How to Become a Surgeon

Surgeons play a critical role in medicine. They lend their specialized expertise to various diagnostic, preventative, and restorative procedures. You'll need a bachelor's degree, medical degree, and surgical residency to become a surgeon.

Skill-wise, you need dexterity, physical stamina, attention to detail, and problem-solving to succeed in this occupation. Learn more below about what surgeons do, what you need to know about becoming a surgeon, and the steps you need to take.

What Are the Steps to Become a Surgeon?

Becoming a surgeon takes least 13 years. Required steps include completing a four-year bachelor's degree, a four-year medical degree, and a minimum five-year residency requirement.

Other steps, like AP or honors classes in high school, gap years, and fellowship experience, differ depending on the student. Explore the academic and clinical requirements for becoming a surgeon below.

Step 1: Take Related AP Courses in High School

If you know you want to become a surgeon this early in the game, you should consider high school AP courses in subjects like chemistry, biology, and physics. If you can devote your time and effort to additional AP courses, AP anatomy or AP physiology would be helpful. Though challenging, they often are worth it because AP students can opt out of some similar introductory college courses.

Step 2: Earn a Bachelor's Degree

Becoming a surgeon requires a bachelor's degree. You can enroll in your school's pre-med program. If your school does not have a pre-med program, you can still earn the credits you need to qualify for medical school.

Aspiring surgeons need a bachelor's degree with required STEM and an English course. Required courses may include:

• Organic chemistry
• Microbiology
• Psychology
• Anatomy and physiology
• English

Because surgeons need many science courses, many pre-med students major in a scientific field, such as biology, chemistry, or human physiology. You could major in a social science like public health or psychology instead, as long as you fulfill the prerequisite requirements for medical school.

Step 3: Gain Practical Experience in the Healthcare Field

Hands-on exposure through internships, shadowing, or volunteering in a healthcare setting is necessary to test-drive your chosen career. Additionally, medical schools only consider applicants if you have practical experience.

Taking a "gap year" between completing a bachelor's program and starting a medical degree can build personal character and develop maturity and professionalism. Students should inquire through their bachelor's program about potential medical assisting, critical care, or clinical internship placement after graduation.

Step 4: Pass the MCAT Exam

To go to medical school, you must first take the Medical College Admission Test (MCAT). The exam tests the skills of aspiring med students across four core concept areas:

• Biological and biochemical foundations of living systems
• Chemical and physical foundations of biological systems
• Psychological, social, and biological foundations of behavior
• Critical analysis and reasoning skills

The MCAT contains 230 multiple-choice questions and takes just over six hours to complete. You should take the MCAT the year before you plan to apply.

The Association of American Medical Colleges (AAMC) administers the test from January through September. AAMC also offers MCAT prep books and MCAT prep courses.

Step 5: Earn a Medical Degree

Once you take the MCAT, you can apply to medical school. Medical degree programs take four years. They train students in broad medical skills, introduce them to a variety of specialties through clinical rotations in their third year, and help students gain hands-on experience in their desired specialty.

• First and Second Year: You spend the first two years focusing on labs and pre-clinical training in subjects such as microbiology, biochemistry, anatomy, pharmacology, and pathology.
• Third Year: According to the American College of Physicians, you would transition from the classroom to clinical training. You have a schedule of rotations in various specialties and work alongside other healthcare providers as members of a patient care team. Attending physicians would supervise you as you gain hands-on experience in a variety of specialties and patient populations. Most programs recommend, but do not require, students take their rotations in a certain order.
• Fourth Year: This year is typically less structured to provide more opportunity for students to hone their skills and take additional elective coursework. This is also when you would choose your specialty and apply to residency programs through the National Resident Matching Program (NRMP). March is Match Day, where you would learn where you would start your residency training.

The next step in becoming a surgeon is attaining your medical license. Though licensure is Step 6, the process actually begins while you're still in medical school.

Medical students often take Step 1 of the exam(s) when they begin their clinical rotations, sitting for the exam the summer between their second and third years of med school.

Step 6: Prepare for Medical Licensure

Each state has their own rules for licensure, but many have a limited medical license that residency students can apply for directly after getting their residency match. This limited license allows practice under supervision.

While you're not expected to have your medical license when your residency starts, you'll need one by the time you conclude the residency. Once you know your residency match, your program may have its own licensure path. The two most common licensing exam pathways are the United States Medical Licensing Examination (USMLE) and the Comprehensive Osteopathic Medical Licensure Examination (COMLEX). DO students take the (COMLEX). Both are similar in structure, but the COMLEX also includes osteopathic manipulation questions.

Both licensing exams are composed of three steps:

1. Step 1 typically occurs during the second year of medical school and covers the fundamental science for the practice of medicine.
2. Step 2 occurs during the third or fourth year and is more specific to clinical skills and clinical knowledge gained during rotations
3. Step 3 is more comprehensive and detailed in the practice of medicine. You would complete it in the first or second year of residency after graduating from medical school.

