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conditions requiring plastic surgery (i.e., conditions largely related to appearance), we concluded that the patient needs validated suffering according to the healthcare system. This validation is required for both functional and non-functional conditions. Functional conditions were validated by distinguishing between statistically normal and abnormal functions. Similarly, for non-functional conditions, we determined statistical normality as a potentional validation concept for distinguishing between what should and should not be publicly funded. However, we acknowledge that such a concept needs further development. Abbreviations CLP: Cleft lip and palate; ICF: The International Classification of Functioning, Disabilities and Health; HIV: Human Immunodeficiency Virus; QoL: Quality of life Acknowledgements We are grateful for the constructive comments from five different reviewers that have helped us improve the manuscript. Authors’ contributions LS and EH conceived, designed and performed the analysis and wrote the paper. Both authors approved the final version of the manuscript. Funding None. Open Access funding provided by Linköping University Library. Availability of data and materials Not applicable. Ethics approval and consent to participate Not applicable. Cases are hypothetical. Consent for publication Not applicable. Cases are hypothetical. Competing interests The authors declare that they have no competing interests. Author details 1 National Centre for Priorities in Health, Department of Health, Medicine and Caring Sciences, Linköping University, S-581 83 Linköping, Sweden. 2 Västra Götaland Region, Sweden. 3 Borås University, Borås, Sweden. 4 Department of Plastic and Reconstructive Surgery, Sahlgrenska University Hospital, Gröna Stråket 8, SE-413 45 Gothenburg, Gröna Stråket 8, SE-413 45 Gothenburg, Sweden. 5 The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden. Received: 29 October 2019 Accepted: 23 September 2020 References 1. Franken M, le Polain M, Cleemput I, Koopmanschap M. Similarities and differences between five European drug reimbursement systems. Int J Technol Assess Health Care. 2012;28(4):349–57. https://doi.org/10.1017/ S0266462312000530. 2. Action on plastic surgery. A strategic approach to the delivery of the NHS plastic, reconstructive and ae The term "plastic" is derived from the Greek word "plastikos" which means moulding or giving form. It is the additional responsibility of the plastic surgeon to employ techniques designed to minimize damage to healthy tissue and to facilitate the healing of injured tissue. The plastic surgeon should be dedicated to enhancing the quality of life of the patient by improving bodily function and appearance which is abnormal due to birth defects, trauma or infection, or by correcting body features displeasing to the patient and thus improving the patient's self-esteem. Upon completion of training, a resident is expected to be a competent specialist in Plastic Surgery, capable of assuming a consultant’s role in the specialty. The resident must acquire a working knowledge of the theoretical basis of the specialty, including its foundations in the basic medical sciences and research. The residents must obtain the competencies expected of a specialist in Plastic Surgery. These include Medical Expert, Communicator, Collaborator, Manager, Health Advocate, Scholar, and Professional. Residents must demonstrate the requisite knowledge, skills, and attitudes for effective patient-centered care and service to a diverse population. In all aspects of specialist practice, the graduate must be able to address issues of gender, sexual orientation, age, culture, ethnicity and ethics in a professional manner. 1.2 General Objectives The program intends to train a Plastic Surgeon for future unsupervised practice who is capable of providing for the total care of the patients referred, in either elective or emergency circumstances. In addition to technical skills, we expect the future plastic surgeon to be a medical expert and demonstrate diagnostic and therapeutic skills for ethical and effective patient-care, access and apply relevant information to clinical practice, demonstrate effective consultation services with respect to patient-care, education and legal opinions. On completion of the training program, each resident will demonstrate: Knowledge A comprehensive knowledge of: 1. The histology, physiology and biochemistry of the skin and adnexae as well as muscles, tendons, ligaments, bones, blood vessels, lymphatics and nerves; 2. Wound healing, normal and abnormal; 3. The pathophysiology of all aspects of thermal injury; 4. The principles of immunology as they relate primarily to tissue transplantation; 5. The genetics, embryology, anatomy and pathophysiology of congenital deformities commonly managed by plastic surgeons; Overview Revised February 2016 6. Sepsis as it especially applies to operative care; 7. The pharmacology, including the principles of metabolism, action and toxicity, of drugs commonly used in the specialty; 8. The pathology and treatment of neoplasia of the skin and soft tissues; 9. Medical-legal, ethical and psychological aspects of plastic surgery. Clinical Skills The capability of independent patient care in all facets of plastic surgery including the investigation, diagnosis and management of disease. This would include
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