Gaps in Nutrition and Exercise Counseling Preparedness among Plastic Surgery Trainees: A Nationwide Exploratory Survey Study

Background: Evidence-based nutrition and physical activity influence perioperative optimization and surgical outcomes, yet formal training in these domains during plastic surgery residency remains unclear. This study surveyed US plastic surgery residents to assess their self-reported knowledge, counseling confidence, and curricular preparation. Methods: A 28-item REDCap survey was distributed to residents in the Northeastern, Southeastern, and Midwestern plastic surgery societies (September 2024–February 2025). Questions covered training level, self-rated counseling skill, 17 knowledge domains, and 4 preparation Likert scales. Categorical variables were reported as counts/percentages, and ordinal skill and curriculum preparation scores were numerically coded and reported as mean ± SD. Two-sample t tests compared integrated versus independent tracks and junior (postgraduate year [PGY] 1–3) versus senior (PGY ≥ 4) residents (α = 0.05). Results: Fifty-two residents responded (12% rate); 75% were in integrated programs and 73.1 % were senior (PGY 4+). Most felt comfortable with weight management counseling, but knowledge was lowest for counseling special populations (children, pregnancy, older adults). Counseling skills were largely “competent,” with 25 % (nutrition) and 31 % (physical activity) reporting “advanced” competence. Preparation scores were neutral (~3/5) and less than10% strongly endorsed curricular adequacy. Skill scores trended higher for seniors and integrated residents, but only the nutrition skill difference between senior and junior residents reached statistical significance ( P < 0.05). Conclusions: Plastic surgery residents report moderate self-perceived preparedness and confidence in nutrition and physical activity counseling, with opportunities for enhanced curricular support. These findings highlighted the potential value of structured education to support comprehensive perioperative patient care.