Know your personality when choosing a career in surgery

I knew the moment that I wanted to become a doctor, I also wanted to be a surgeon. This was not because I thought it was "cool or fun," or that I like played the game "operation" when I was a kid, but because I knew that my personality and values matched this profession: I liked working with my hands, the idea of "healing patients with my hands," and requiring technical precision to produce results. I was impatient, and wanted to see the results of my work immediately, not months or years later. I knew the moment that I tied my first knot around a blood vessel, cut out a cancer on the body, and fixed a broken bone, that this was the greatest profession in the world. Every time I stepped foot in the operating room, there was a reaffirming moment or experience that made me certain that surgery was the right field for me.

Understanding your own personality and values will go a long way in determining your fit and longevity in plastic surgery. Surgical training is long and gruelling (between 6-10 years), and plastic surgery training is not a "walk in the park." If you think that the years of training in plastic surgery will be centered around "boob jobs and liposuction," you will be sorely disappointed. Try thinking of days in the burn intensive care unit managing the sickest of patients, 100 degree operating rooms reconstructing a burned child, 10 hour operations reconstructing a mangled face or limb, being wallowed up by the odor of a necrotizing infection, then going home to prepare a power point lecture on a topic you know little about, and giving that lecture to your peers and attendings who will criticize your work--then getting up at 5am to round on your patients to start the cycle all over.

I have seen many in surgery who quit in the middle of training because the surgical lifestyle does not fit their life. When you choose the road to become a surgeon, you need to know your personality, values, and motivators. If you cannot love the operating room like you love your own home, then you need to think twice about embarking on this journey. For those who can, there is an infinitely bright future in this field for you.

Education

Here on the basics in terms of education in becoming a board certified plastic surgeon:

4 years of undergraduate education with a bachelors degree in science or the arts-- this includes the basic premed requirements. The premed requirements usually requires biology, physics, calculus, etc. It is important to see what the medical school requires for the prerequisite education to enter medical school.

4 years of medical school. The first two years will be in the basic sciences and pathophysiology. The last two years are clinical, requiring the student to observe and start taking part in patient care. Usually in the third year, the student decides on his or her specialty. It is at this time, that it is important to obtain preceptorships and mentor ships with specific physicians in the field of plastic surgery. By the end of the third year and in the beginning of fourth-year applications will be due for plastic surgery residency positions.

6 years of plastic and reconstructive surgery training. There are between 40 to 60 positions in plastic surgery training every year. This is for the "combined or integrated program," where a medical student will enter into a training program with the end goal of becoming a trained plastic surgeon. This is considered a newer or more modern pathway for training. The classic pathway required formal training in general surgery (5 years), then applying again during general surgery residency for a fellowship in plastic and reconstructive surgery. (2-3 years) During training, the first year is considered the internship year where one rotates through multiple core surgical rotations such as vascular surgery, general surgery, transplant surgery etc. In the second and third years, there is increased responsibility and expectation of the resident to take on more patient care and increased operating exposure. Usually in the final three years, the resident will begin working directly with their attending plastic surgeons to learn specifically the operations and thought process. Near the final year in plastic surgery training, one may apply for further training in fellowships in hand and microsurgery, craniofacial surgery, and cosmetic surgery.

Board certification: there is only one true board certification in plastic surgery, The American Board of Plastic Surgery (ABPS). It is the only certfication in plastic surgery that is recognized by the American Board of Medical Specialties (ABMS). There are many copycats, and pseudo boards where nonsurgeons and non-plastic surgeons try to credential themselves with pseudo titles to be able to use the terms plastic or cosmetic surgeon. The certification process is extremely difficult, and has the highest failure rate of any certificate in medicine and surgery. This grueling examination requires six to nine months of preparation with a written examination and oral examination. Once this process is complete, one is able to state that they are a "Board Certified Plastic Surgeon."

Choosing Medicine First

Choosing a path toward surgery first requires the choice to go to Medical School. That decision can be made throughout your undergraduate and post graduate years. The vast majority of us were "PreMeds" in undergraduate, taking the requisite courses to apply to medical school. Most of us were Science majors (biology, biochemistry, etc); I chose the Humanities, as a philosophy major and a biology minor. I studied hard to keep up a high GPA and often wondered if I had made a good choice while my friends were "partying" on the weekends. The road to surgery is gruelling, and requires steadfast commitment to academic achievement. Once you've made your choice, you go all the way--"half of the way" won't get you there.

What is Plastic Surgery?

The ultimate goal of Plastic Surgery is the creation of form and function in the pursuit of aesthetic ideals. Accomplishing this requires the technical skills, the vision, and understanding of the individual needs of the patient combined with compassion and a relentless pursuit of perfection.

Plastic Surgery has gone through many changes since its inception as a specialty; however, its foundations have not changed in its principled and rigorous approach to wound healing, understanding of 3-dimensional anatomy, and problem solving. Plastic Surgery is a fusion of these fundamentals with an eye for the "aesthetic." It is the fusion of Form & Function and the fusion of Science and Art that sets our specialty apart. Plastic Surgery is more than "skin deep." It starts from the skeleton to the skin and keeps in mind movement and sensation. Plastic Surgery is the specialty that allows us to rebuild and rejuvenate the human body from the ground up with safe techniques and lasting results.