How to Become a Surgeon

• Becoming a surgeon requires at least 13 years of training after high school.
• Most surgical specialties earn the sixth-highest median salary of any medical specialty.
• Surgeons must complete at least five years of residency.
• Surgeons can choose from 14 surgery specialties, including neurosurgery and orthopedics.

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, the steps you need to take.

What Is a Surgeon?

Surgeons are responsible for diagnosing and treating conditions that require operations. Both physicians and surgeons complete medical school and obtain a doctor of medicine (MD) or doctor of osteopathic medicine (DO) license. However, surgeons specialize in treating injuries, disabilities, diseases, and deformities that require surgical procedures.

Common conditions that require a surgeon's care include

• Appendicitis
• Cancerous tumors
• Heart attacks
• Broken bones
• Torn ligaments
• Cleft palates
• Hernias

Surgeons may work in a hospital or private practice, spending the majority of their 12-28 hour shifts in the operating room. Surgeons may also remain on-call during off hours. Specialized practitioners include general, critical care, orthopedic, and neurosurgeons.

Surgery Not For You? Check Out These Related Careers

What Are the Steps to Become a Surgeon?

Most aspiring surgeons spend at least 13 years on the path to becoming a surgeon. 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

Aspiring doctors and surgeons should consider high school AP courses in subjects like chemistry, biology, and physics. High school students who can devote their time and effort to additional AP courses might take AP anatomy or AP physiology, where available. AP courses in these subjects are known to be especially challenging. But, they often prove to be worth it because AP students can opt out of some similar introductory college courses.

Step 2: Earn a Bachelor's Degree

Aspiring surgeons must earn a bachelor's degree. These programs emphasize essential skills like discretion, communication, and teamwork. You can enroll in your school’s pre-med program to ensure you take the right credits in the right subjects. 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 filled with STEM and English courses. Required courses may include:

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

Because surgeons need so 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

No matter your major, you need experience before applying to medical school. 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 as serious if they have practical experience.

Taking a "gap year" between completing a bachelor's program and starting a medical degree can build personal character and inspire 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

Any student planning to attend medical school 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. Students should take the MCAT in the calendar year before the year they plan to apply to medical school.

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 students have taken the MCAT, they 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: Students 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, during the third year, students transition from the classroom to clinical training. They have a schedule of rotations in various specialties and work alongside other healthcare providers as members of a patient care team.

  Attending physicians supervise the students as they 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. Students may have some flexibility with their rotations based on their interests, needs, and other responsibilities.

• Fourth Year: The fourth year is typically less structured and provides more opportunity for students to hone their skills and take additional elective coursework. This is also when they choose their specialty and apply to residency programs through the National Resident Matching Program (NRMP). On Match Day each year in March, students learn where they will start their residency training.

The next step in becoming a surgeon is attaining your medical license. While licensure is listed as Step 6 of this guide, 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 a licensure path to share with you. The two most common licensing exam pathways often look like:

• MD students take the United States Medical Licensing Examination (USMLE), and DO students take the Comprehensive Osteopathic Medical Licensure Examination (COMLEX).
• Both licensing exams are composed of three steps:
  • Step 1 typically occurs during the second year of medical school and covers the fundamental science for the practice of medicine.
  • Step 2 occurs during the third or fourth year and is more specific to clinical skills and clinical knowledge gained during rotations
  • Step 3 is more comprehensive and detailed in the practice of medicine. Students complete it in the first or second year of residency — after they have graduated from medical school.
  • Both the USMLE and COMLEX are similar in structure. However, the COMLEX also includes osteopathic manipulation questions
• The USMLE fees: Step 1 - $1,000, Step 2 - $1,000, Step 3 - $925 *
• The COMLEX is $715 per exam according to the NBOME (National Board of Osteopathic Medical Examiners)
• 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. In the U.S. some specialties, like obstetrics, start their surgical residency in their specialty.

To get into a surgical residency program — the Match Day mentioned above — 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.

