The training pathway

Plastic surgery remains a very popular career choice amongst newly qualified doctors, and progression through each stage of training is via a competitive national selection process.

Time to complete the training programme following 5-6 years at Medical School includes 2 years in the Foundation Programme, 2 years in Core Surgical Training, and 6 years in Specialty Training, totalling 10 years as a minimum following graduation. Trainees may also choose to take additional time between these stages of training to gain more experience and strengthen their application for the next stage. The period of training may also be lengthened by working part-time or undertaking a higher degree. Trainees may choose to complete a fellowship towards the end of their training prior to applying for Consultant posts.


Foundation programme years 1 & 2 (FY1 & FY2)

 

After finishing medical school, trainees will spend two years in a foundation programme to gain experience in a variety of specialties and healthcare settings including surgery, medicine, and General Practice. By the time this is completed, trainees will have acquired full registration with the General Medical Council and can then apply for Core Surgical Training.

There are very few Foundation Programme jobs in the UK that include Plastic Surgery but completing a foundation year job in Plastic Surgery is not required to apply for specialty training in the future. 


Core surgical training years- 1 & 2 (CT1 & CT2)

 

Entry to Core Surgical Training is by a competitive national selection process using a combination of portfolio assessment and interview. Successful applicants rotate through 2 years of jobs lasting 4-6 months in a variety of surgical specialties. Candidates must have passed the MRCS exam by the end of Core Surgical Training and achieved basic surgical competencies in preparation for Specialty Training applications.

Some regions offer ‘themed’ Core Surgical Training Programmes during which trainees spend 12-18 months in their ‘themed’ specialty. This results in experience in a fewer number of surgical specialties, but a longer experience in the specialty for which the trainee intends on pursuing. 

Towards the end of CT2 candidates will apply for Specialty Training in a specialty of their choosing. The selection process for plastic surgery is held once per year and is one of the most competitive. Successful candidates must have spent a minimum of 6 months in plastic surgery posts. Selection is via an interview process that includes assessment of clinical experience and skills, communication skills, presentation skills, and the portfolio.

Candidates preferentially rank the regions in which they wish to work, and jobs are allocated according to interview score. 

Specialty training year 3-8 (ST3-8)

 

Successful candidates will undertake a further 6 years of specialty training exclusively in Plastic Surgery. Trainees are required to complete the Intercollegiate Specialty FRCS (Plast) examination prior to gaining their Certificate of Completion of Training (CCT).

To acquire a CCT in the specialty of Plastic Surgery, trainees must meet all of the requirements of the broad syllabus, to the level required of a surgeon working independently as a consultant in the NHS.

Specialty training is divided into:

  • Intermediate (ST3-6)
  • Final (ST7-8)

During the intermediate stage, trainees are expected to acquire the body of knowledge and skills that are expected of all plastic surgeons. The final years are used to develop more advanced skills and develop a sub-specialist interest.

Increasingly, senior trainees are undertaking training in an area of special interest that crosses specialty boundaries, and these are known as Training Interface Group (TIG) Fellowships, during their ST7 or ST8 year.

At the time of writing, TIG fellowships are available in:

  • Cleft lip & palate surgery
  • Hand surgery
  • Head and neck surgical oncology
  • Oncoplastic breast surgery
  • Major trauma
  • Reconstructive and aesthetic surgery
  • Skin Oncology
  • Therapeutic Use of Lasers

Upon gaining the CCT, doctors are then eligible to be placed on the GMC specialist register and apply for consultant posts.

Post-CCT

 

After completing training, many trainees choose to complete a fellowship prior to taking up Consultant posts. These are usually in an area of special interest and may be in the UK or abroad.

Areas of special interest associated with the specialty of plastic surgery include:

  • Academic plastic surgery
  • Aesthetic surgery
  • Burns
  • Cleft lip and palate surgery
  • Complex wound
  • Craniofacial surgery
  • Ear reconstruction
  • Genitourinary reconstruction
  • Head and neck surgical oncology
  • Hand and upper limb surgery
  • Lower limb trauma
  • Oncoplastic breast surgery
  • Pelvic reconstruction
  • Skin and soft tissue tumour surgery (including sarcoma)
  • Vascular anomalies



Academic career pathways

 

Information on academic career pathways in plastic surgery can be found in the research section of the website by following Professionals – Research – Academic Careers.