Plastic Surgery Training Programs

Plastic Surgery training has been rooted in the principles of general surgery training for many decades. The traditional path to become a plastic surgeon usually meant you completed 5-7 years of general surgery, and then completed another 2-3 years of “plastic and reconstructive surgery” fellowship. That’s almost 10 years of training after your 8 years of undergrad/med school.

Most specialties, such as orthopedic, neurosurgery, etc, have moved beyond so many years of general surgery, and have abbreviated time (1 year), and the rest of the their training is in their specific field. Plastic Surgery has also moved toward this route with “Integrated” programs. These programs have typically 3 years of general surgery, and 3 years of plastic surgery, hence the term “3 and 3 program.” The vast majority of the top plastic surgery institutions at major academic centers have moved toward this model.

The advantage of these programs is that you have an earlier start and focus to plastic surgery training. In your junior years, you will also have exposure to other specialties such as ENT, Dermatology, Orthopedic, etc, making your background that much more focused and relevant. You will be in “plastic surgery” much sooner than the usual 5 years and will finish sooner. It is the future of training and the way most programs have moved toward. It is the way I trained at the University of Chicago, and I am most grateful for my program’s opportunities and forward thinking.

The disadvantage is that these programs are highly competitive. Usually there are 2 spots per medical center, and there are probably 50 programs at this time. The other disadvantage that most people don’t realize is that you have made the “early decision” to go into plastic surgery. This is often times a premature decision when you see the number of people who drop out of the programs. You might think that no one would do this, but it happens more often than you think. The reasons are many: burnout, change of heart to different specialty, dislike for general surgery, etc.

There are many changes going in plastic surgery education. The breadth of plastic surgery is great, and our time in training is limited. To gain depth in the specialty requires one to start training earlier in the field. This is the way all surgical specialties are headed.