USMLE fees are hefty. Step 1 and 2 are both $1,000, and Step 3 is $925 (scheduled to go up to $935 in 2025).* The COMLEX is $730 per exam.

You can take each step a limited number of times. For instance, If you have attempted a step four or more times and do not pass, you are ineligible to apply for any other steps in the USMLE sequence. You must pass Step 3 before applying to any State Medical Board

*There will be extra steps and fees if you're a graduate of a medical school outside the United States.

Step 7: Complete a Residency Program

Most surgeons complete a general surgery residency after they finish medical school. "Residency is where you learn the specialty that you decided to go into," said board-certified general and colorectal surgeon Dr. Kyle Eldredge. "How long it is depends on which residency you go into. For general surgery, it's five years."

Some specialties like obstetrics start their surgical residency in their specialty. Accredited surgical residency programs cannot require residents to work more than 80 hours a week. An important thing to keep in mind is that programs in surgical specialties can apply for an extension to increase the weekly limit to 88 hours.

To get into a surgical residency program, you'll participate in an algorithm-like process that matches you to a residency program. Most students begin applying to residencies in their final year of medical school, but the American Colleges of Surgeons recommends you familiarize yourself and start some steps of the process in your third year. A residency helps surgeons refine their acute operating skills and on-the-spot decision-making abilities. Surgical residencies last a minimum of five years, unless you go into dental or eye surgery.

Step 8: Begin a Fellowship Program

A fellowship helps surgeons gain experience in their chosen surgical specialty. Hospitals offer fellowships in surgical specialties like orthopedic, plastic, cardio-thoracic, and neurological surgery.

"The fellowship is the more specialized version of general medicine or general surgery," said Eldredge. "The fellowships are different lengths: Colorectal surgery is one year; cardiac surgery is two years. Cardiothoracic surgery is three years; plastic surgery is three years. So my training ended up being a total of six years. I could have just done my five years of general surgery, finish, and become a board-certified general surgeon. Instead, I decided to do specialty training, which is what a fellowship is."

Candidates can apply directly to some colleges or search for fellowships through an agency like the Fellowship Council.

Step 9: Become Board Certified in Your Surgical Specialty

Board certification is regulated by the American Board of Medical Specialties (ABMS) and includes 24 medical and surgical specialty boards. While surgeons may be able to get a job as a board-eligible surgeon, most reputable employers require surgeons to become board certified in a timely manner after they finish residency.

When applying, surgeons must provide detailed documentation of their training and operative experience. Additionally, the director of their training program must also attest to their surgical skills, ethics, and professionalism. If the application is approved, the surgeon may take the required exam for certification for their board.

The ABMS sets the eligibility criteria that physicians must meet to take certifying examinations in their specialty. To qualify, surgeons must meet the following requirements:

• Be graduates of an accredited medical school or have a certificate from the Educational Commission for Foreign Medical Graduates.
• Complete about five years of residency in their specialty from a program approved by the Accreditation Council for Graduate Medical Education or the Royal College of Physicians and Surgeons of Canada.
• Acquire extensive operative experience and a vast knowledge of disease management within their specialty.

What to Know Before Becoming a Surgeon

Cost

While college costs vary by school, students spent $9,680-$38,770 on undergraduate tuition and fees at four-year colleges in 2021-22, according to the NCES. If you get your bachelor's degree on campus rather than online, you could pay an average total of $15,550-$43,950 in room and board over four years.

Students must pay $335 to register for the MCAT before applying to medical school. Applying to medical school in 2024 requires an initial $175 application fee and $45 per additional school.

Once enrolled in a medical degree program, students at public colleges paid an average of $40,493 in first-year in-state tuition, fees, and health insurance for the 2023-2024 school year, according to the AAMC. Out-of-state students paid an average of $64,473 to attend a public university.

Salary

Across the spectrum of medical specialties, the top six highest-paid medical specialties are all surgical specialties. Among the top-paid surgical specialties, neurosurgeons are the top earners and also have the longest residency.

This graph shows the average compensation and does not necessarily include production bonuses and variations due to experience, patient population and geographical region.

Surgery Not For You? Check Out These Related Careers

Interview with a General and Colorectal Surgeon

Dr. Kyle Eldredge

D.O. General and Colorectal Surgeon

Dr. Kyle S. Eldredge is Board Certified by the American Board of Surgery and is a fellowship-trained colorectal surgeon.

Before attending medical school at Lake Erie College of Osteopathic Medicine, Dr. Eldredge spent four years caring for patients as a paramedic in central Florida. He completed his general surgery residency at Emory University in 2021, and a minimally invasive colorectal surgery fellowship at Emory University in 2022.

Dr. Eldredge is interested in research regarding surgeon performance and assessment during robotic surgery.

Currently, he is in private practice at Advanced Surgical Physicians and routinely treats or performs colorectal cancer and diseases, hemorrhoids, pilonidal disease, minimally invasive surgeries, and all general surgeries.

Dr. Eldredge has privileges at multiple Wellington and Royal Palm Beach, Florida hospitals and private practice. Learn more online at Dr. Kyle S. Eldredge, DO | Advanced Surgical Physicians.

