> ## Content Index > Fetch the complete content index at: https://www.theplasticsfella.com/llms.txt > Use this file to discover other available public pages before exploring further. # Special Edition: Sub-Internships and Electives in Plastic Surgery - URL: https://www.theplasticsfella.com/june-8th/ - Published: 2025-06-06T20:02:19.000Z - Updated: 2025-06-08T08:10:22.000Z - Description: Also: Foundations update, the Sunday quiz, & events calendar. - Author: PlasticsFella - Tags: thePlasticsPaper #### In this week's edition 1. ****✍️** [****Letter from P'Fella**](https://www.theplasticsfella.com/june-8th/#a-letter-from-pfella) Are sub-internships education or a job interview? 2. ****🤓** [****The Sunday Quiz**](https://www.theplasticsfella.com/june-8th/#the-sunday-quiz) How well do you know TENS? 3. 🖼️ [****Image of the Week**](https://www.theplasticsfella.com/june-8th/#image-of-the-week) How to design a rotation flap. 4. ****🚑** [****Technique Tip**](https://www.theplasticsfella.com/june-8th/#technique-tip) Know your dressings. 5. 🎓 [****JPRAS Journal Club**](https://www.theplasticsfella.com/june-8th/#jpras-journal-club) How much does a sub-internship actually cost? 6. ****🎈** [****Upcoming Events**](https://www.theplasticsfella.com/june-8th/#upcoming-events) We welcome contributions from you! 7. 📘 [****Foundations Textbook**](https://www.theplasticsfella.com/june-8th/#foundations-textbook) Help us decide what’s next. 8. ****🔥** [****Articles of the Week**](https://www.theplasticsfella.com/june-8th/#articles-of-the-week) Perspectives of sub-I, influences to pursue plastic surgery, & what attendees think of students: with 1-sentence summaries. 9. 💕 [****Feedback**](https://www.theplasticsfella.com/june-8th/#feedback) Suggest ideas & give feedback! ## A Letter from P'Fella **Are Sub-Internships Education or a Job Interview?* 👋 Let’s be real. Sub-internships might look like learning experiences on paper, but in practice, they often feel more like ****auditions**. Especially in plastic surgery. We ask students, many of whom have barely seen a scalpel, to fly across the country, pay a small fortune in fees, juggle clunky admin systems, and then quietly perform under pressure while never appearing too eager. And somehow, we still call that education. It’s a system built on vibe checks, whispers, and quietly shifting expectations. **Have We Turned Electives Into Gatekeeping?** These rotations aren’t always about clinical growth. They’re often silent interviews with invisible rules. The best-prepared student tends to stand out. Not necessarily the most promising one. What did you learn on your Sub-I or elective? **Let’s Not Confuse Testing With Teaching** We’ve accepted this setup for too long. And now we act surprised when burnout begins before residency even starts. The students aren’t the problem. The system is. We’re launching a Sub-I Survival Guide to help students find their footing. **Want early access?** Drop your name, email, and location below. With love (and a gentle wink), P Fella ❤️ ps - check out this now blog post on [Sub-Is](https://www.theplasticsfella.com/10-essential-tips-to-prepare-for-your-plastic-surgery-sub-internship-sub-i/). ## The Sunday Quiz **How Well Do You Know TENS?* ****Ready to climb the leaderboard?** Join **The Weekly Quiz* in each edition of thePlasticsPaper. Tackle one question per week for seven rounds! The ****top** scorer wins a copy of our upcoming textbook, [**Foundations*](https://foundations.theplasticsfella.com/?ref=theplasticsfella.com). ## Image of the Week **How to Design a Rotation Flap* 🖼️ ****Image of the Week** This week’s image highlights the design of a ****rotation flap** for a lateral cheek squamous cell carcinoma excision. The flap is drawn with its apex positioned superior to the lateral canthus, ensuring tension redistribution and natural vector alignment. A back-cut may be added if needed to facilitate rotation and minimize dog-ear formation. This AI-generated diagram demonstrates key planning principles, ideal for those brushing up on facial flap design. ![How to Design a Rotation Flap](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2025/06/image.png) How to Design a Rotation Flap ## Technique Tip **Know Your Dressings* 🚑 ****Technique Tip of the Week** This week’s tip focuses on matching wound characteristics to the right dressing strategy. From dry eschar to exudative wounds, choosing the appropriate dressing improves healing outcomes, prevents complications, and supports tissue regeneration. This breakdown gives you a quick reference for clinical decision-making — perfect for ward rounds, on-calls, and OSCE prep. ![Know Your Dressings](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2025/06/image-1.png) Know Your Dressings ## JPRAS Journal Club **How Much Does a Sub-Internship Actually Cost?* 🎓 ****How Much Does a Sub-Internship Actually Cost?** This JPRAS Journal Club review uncovers the true financial burden of plastic surgery sub-internships, especially for international applicants. 📊 The Inequity in Numbers: \- IMGs pay 17x more than US students. \- Median cost for \~4.5 rotations: $9,114 for IMGs vs $410 for US students. \- IMGs also face 80% fewer program opportunities. It’s a wake-up call for the system, and a must-read for any student planning their path to residency. ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2025/04/How-much-does-a-sub-internship-actually-cost---Journal-Club--1-.png) ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2025/04/How-much-does-a-sub-internship-actually-cost---Journal-Club.png) ![](https://storage.ghost.io/c/a0/9f/a09fd7b4-d396-4b28-aed3-b87e20483292/content/images/2025/04/How-much-does-a-sub-internship-actually-cost---Journal-Club--2-.png) How Much Does a Sub-Internship Actually Cost? [Read the Article](https://www.theplasticsfella.com/journal-sub-internships/) ## Upcoming Events **We Welcome Contributions from You!* 📅 ****Looking for upcoming webinars, courses, or conferences?** We keep the calendar updated with events that are practical, relevant, and worth your time. If you're running something yourself, whether it's a teaching session, journal club, or surgical course, you can submit it too. We welcome contributions from the community. 👇 Check out what’s coming up, or add your own event below: ## Foundations Textbook **Help Us Decide What’s Next* 📙 With our June update, we’re getting close to finishing the chapters for [Foundations](https://foundations.theplasticsfella.com/?ref=theplasticsfella.com). As we prepare for print, we’re deciding between two formats: ****hard cover** or ****soft cover**. In your bag, on your desk, or next to you in theatre: ****Which format would you prefer?** 🗳️ Cast your vote below! ## Articles of the Week **3 Interesting Articles with One-Sentence Summaries* ✅ ****Are Plastic Surgery Sub-Is Fairly Judged?** ([Qiu](https://www.sciencedirect.com/science/article/abs/pii/S1931720420303706?ref=theplasticsfella.com), 2021) Program directors say letters matter more than actual performance, meaning who writes your recommendation may matter more than how you perform. ✅ ****What Influences Students to Pursue Plastic Surgery?** ([Glynou](https://www.jprasopen.com/article/S2352-5878%2824%2900052-4/fulltext?ref=theplasticsfella.com), 2024) Social media is the strongest influence shaping medical students’ interest in plastic surgery, more than formal teaching or personal experience. ✅ ****What Do Attendees Think of Students Interested in Plastic Surgery?** ([Oliver](https://academic.oup.com/asj/article-abstract/39/5/NP159/5373028?redirectedFrom=fulltext&ref=theplasticsfella.com), 2019) Senior surgeons view early student participation at aesthetic meetings as a sign of strong commitment and a smart career move in a competitive specialty. ## Feedback ### I hope you enjoyed it 😄 ---