The Making of a Surgeon
Decades ago, virtually all cosmetic surgery was performed by plastic surgeons who trained for years to do specifically that... plastic surgery. Today, in the state of Arizona, any MD or DO can perform plastic surgery with little to no structured surgical training. Indeed, an alarming number of cosmetic "surgeons" aren't even surgeons as defined by the American College of surgeons training standards. Some simply read how to do cosmetic surgery from a book. Others receive limited study (or worse, a week-end course!) from other non-plastic surgeons and then... begin practice. And the results can be disastrous.
In times of an unstable economy and with the uncertainty of healthcare, vast numbers of physicians are retiring or are leaving their field of training to seek more cash-based and non-insurance work. Many have gone into weight loss clinics, hair loss clinics, laser clinics, Botox clinics, hormone and steroid clinics or other forms of alternative or non-traditional medicine. And of course, cosmetic plastic surgery.
An added contributing factor to all this is the long and arduous journey it takes to become a board-certified plastic surgeon.
Following graduation from medical school, basic requirements involve several years (3-5) of preliminary surgical training, most commonly in the field of general surgery. These are the years of treating surgical illness, emergencies and at times, life-threatening trauma. Rotations are done on other surgical subspecialties and it is during these first few years that valuable experience is obtained with an emphasis on patient safety, critical care and recovery. The transition is then made to a more focused Plastic Surgery curriculum and over the next three years, all aspects of the specialty are learned, from pediatric birth defects, cancer reconstruction, cosmetic surgery, hand surgery, burn surgery, microsurgery, head and neck surgery, extremity reconstruction from newborns to the elderly... and are taught with mentors overseeing procedures and results. Daily feedback is given to optimize outcomes and decrease the frequency and severity of complications.
The overall training after completing medical school takes six to seven years depending on sub-specialization. But wait... there's more! Following the completion of this surgical training, there is a written test that must be passed and if successful, a two-day oral exam in which specific cases and outcomes of the candidate surgeon are reviewed as well as a "flashcard" picture session with multiple pathologies being presented in rapid succession. Then and only then, can you become board certified in plastic surgery.
And even after all that, members are tested every ten years to maintain their certification.