first impression that might be long lasting and resistant to any subsequent attempts to change – even if those attempts are part of medical students’ formal undergraduate medical education.

It would surely be better if education were aimed at the general public and that it sought to educate lay people about the core role of plastic surgeons. Is such an approach possible? It is likely to be possible, albeit not completely straightforward. To succeed, this approach will require a joined up multimedia strategy that aims to change not just knowledge but also attitudes, beliefs and behaviors. Currently many newspapers and television programs cover the topic of plastic surgery as if it was exclusively concerned with cosmetic matters. Programs could be created that show the important role that plastic surgeons play in helping patients who have suffered from burns or severe road traffic accidents or other injuries or diseases that can severely affect people’s lives. Such programs would address knowledge deficits, but as importantly they would address misconceived attitudes and wrongly held beliefs. These might relate to the motivations of those people who wish to undergo plastic surgery or the motivations of surgeons who decide to specialize within this particular area of surgical practice. All too often the motivations of both of these important stakeholders has been maligned – but the simple truth is that the vast majority of patients who undergo plastic surgery do so because they need to and the vast majority of surgeons who specialize in this area do so because they wish to improve the quality-of-life of people with disfiguring conditions.

Changing public perceptions is not a quick or easy task–it will take time and co-ordinated effort. However, medical students come from the general public and form their first and most strongly held beliefs before they ever enter a medical school. If we are to change beliefs about plastic surgery, then we must tackle any problems at their source.


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