Plastic surgery is a medical specialty with two educational paths, instead of the single path common to most surgical specialties. After completing college and medical school, or completing college, medical school and part of a surgical residency, you can choose an integrated or independent pathway. Both programs are extremely competitive. For example, fewer than half of the doctors who applied to integrated programs in 2011 were accepted, according to a February 2013 article in “Plastic and Reconstructive Surgery.”

College and Medical School

As physicians, all plastic surgeons must complete college and medical school. Medical schools require a bachelor’s degree for admittance; any major is acceptable as long candidates meet prerequisites, such as biology, chemistry, math and English. Candidates also must pass the Medical College Admissions Test, or MCAT, to enter med school. In addition, aspiring doctors must submit copies of their transcripts and letters of recommendation, and must typically complete an interview with the school admissions committee. The U.S. Bureau of Labor Statistics notes that in addition to academic achievements, most medical schools consider leadership qualities and personality in the evaluation process.

Integrated Residency

The integrated pathway is the traditional residency program for plastic surgery. Residents complete five or six years of training in an accredited plastic surgery program. The training includes both general surgery and plastic surgery procedures, but no fewer than two years of the training must be in plastic surgery, according to the American College of Surgery. Plastic surgeons must also spend at least one year as the chief resident in the plastic surgery clinical service, and the ACS notes that the last two years of their training must take place in the same institution.

Independent Residency

The independent method of plastic surgery residency training is for doctors who begin their surgical training in another field and change to plastic surgery after completing part of a residency program. An independent training program lasts two or three years, according to the ACS. Physicians who have completed college and medical school and at least three years of a residency in general surgery, neurological surgery, orthopedic surgery, oral and maxillofacial surgery, otolaryngology or urology are eligible to enter an independent program, according to "Plastic and Reconstructive Surgery.” The three-year requirement ensures that the student has sufficient general surgical experience before beginning plastic surgery training. Independent programs also require at least one year of chief or senior resident experience in plastic surgery.

Fellowship Training, Licensing and Certification

Some plastic surgeons go on for an additional one to two years of training in a fellowship, such as burn surgery or reconstructive microsurgery. Once training is complete, the plastic surgeon must become licensed in her specialty. All states require plastic surgeons to be licensed. The candidate must have graduated from an accredited medical school, completed residency training, and pass both written and practical exams to become licensed. Certification is not required for practice, but most plastic surgeons seek board certification to bolster their credentials.

Physicians and Surgeons salary

• Median Annual Salary: $208,000 or more ($100/hour)