The Plastic Surgery In-Service Examination: A Scoping Review

Introduction: The Plastic Surgery In-Service Examination (PSITE) is a valuable assessment modality for programs and trainees. Obtaining objective metrics and measuring performance longitudinally is how programs leverage the PSITE. This study aims to synthesize the current body of literature on the PSITE and provide recommendations for future investigations. Methods: A scoping review of the literature was performed for the PSITE, including articles up to December 2025, using PubMed, Embase, Google Scholar, and web scraping of popular plastic surgery journals. Data were extracted on journal, article type, study focus, purpose, years of PSITE utilized, findings, reference analysis, recommended preparatory resources, and methodology to isolate themes and perspectives from past studies. Results: A total of 45 studies were included, with 34 (76%) being original articles. Content focused on general plastic surgery education in 22 (49%) articles and hand surgery in 5 (11%) articles, followed by cosmetic and breast each covered by 2 (4%) articles. Chatbot performance was evaluated in 5 (11%) articles. Reference analysis was performed in 11 (24%) studies, with a mean lag time of ∼7 years. Conclusions: The PSITE is an important objective marker and assessment modality for programs and trainees but remains understudied. Contributions to the literature take the form of citation analysis, question quality assessment, and examination of subspeciality representation. There remains a need for studies that determine PSITE alignment with knowledge needed in practice, and how test preparation aligns with resident clinical and didactic experiences. Future studies examining these themes will determine if the PSITE could be improved to better align with the knowledge needed for success in plastic surgery.