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There are many possibilities when it comes to choosing your medical specialization and there's a lot to consider. This “Choosing Your Medical Specialty" series can help you learn more about each specialty and explore which one best matches your values, interests and abilities.

When you think about plastic and reconstructive surgery, what comes to mind? Cosmetic procedures? Reconstruction after an accident? It’s all that and more.

“Plastic and reconstructive surgery covers multiple anatomic areas, organ systems, and patients of all ages as well as simple to extremely complex procedures,” says Dr. Carolyn Levis, Service Chief for Plastic Surgery at St. Joseph’s Healthcare in Hamilton, Ontario, and president of the Canadian Society of Plastic Surgeons.

While you might be imagining working in a private clinic performing surgeries for aesthetic (cosmetic) reasons, most plastic and reconstructive surgery is focused on medical needs.

“The best fit is someone enthusiastic about surgery in general, not just plastic surgery,” says Dr. Levis. “One should have a creative and inquisitive mind and strong technique.”

If you’re considering a career in plastic and reconstructive surgery, here are some things to consider.

What do plastic and reconstructive surgeons do all day?

Plastic Surgeons perform reconstructive surgery including breast reconstruction, reductions, restoring tissues after accidents and repairing facial deformities such as a cleft lip. Hand surgery is a major part of plastic surgery care which includes injuries caused by trauma or conditions like carpal tunnel syndrome. Some plastic surgeons also perform aesthetic procedures, like breast augmentation, facial surgery or liposuction.

“Each day is different,” says Dr. Levis.

As a plastic surgeon, you could work in a community or an academic centre. You could have a hospital-based practice or work in a private clinic.

“Other than a select few with only private, aesthetic surgery practices, all plastic surgeons work in hospitals to some degree,” says Dr. Levis. A typical week might include:

  • Clinic days: Consultations for elective and urgent assessments as well as follow-up care after injury or surgery.
  • Minor surgery: A day or more in the operating room performing minor procedures where patients are awake and local anesthesia is used. Examples of surgeries include skin cancers, hand procedures, and minor aesthetic surgery.
  • Major surgery: At least one day in the main operating room performing more complex surgery. These surgeries often involve collaboration with surgeons from other disciplines who require the expertise of a plastic surgeon for reconstruction after the primary surgery.
  • Other duties: Administrative and management duties, and potentially educational and research office hours

What are the greatest challenges of being a plastic surgeon?

“Some of the biggest challenges are also the greatest strengths and most interesting aspects of the specialty,” says Dr. Levis.

One challenge is the sheer technical skill involved in complex surgeries. “We are routinely confronted with devastating injuries or post-cancer surgery defects that require complex and multi-staged reconstructions. Working through a strategy to optimize the best functional and aesthetic outcome can be extremely challenging,” says Dr. Levis.

This is also what makes the profession rewarding, as a plastic surgeon’s work can have a huge impact on the quality of life of patients. “Restoring form and function to patients who have suffered devastating injuries, loss from cancer or congenital anomalies is highly rewarding,” says Dr. Levis.

What should students interested in reconstructive and plastic surgery consider?

Plastic surgery is a competitive specialty. At her institution, Dr. Levis says they receive 70 applications per year for two available training positions and says this is similar across the country.

“I recommend that students request at least one elective, ideally in more than one training centre in the first half of medical school if they have an interest [in plastic surgery]” she says.

During that elective, you should spend as much time with a plastic surgeon as well as trainees. Students should also, “arrive early for rounds, attend all clinical and educational activities and stay for after-hours cases to really learn what the specialty involves as well as what the training and lifestyle are like for surgeons,” says Dr. Levis.

What are the opportunities like in plastic and reconstructive surgery?

There is a good job market for plastic and reconstructive surgeons after residency and fellowship training, says Dr. Levis. Job prospects for plastic surgeons are good but competitive according to the 2021 CaRMS Forum.

If you’re interested in complex and rewarding surgeries, plastic and reconstructive surgery might be an exciting option for you to consider.

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