Becoming a surgeon is a lengthy and rigorous path, requiring extensive educational commitment and personal dedication. The journey is structured and sequential, with each stage building upon the last. This process transforms a student into a physician and, finally, into a specialist entrusted with performing complex procedures.
Earn a Bachelor’s Degree
The first step toward a surgical career is earning a four-year bachelor’s degree. While no specific “pre-med” major is required, medical schools expect applicants to complete a series of prerequisite courses. This coursework includes a year of biology, two years of chemistry (general, organic, and biochemistry), and a year of physics, all with laboratory components. Many programs also require competency in mathematics, like calculus and statistics, and writing-intensive courses.
Beyond the curriculum, undergraduate years are for building a competitive profile. A high Grade Point Average (GPA), particularly in science courses, is a primary screening tool for admissions. This academic performance must be paired with a strong score on the Medical College Admission Test (MCAT), a standardized exam that assesses problem-solving, critical thinking, and scientific knowledge.
Extracurricular activities are another component of a strong application. This includes gaining clinical experience through hospital volunteering or shadowing physicians. Involvement in scientific research demonstrates a commitment to the foundations of medicine. These experiences, supported by strong letters of recommendation, showcase the maturity and motivation necessary for a medical career.
Complete Medical School
Following a bachelor’s degree, the next step is a four-year medical school program, culminating in either a Doctor of Medicine (MD) or a Doctor of Osteopathic Medicine (DO) degree. Both degrees qualify graduates to practice medicine in the United States. MD programs follow an allopathic approach focused on diagnosing and treating diseases, while DO programs take a holistic, osteopathic approach, providing additional training in hands-on musculoskeletal manipulation.
The medical school curriculum is divided into two phases. The first two years are classroom-based, focused on foundational sciences like anatomy, physiology, and pharmacology. The final two years consist of clinical rotations, where students gain hands-on experience in various medical specialties, including internal medicine, pediatrics, and surgery. It is during these rotations that students can solidify their interest in a specific field.
Students must pass a series of national licensing examinations during medical school. MD students take the United States Medical Licensing Examination (USMLE), while DO students take the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA). The first part of these exams is taken after the second year, and the second part is taken during the fourth year, evaluating clinical knowledge. Success on these exams is necessary for licensure and for securing a residency position.
Undergo Surgical Residency
After medical school, completing a residency program is what makes a doctor a surgeon. This period of graduate medical education is dedicated to intensive, hands-on training. For aspiring surgeons, this begins with a general surgery residency, which lasts a minimum of five years. Other surgical residencies, such as neurosurgery or orthopedic surgery, can be longer.
Securing a position in a surgical residency is a competitive process managed by the National Resident Matching Program (NRMP). During their final year of medical school, students apply to residency programs using the Electronic Residency Application Service (ERAS). After interviews, both the applicant and the programs create a confidential rank-order list of preferences. The NRMP’s algorithm then processes these lists to pair applicants with programs.
Life as a surgical resident involves long hours, significant responsibility, and a steep learning curve. Residents work up to 80 hours per week, managing patient care and spending time in the operating room under the supervision of senior surgeons. As they progress, their autonomy and responsibilities increase. During the first year of residency, doctors also complete the final step of their licensing exams, either USMLE Step 3 or COMLEX Level 3, which assesses their ability to practice medicine without supervision.
Pursue a Fellowship for Sub-specialization
After completing residency, many surgeons opt for further training in a subspecialty through a fellowship. This one-to-three-year period allows a surgeon to develop highly specialized expertise in a specific area of surgical practice. This is the standard path for a general surgeon to become a specialist in a field like cardiothoracic surgery, pediatric surgery, or surgical oncology.
Surgeons pursue fellowships to focus on a particular type of surgery, patient population, or disease. For example, a general surgeon might complete a fellowship in colorectal surgery to focus on diseases of the intestine and colon. Another might pursue a fellowship in surgical critical care to manage critically ill patients in an intensive care unit. While not mandatory for all surgeons, a fellowship is necessary to practice in many of the most complex surgical fields.
Obtain Licensure and Board Certification
The final credentials required to practice independently are state licensure and board certification. A medical license is a legal requirement granted by a state medical board that permits a physician to practice medicine within that state. Licensure is obtained after graduating from medical school, completing at least the first year of residency, and passing all parts of the USMLE or COMLEX-USA exam series.
Board certification is a voluntary credential that signifies a surgeon’s expertise in their chosen specialty. It is granted by private specialty boards, such as the American Board of Surgery or the American Board of Orthopaedic Surgery. To become board-certified, a surgeon must have completed an accredited residency program, hold an unrestricted medical license, and pass rigorous written and oral examinations. While licensure sets the minimum standard to practice, board certification demonstrates a higher level of expertise.