Accredited surgical residency programs cannot require residents to work more than 80 a week. However, programs in surgical specialties can apply for an extension to increase the weekly limit to 88 hours per week.

Surgical residencies can be more taxing than other types of clinical experiences. 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, cardiothoracic, and neurological surgery.

Fellows have already passed the USMLE or COMLEX and received a medical license. They tend to earn more than surgical residents. Fellowships can last for one to three years.

Candidates must have completed a residency training program approved by the Residency Review Committee and accredited by the Accreditation Council for Graduate Medical Education. 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

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.

Board certification demonstrates a surgeon’s commitment to professionalism, lifelong learning, and quality care.

According to the American College of Surgeons, board certification is regulated by the American Board of Medical Specialties (ABMS) and includes 24 medical and surgical specialty boards.

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

• 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.

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.

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 describe what types of patients you see and conditions you treat?

Sure. I'm a general and colorectal surgeon, and so I generally see anyone -- mostly adults, 18 years of age or older. I do see some pediatrics, meaning usually people 13 years or older as well, occasionally.

The types of things that I treat. . .are hernias, and there are different types of hernias, like umbilical hernias, inguinal hernia -- which is a groin hernia. People who have hernias after previous operations.

I treat gallbladder disease if someone has gallstones or if the gallbladder's not squeezing right. Take out the appendix. I deal with colon cancers, inflammatory bowel disease such as Crohn's disease and ulcerative colitis, skin cancers like melanoma and squamous and basal cell cancers. And then with the colorectal surgery, I also do things like hemorrhoids and fistulas and things like that.

Could you tell me what your work day can look like? I know it's not going to be typical, but describe what that day can look like.

So right now, the average day starts for me somewhere around six or 6:30 [a.m.]. I'll typically wake up and start my day going to the hospital. I work at two different hospitals. And so I might have patients at both of them.

I'll usually go to one hospital and see my patients there, ask them how they're doing, and make any changes to the plan that I need to. And then I'll go to the other hospital and do the same thing.

I try and get all that stuff done by about 7:30. And then two days a week I'm in the operating room. I have cases that are scheduled for people who come into my office, and we schedule those surgeries.

Then two days a week I have office [hours] where I see the patients who are referred to me by their primary care doctor, or they say, "I've got a lump or a bump here on my arm," and they just look up a surgeon and they come and see me. And then my day, on average, is usually done by about five o'clock.

So you are a doctor of osteopathic medicine (D.O.), which is different from a medical doctor (M.D.). Could you explain some of the differences in your experience versus what it would've been if you had become an M.D.?

So both of them, D.Os and M.Ds are both medical doctors, and we describe them differently. Osteopathic physician and an M.D. is an allopathic physician, and that's how we really distinguish them. So yes, it says medical doctor, the M.D. as part of their name, but we're both considered medical doctors. It's just osteopathic, allopathic.

Now, as a patient, you probably won't know the difference at all. The medical school training that we go through is almost exactly identical, same exact training. 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. As a patient though, I don't think you would know a difference at all.

For someone who wants to understand in case they want to become one or the other, how would you explain the difference between the two?

The main difference would be that the osteopathic physicians go through an extra couple thousand hours of specifically diagnosing musculoskeletal disease and treating it. If you come into 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. Kind of like what a chiropractor does, or massaging or different ways that we move it to try and get it back into place.

That would be the main difference. It's kind of a nuanced question too, because up until a few years ago, the schooling and everything -- the boards and everything -- 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. It used to be a lot more separated. Now it's becoming more together under the same umbrella.

This might've been different if you knew what your specialty was going to be before you got to this point, but how did that process guide you through to becoming a surgeon and applying for residency?

I'm what you call a nontraditional; 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.

That being said, when I started medical school with a paramedic background, I thought that I was going to do emergency medicine. That was my plan going through. And one of the things that we do is you meet with other people that you're in school with and you kind of find shared things. Who else wants to do emergency medicine?

