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Medical Education
Medical Student Education

Career Information: Plastic & Reconstructive Surgery

Specialty: Plastic and Reconstructive Surgery
Completed by: William Hoffman, MD
Date completed/updated: May 2014

  1. What can students do in the 1st and 2nd years to explore and/or prepare for this career?
    ​Meet with faculty - they are always receptive to students
    Shadow in the OR
    Come to journal club (3rd Tuesday evening)
    Read the plastic surgery journal or a basic textbook
  2. What common variations exist in the length/content of residency programs for this career?
    There are two paths for residency in plastic surgery:
    Integrated (categorical) - admitted from medical school to six year residency in plastic surgery, basically 2-3 years of general surgery and 3 dedicated years of plastic surgery
    Independent - three years of plastic surgery training following full training in any other surgical specialty (usually general surgery, but people have done PS after OHNS, ortho, oral surgery, ophthalmology, even neurosurgery)
  3. What common variations exist in this career after training?
    There are fellowships for additional training (all one year) in microvascular surgery, hand, craniofacial, pediatric plastic surgery and cosmetic surgery. Many plastic surgeons in different settings may do a mix of these often including cosmetic surgery but in some places there may be a focus on specific practice. After fellowship or residency, variations are the usual - academic vs. private practice, employment in a group (e.g. Kaiser) vs. self-employed.
  4. What is a typical work day for someone in this field?
    Highly variable depending on the practice - some mix of clinic visits and operating room. Many plastic surgeons in private practice have their own operating suite esp for cosmetic procedures so it is easier to mix clinic with OR on a given day. Microsurgery and complex craniofacial cases can be long days with cases that can take 8-12 hours; hand cases tend to be shorter with more volume.
  5. What is the culture of this career?
    Plastic surgery is unique in that it is a specialty devoted to a concept rather than an anatomic area; problem solving is critical for evaluating multiple surgical approaches to a problem and coming up with the best solution. This means that there is overlap with many other specialties and that frequently one is doing reconstruction with other surgeons. Therefore, the culture is one that promotes excellence and technical virtuosity, creative thinking, and cooperation with other surgical specialists.
  6. How compatible is this career with raising a family? How is this different for men and women?
    Like any career, this is what you make it. There are so many variables in practice models and career choices that is difficult to generalize. In general, a surgical career probably puts more stress on family life than with other fields, not necessarily different for men and women.
  7. What are the most important qualities or character traits for a person in this field?
    Enjoy the operating room, technical aspects of surgery
    Inquiring mind, synthetic thought process
    Good with patients
  8. How competitive are the residency programs in this field?
    Statistically, plastic surgery is one of the most competitive residency matches; there are about 2x times number of applicants to the number of positions. Plastic surgery has the highest average Step I scores of any specialty.
  9. How competitive is the job market after residency?
    It depends greatly on the geographical area - as with many specialties, the SF Bay Area is the most competitive place in the country. In other areas of the country there are plenty of opportunities for plastic surgeons who are willing to do complex reconstruction. Cosmetic surgery requires time to develop a practice and is probably more competitive in most major urban areas.
  10. What programs have been popular among UCSF applicants, or how should applicants go about considering programs?
    There are about 50 programs that are currently integrated and are taking medical students directly into categorical positions. Students from UCSF have tended to gravitate toward the programs on the West Coast - U Wash, Oregon, UCLA, USC, Loma Linda, and of course UCSF. Top-tier programs require a very strong medical school record, high USMLE scores, publications, etc.
  11. What resources (eg, websites, books, professional groups) would you recommend for students interested in learning more about this field?
    The American Council for Academic Plastic Surgery (ACAPS) has an excellent website with resources about programs:
    Basic reading - the primary journal is called Plastic and Reconstructive Surgery; a good general textbook is Grabb and Smith (2 volumes)
  12. How important is each the following for admission to a competitive program?
  Very Important Somewhat Important Not Important
Extracurricular/volunteer work   x  
Research/publications x    
Honors in third year x    
Subinternship   x  
Externship   x