This program enhances residency training in aesthetic surgery. It prov
ides hands-on operating experience in a supervised hospital setting. C
oncerns of financial support and liability are addressed. Four chief r
esidents from two university programs each spend 3 months conducting a
''private'' practice in a service population. A separate resident ope
rative consent form unambiguously specifies the resident as the operat
ing surgeon. Patients are derived from an advertised, free screening c
linic every 3 months. The hospital has a special aesthetic surgical fe
e schedule for the residents. A resident operative fee is collected in
support of resident salaries and insurance. An additional fee is coll
ected an behalf of our anesthesiologists. During their 3 months the re
sidents perform 30 to 40 operations as primary surgeon and 50 to 60 as
the first assistant. Patient discontent, though rare, is resolved in
conference with the patient, the resident, the attending surgeon, and
the chief of section. Didactic training consists of monthly surgical c
onferences, journal club, and guest speaker presentations. Residents e
xperience a practice setting by overseeing appointments to their clini
c, booking operating roam cases, and providing ail paperwork for pread
mission testing and certification, as well as fulfilling utilization a
nd quality assurance requirements. They are responsible for their oper
ative patients 24 hours a day, 7 days a week. The program is in its se
venth year and its success is noted by continued full certification of
the two participating university programs and absence of litigation.