We had all these interest groups, so the emergency medicine interest group, the neurology interest group, where we would have these extracurricular groups where you'd find an emergency physician in the community and have them come in and talk. And we would do different things as a group because that's what we wanted to do, and all of the professors, instructors, the doctors who are teaching you, they all have had specialties and so you can speak with them.

When you're in your third and fourth year, you do what are called rotations where you go through different specialties to learn, essentially. You need to learn all the different specialties. So you rotate through internal medicine and neurology and nephrology and surgery, gastroenterology, pediatrics, because you need to learn it all.

But the other benefit of that is you get to see all the different specialties of medicine -- or a lot of them, I should say -- and you can decide what you do and don't like. I knew very early on I didn't want to do pediatrics. I knew that even if I was going to do medicine, I didn't want to do nephrology or something.

So that way you can use it to rule out [specialties]. How I came to surgery was I did my surgery rotation at a small community hospital in St. Pete, Florida, which had about -- I think it was a 300 bed hospital, so a smaller size hospital.

And there were no residents there, no trainees. And so it was just me and the surgeons who were doing the operations. And so 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. And it was just so cool. I got to do a lot of stuff as a med student. And it was just amazing.

I liked that you can immediately help someone by taking out the appendix or taking out the gallbladder or someone who has a hernia that's been bothering them for years, and you fix it. And so you get that real quick gratification.

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. And so that's when I knew I wanted to change to surgery.

One of the surgeons told me that when you're in the emergency department and someone comes in who needs surgery, you call the surgeon and then they wheel them out of the emergency department, and the surgeon takes care of it. And they told me, "I get the feeling that you're always going to be wondering what happens, or you're always going to have wanted to be the person who takes them and figures out what's going on, rather than the one who just waves that goodbye at them." And so that's when I decided.

Some other people, I think they knew right away exactly what they wanted to do. They started med school, they're like, "I want to do cardiology. My dad's a cardiologist. My brother's a cardiologist." And there's some people who have those notions. I saw plenty of people who knew for certain, 100% sure that they wanted to do a specialty, and they didn't end up doing it. They found out they liked something else. And so I think it's just a learning process along the way.

So, you had a residency and a fellowship, and one thing that's hard to tell for someone who hasn't been through that is, what's the difference? And I guess what is the point of both of them?

Another part to that, that I get asked a lot is: "Are you a doctor when you graduate med school?" Or they think because you haven't passed residency that you're not a doctor yet. And that's not true.

As soon as you graduate medical school, you are a doctor, period. Now that being said, hospitals and places aren't going to hire you because you have no formal training. You're just a med student, and that's it. No hospital is going to hire "just a med student" out there to take care of patients because they haven't learned. Really, residency is where you learn the specialty that you decided to go into. And it depends on which residency you go into, how long it is. For general surgery, it's five years. For internal medicine, it's three years. For primary care, I think it's three years.

For orthopedic surgery, I think it's five years. And neurosurgery I think is six or seven years. And so that's just kind of the curriculum that they've determined how long you need to go through the training throughout those years. Then you have the internal medicine specialty such as gastroenterology, nephrology, and any of the other ones. In order to do those, you have to do internal medicine first.

So gastroenterology, nephrology, and then what I did -- colorectal surgery -- that's what we call a fellowship. So your basic training is your residency, and you can be done after that. If you go see an internist or primary care doctor, they just did their three years and finished their training. Similarly, I could just do my five years of general surgery, go out and I'm a board-certified general surgeon. Now, on top of that, you can do specialty training, which is what a fellowship is.

And that's what I did. Colorectal surgery, which is a one year fellowship or one year of specialty training where I do specifically colorectal surgery -- meaning colon surgeries, bowel surgeries, anal-rectal surgeries, which is the hemorrhoids and the fissures and fistulas, things like that.

The fellowship is the more specialized version of the general medicine, general surgery. And the fellowships are different lengths as well. Colorectal surgery is one year, cardiac surgery is two years. Cardiothoracic surgery is three years, plastic surgery, three years. A lot of my friends who went on and did those, we all did our five years together. I did one extra year, and someone that goes and does plastic surgery, they do three extra years. So their training is a total of eight years, mine was six years.