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Can you explain the differences between an O.D. and an M.D.?

D.Os and M.Ds are both medical doctors, and we describe them differently. D.O. is an osteopathic physician and an M.D. is an allopathic physician – that's how we really distinguish them. We're both considered medical doctors. It's just osteopathic, allopathic.

As a patient, you probably wouldn't know the difference at all. The medical school training that we go through is almost exactly identical. The only difference is that with the osteopathic training, we also do a couple thousand hours throughout the four years of specific osteopathic manipulative medicine as we call it, treating musculoskeletal disease and diagnosing it and coming up with plans to treat it. Everything else in the school is exactly the same, and we can take some of the same tests during our training.

How would you explain the difference between an osteopathic and allopathic physician?

The main difference would be that osteopathic physicians go through an extra couple thousand hours of specifically diagnosing musculoskeletal disease and treating it. If you come to me and you say, "My back hurts, my hip hurts, my foot hurts," we're specifically trained to examine it, diagnose it, and treat it through different types of manipulation.

That would be the main difference. It's kind of a nuanced question too because up until a few years ago, the schooling and the boards were completely separate. They had different governing bodies for osteopathic and allopathic training. A couple years ago they joined those two. So it's all under one governing body, as far as the training goes for those two specialties.

How did you become a surgeon?

I was a nontraditional student, meaning I had a career, I was a paramedic for four years before I started medical school, so I didn't start medical school until I was 28 years old.

When I started medical school with a paramedic background, I thought I was going to do emergency medicine. When you're in your third and fourth year, you do rotations where you go through different specialties to learn, essentially. You need to learn all the different specialties, so you rotate through internal medicine, neurology, nephrology, surgery, gastroenterology, and pediatrics because you need to learn it all, but the other benefit of that you can decide what you do and don't like.

I did my surgery rotation at a small community hospital in St. Pete, Florida, which was a 300-bed hospital. There were no residents there and no trainees, so it was just me and the surgeons who were doing the operations. As a med student, I was right there, hands-on. The surgeons would take my hands and put it on there and do this, do that. It was just so cool. I got to do a lot of stuff as a med student, and it was amazing.

The other thing is I thought that the surgeons were the smartest doctors and hardest-working ones in the hospital. They got up before everyone else did. They knew every little detail about the equipment and the machines and everything that they were using. That's when I knew I wanted to change to surgery.

I knew some other people who knew right away exactly what they wanted to do. I saw plenty of people who knew for certain, what specialty they wanted to do, and they didn't end up doing it. They found out they liked something else, so I think it's just a learning process along the way.

Are there any pro tips you have for people considering a career as a surgeon?

My best piece of advice is to reach out to a surgeon. The majority of them are very open and willing to talk to someone they know who is eager about it, wants to learn more about it, and potentially do it.

Even reaching out to the office [of a surgeon] – I know if there was someone in high school or college who called the office and said, "Hey, I'm thinking about going into medicine. Is it possible if I could speak with Dr. Eldridge or someone else?", I'd be very open and willing to do that.

I think getting experience is important too, because I've seen a lot of people who want to do surgery and decide blood isn't for them. But I think just working hard when you can and getting exposed to it – I think [that] is probably the best thing.

Everything Else You Need to Know about Becoming a Surgeon

How long does it take to become a surgeon?

Aspiring surgeons spend between 13-18 years meeting the requirements to practice surgery in their desired specialty. You must complete a four-year bachelor's degree and four years of medical school. You would also spend at least five years in a residency program. Then, if you want to specialize further, you must complete a fellowship of 1-3 years.

It may take you longer to become surgeons if you take one or two years off between your bachelor's and medical degrees to accumulate field experience.

How many different types of surgeons are there?

The American College of Surgeons recognizes 14 surgical specialties:

• Cardiothoracic surgery
• Colon and rectal surgery
• General surgery
• Gynecology and obstetrics
• Gynecologic oncology
• Neurological surgery
• Ophthalmic surgery
• Oral and maxillofacial surgery
• Orthopedic surgery
• Otorhinolaryngology
• Pediatric surgery
• Plastic and maxillofacial surgery
• Urology
• Vascular surgery

Surgeons may also focus on performing open, robotic, or minimally invasive surgical procedures. They may operate in a large medical facility or hospital or an outpatient clinic, depending on their specialty.

What does surgeon training look like?

Many aspiring surgeons gain healthcare experience after graduating from a bachelor's program and before applying to medical school, but they officially begin hands-on medical training in the final two years of medical school. Here, they participate in clinical rotations with various medical specialties and complete internships, or supervised training with attending surgeons.

Upon graduating with a medical degree, aspiring surgeons enter into at least five years of surgical residency, where they practice under the supervision of an attending surgeon. Residency may include preparing patients for surgery, acting as "first assist" during operations, and providing post-operative care. Fellowships can offer 1-3 years of additional specialized surgical experience.

Note: The insights on this page were reviewed by an independent third party compensated for their time by BestColleges. Page last reviewed October 17, 2023.