The Evolving Role of Artificial Intelligence in Plastic Surgery Education: Insights From Program Directors and Residents.

[OBJECTIVE] To assess the current state of artificial intelligence (AI) policies, educational resources, and perceptions within U.S. plastic surgery residency programs from the perspectives of program directors (PDs) and residents.

[DESIGN] Cross-sectional study using 2 anonymized surveys to evaluate AI-related policies, current use, educational tools, perceived barriers, and attitudes toward AI use in surgical education and residency applications.

[SETTING] Plastic surgery residency programs across the United States PARTICIPANTS: Program directors (n = 77) were invited via email, with 24 (31%) responding. Residents (n = 89) were recruited via social media; 1 resident per program was randomly selected to ensure institutional diversity, with 23 (26%) completing the survey.

[RESULTS] Institutional adoption of AI was limited. Only 8% of PDs reported screening residency applications for AI-generated content, and 88% indicated their programs had no formal policies on AI use. AI-based educational tools were available in 13% of programs, 21% offered AI ethics training, and 8% reported using AI to assess surgical skill. Barriers included lack of expertise (65%), data privacy concerns (52%), cost (48%), and limited evidence of efficacy (48%). In contrast, residents reported substantial independent AI use (50%). Residents used platforms such as ChatGPT (50%), Google Gemini, Microsoft Copilot, and Claude (each 9%)-often to generate clinical explanations (43%), procedural guides (17%), and differential diagnoses (13%). One resident also reported undergoing AI-based surgical skill assessment. Despite this engagement, 74% stated their programs lacked AI-related educational resources. Residents expressed moderate trust in AI (mean 5.26/10), stating it "probably" or "definitely" has a place in their education (86%).

[CONCLUSIONS] A marked discrepancy exists between institutional policies and resident usage of AI in plastic surgery education. As residents adopt these tools independently, there is an urgent need for evidence-based guidelines, validated resources, and structured implementation to ensure safe, effective integration into surgical training.