ࡱ> SUR bjbj 4P{{ JJJJJ^^^^,^3.NNNNN)))$a vJ))JJNN222"JNJNBp2222Np$Q2.032 | 2 J2)Z@24))))))3 ))))))))) : UNIVERSITY HOSPITAL DEPARTMENT OF SURGERY SECTION OF PLASTIC SURGERY REQUEST FOR PRIVILEGES To be eligible to request clinical privileges, the following threshold criteria must be met. EDUCATION: MD or DO TRAINING: Successful completion of an approved residency/fellowship training program in Plastic Surgery. Applicant must meet the requirements for board certification outlined in the Medical Staff Bylaws. EXPERIENCE: The initial applicant must be able to demonstrate training and/or experience on a level commensurate with specialty training from an accredited plastic surgery residency/fellowship program or current competency in providing medical/surgical management and/or treatment to patients within the scope of core privileges for Plastic Surgery. Adequate documentation of this performance requires submission of a case list and a reference letter. All initial applicants at completion of residency and/or fellowship must provide an official case list and letter of recommendation assessing performance from the Residency and/or Fellowship Program Director. All initial applicants beyond 12 months of residency completion must provide a case list from the hospital where the applicant has been actively practicing for the last year and a letter of recommendation assessing performance from the hospitals Chief of Staff or Department Chair. The reappointment applicant must demonstrate continuing competence and meet requirements for C.M.E. according to the Medical Staff Bylaws. Reappointment is based upon unbiased, objective review of result of care according to the hospitals existing quality mechanisms. CORE PRIVILEGES: (This list is a sampling of privileges included in the core but is not intended to be an all-encompassing list but rather reflective of the categories/types of privileges included in the core.) REQUESTED GRANTED Admission of patientsEvaluation, diagnosis, management and treatment of all patients presenting to the plastic surgery serviceProvision of consultation, including assessment, diagnosis and ordering of diagnostic studies and proceduresSPECIFIC CORE PROCEDURES:Head and neck surgeryHand surgery and related proceduresBreast surgery (excluding radical mastectomy)Surgery of the integument and its defectsRegional node dissectionAbdominoplasty and associated procedures (body sculpturing)Tissue grafts and transfersImplantation prostheticsMicrovascular surgeryExternal genital surgeryCongenital anomaly reconstructionAcquired deformity or functional deficiency reconstructionAesthetic (cosmetic) surgeryMaxillofacial surgery including fractures Applicants requesting any other special privileges listed below must present documentation of training in each privilege requested with a letter from the training director attesting to the applicants competence and/or must meet any additional/other credentialing criteria which has been approved by the Medical Staff and the Governing Board of University Hospital. 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