The Timeline: 13 to 15 Years After High School

Becoming a plastic surgeon takes 13 to 15 years of education and training after you finish high school. That breaks down into four years of undergraduate study, four years of medical school, five to seven years of surgical residency, and often one to two additional years of fellowship training in plastic surgery specifically. The exact length depends on whether you pursue additional specialization and whether you complete your training consecutively or with breaks in between.

The path is long because plastic surgery is a surgical specialty that requires mastery of general surgery first. You cannot enter plastic surgery training directly from medical school. Instead, you complete a general surgery residency, then explore for a plastic surgery fellowship. This structure means your timeline includes two separate residency programs rather than one.

Key Takeaways

  • Medical school takes four years, and you must complete it before any surgical training begins.
  • General surgery residency lasts five to seven years and is required before you can enter plastic surgery fellowship.
  • Plastic surgery fellowship adds one to two additional years of specialized training after general surgery.
  • Board certification through the American Board of Plastic Surgery requires passing written and oral exams after fellowship completion.
  • Some surgeons pursue additional fellowships in subspecialties like hand surgery or microsurgery, which extends the timeline by one to two more years.

Undergraduate Degree and Medical School Prerequisites

Your first four years are spent completing an undergraduate degree. Medical schools do not require a specific major, but you must complete prerequisite courses in biology, chemistry, organic chemistry, physics, and biochemistry. Many students major in biology or chemistry, though some choose other fields and take prerequisites alongside their major coursework.

After your undergraduate degree, you explore to medical school. The process process itself takes several months, and medical school admission is competitive. Once admitted, medical school lasts four years. During these four years, you take classroom courses in your first and second years, then begin clinical rotations in your third and fourth years. By the end of medical school, you will have rotated through general surgery, which helps you decide whether surgical specialties interest you.

General Surgery Residency: The Required Foundation

After medical school, you enter a general surgery residency program. This is not optional for plastic surgeons — it is a requirement set by the American Board of Plastic Surgery. General surgery residency lasts five to seven years depending on the program. During this time, you work as a resident surgeon, performing operations under supervision and gradually taking on more responsibility.

The length of general surgery residency varies. Most programs are five years, but some are six or seven years. A few programs offer integrated plastic surgery tracks where you spend part of your general surgery years focused on plastic surgery cases, though you still complete the full general surgery training. The intensity is high: residents typically work long hours, including overnight calls, and spend most of their time in the operating room or on the surgical floor.

Toward the end of your general surgery residency, usually in your fourth or fifth year, you explore for plastic surgery fellowship positions. This is a separate competitive process. You interview at programs across the country and rank your preferences, then programs rank candidates and match you to a position.

Plastic Surgery Fellowship: The Specialty Training

Plastic surgery fellowship is where you specialize in cosmetic and reconstructive procedures. Most fellowships last one year, though some are two years. A one-year fellowship is the standard, but a two-year fellowship gives you more time to develop informed and may be preferred if you want to focus on complex reconstruction or microsurgery.

During fellowship, you work primarily in plastic surgery cases. You perform procedures like breast reconstruction, hand surgery, facial reconstruction, and cosmetic surgery under the guidance of experienced plastic surgeons. You also rotate through related specialties like otolaryngology (ear, nose, and throat surgery) or orthopedic surgery to understand how those fields intersect with plastic surgery.

After completing your plastic surgery fellowship, you are may be able to access to take the board certification exams through the American Board of Plastic Surgery. These include a written exam and an oral exam. Passing both certifies you as a board-certified plastic surgeon.

Additional Subspecialty Fellowships

Some plastic surgeons pursue additional fellowship training in a subspecialty after completing their plastic surgery fellowship. Common subspecialties include hand surgery, microsurgery, craniofacial surgery, and aesthetic surgery. These additional fellowships typically last one to two years.

Hand surgery fellowship is one of the most common choices. It focuses on surgical repair of injuries and conditions affecting the hand, wrist, and forearm. Microsurgery fellowship trains you in techniques using an operating microscope to repair small blood vessels and nerves, which is essential for complex reconstruction and replantation of severed fingers or limbs. Craniofacial surgery focuses on birth defects and injuries affecting the face and skull.

Pursuing a subspecialty fellowship extends your total training time by one to two years but makes you more competitive for certain types of positions and may allow you to charge higher fees for specialized procedures.

Timeline Variations and Breaks in Training

The 13 to 15 year estimate assumes you move directly from one training level to the next without interruption. In reality, many surgeons take breaks. Some take a year off between medical school and residency. Others take research years during residency, which extends the residency timeline but does not count as clinical training time. A research year means you spend 12 months conducting research instead of performing surgery, so your residency takes six or seven years instead of five.

If you take a year off for any reason — whether for family, research, or personal circumstances — add that year to your timeline. Similarly, if you pursue a two-year plastic surgery fellowship instead of one year, add that extra year. If you then pursue a subspecialty fellowship, add another one to two years.

Licensing and Board Certification Requirements

Throughout your training, you must pass licensing exams to practice medicine. After medical school, you take the United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX), depending on whether you attended an allopathic or osteopathic medical school. You typically take these exams during medical school or when ready after.

After completing your plastic surgery fellowship, you become may be able to access for board certification through the American Board of Plastic Surgery. The written exam covers the breadth of plastic surgery knowledge. The oral exam, taken after you pass the written exam, involves presenting cases and discussing your surgical decision-making with examiners. You must have completed your fellowship and be licensed to practice medicine before taking these exams.

Board certification is not legally required to practice plastic surgery, but it is expected by most hospitals and insurance companies. Patients also often look for board certification as a marker of training and competence.

Frequently Asked Questions

Can you become a plastic surgeon in less than 13 years?

No. The minimum is four years of medical school plus five years of general surgery residency plus one year of plastic surgery fellowship, which equals ten years. However, most general surgery residencies are five to seven years, and most plastic surgeons complete additional training, bringing the realistic minimum to 12 to 13 years. Some surgeons also take research years or pursue additional fellowships, extending the timeline further.

Do you have to do general surgery residency before plastic surgery?

Yes. The American Board of Plastic Surgery requires that you complete an accredited general surgery residency before entering a plastic surgery fellowship. This is a formal requirement, not a suggestion. A few integrated programs allow you to spend part of your general surgery years focused on plastic surgery, but you still complete the full general surgery training.

What is the difference between a one-year and two-year plastic surgery fellowship?

A one-year fellowship is the standard and allows you to specialize in plastic surgery after general surgery. A two-year fellowship gives you more time to develop informed in complex cases, research, and subspecialties. Two-year fellowships are often preferred for surgeons interested in microsurgery or craniofacial reconstruction, where additional training time is valuable.

Do you need a subspecialty fellowship to practice plastic surgery?

No. After completing your plastic surgery fellowship and passing board certification exams, you can practice as a plastic surgeon without additional fellowship training. A subspecialty fellowship is optional and is pursued by surgeons who want to focus on a specific area like hand surgery or microsurgery.

How much does it cost to become a plastic surgeon?

Medical school tuition varies widely depending on whether you attend a public or private school and whether you receive scholarships. Public medical schools typically cost between $30,000 and $60,000 per year, while private schools often cost $60,000 to $90,000 per year. Many students graduate with significant debt. Residency and fellowship positions are paid positions, so you earn income during those years, though the salary is lower than what you would earn as a practicing surgeon.