The competition to enter in a medical school is extremely high. Make sure your MCAT scores are good. After medical school training, nearly 5 or 6 years of further training or residency is essential. After this, the surgeons are required to apply for fellowship in one special area. There are several specialties like hand surgery, craniofacial surgery, cutaneous malignancy surgery, aesthetic surgery, and breast reconstruction surgery. Depending on state laws, the surgeons also need to obtain licensing and certification.