Is there anything else you would say to someone considering a career as a surgeon or about your medical training or your career as a surgeon?

I think my best piece of advice is: Reach out to a surgeon. I think the majority of them are very, very open and willing with someone who is eager about it and wants to learn more about it, and potentially do it if they know someone who knows a surgeon or they have a surgeon in the family.

Or I think 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?," they'd be very open and willing to do that.

I think getting experience too, because I've seen a lot of people who want to do surgery and decide that 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.

What to Know Before Becoming a Surgeon

Accreditation

Students should consider pre-med or bachelor's programs only from accredited schools. The U.S. Department of Education (ED) oversees institutional accreditation, which ensures a program meets national standards of higher education and career preparation.

Medical schools require accreditation through the Liaison Committee on Medical Education, recognized by ED as the accreditation standard for programs leading to MD licensure.

It is important that students obtain their degrees through accredited programs because:

• Students at accredited colleges tend to receive a consistently higher-quality education than those at unaccredited schools.
• It is easier to transfer credits. Many colleges do not recognize credits for classwork from unaccredited colleges.
• Your medical school may not recognize your undergraduate degree if your undergraduate program is not accredited.
• To be eligible for federal financial aid, whether it be a grant, loan, or work study, students must attend an accredited program.
• You must attend and graduate from an accredited medical school to sit for the USMLE or the COMLEX, become a licensed medical doctor, and practice surgery.

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 — as noted in the graph below — and also have the longest residency.

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

Everything Else You Need to Know about Becoming a Surgeon

What degree do I need to be a surgeon?

Surgeons need a bachelor’s degree and a medical degree to become licensed to perform surgery. Before applying to medical school, they must first complete a bachelor's degree and take the MCAT. Most aspiring surgeons choose an undergraduate major in biology, biochemistry, or human physiology.

Aspiring surgeons learn about medical practice and policies during their first two years of medical school. Then, they focus on clinical rotations and surgical experience in the final two years.

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. Students must complete a four-year bachelor's degree and four years of medical school. Surgeons also spend at least five years in a residency program. Then, if they want to specialize further, surgeons must complete a fellowship of 1-3 years.

Students may take longer to become surgeons if they take one or two years off between their 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.

How much does it cost to become a surgeon?

Not only does becoming a surgeon require a large time commitment and dedication to learning, it comes with a significant financial burden.

When you factor in the cost of an undergraduate degree, a graduate degree, fees for the MCAT exam, USMLE exam, medical school applications, and board certification, students could spend an average of at least $307,020 to an average of more than $641,720.

There are several factors to consider when planning your college experience:

• On-campus vs. off-campus
  • The average room and board on campus at a four-year public in-state school was $26,027 for the 2021-2022 academic year.
  • Public school vs. private school contributes to tuition charges
  • Off-campus can vary depending upon location and if you have roommates but is usually similar
  • However, four-year public school students who live with family and don't have to pay rent can save around $15,000 per year
• In-state vs. out-of-state
  • In-state tuition at a 4-year public institution is on average 25% cheaper than out of state tuition based on NCES data from 2021-2022
    • Average yearly tuition for medical school is around $57,574
    • Total med school costs could come in between $159,620 - $256,412 total depending on if the school is private or public
• Public vs. private
  • Total med school costs could come in between $159,620 - $256,412 depending on if the school is private or public
• Other factors impacting cost include: number of medical schools students apply to, the cost of transportation and books, and exam fees for the MCAT, USMLE and board certification

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. However, students 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.

How much does a surgeon make?

Surgeons are the top earners among medical specialties. The top five earners are surgical specialties with average salaries ranging from $557,630 for vascular surgeons to $788,313 for neurosurgeons based on the 2023 Physician Salary Report. Patient population, practice type, geographical location, and years of experience affect how much surgeons make

Page last reviewed on October 17, 2023