Overview
Plastic surgery is the craft specialty of soft tissue: microsurgical free-flap reconstruction after cancer, hand and peripheral nerve surgery, burns, craniofacial work, complex skin cancer of the head and neck, and, in private practice, aesthetic surgery. The breadth is unmatched: one week can span replanting a finger, a DIEP flap breast reconstruction and a facelift.
Selection sits alongside orthopaedics and neurosurgery at the sharpest end. Small intakes (19 nationally for 2026), heavy research expectations and multi-year unaccredited apprenticeships are the norm.
The pathway
- PGY1–2Surgical terms incl. plastics if possible; GSSE prep; first research projects (skin cancer databases are productive).
- Unaccredited plastics registrar (PGY3–6)2–4 years typical, trauma hands, burns, skin lists; build referees inside plastics units.
- ABPRS SET selectionGSSE + application → structured CV, referee reports, national interview → very small national intake (19 for 2026).
- SET 1–5Rotations across recon, hands, burns, craniofacial, paeds; fellowship exam near the end.
- FRACS (Plast) → fellowship → consultantMicrosurgery/hand/aesthetic fellowships common, then mixed public-private consultant practice.
Formal requirements
- General (unconditional) AHPRA registration and Australian or NZ citizenship / permanent residency.
- Completion of PGY1 and PGY2 by the time training starts (most successful applicants are well beyond this).
- GSSE pass before applying: the Generic Surgical Sciences Examination is now an eligibility requirement at application for the SET specialties (confirm timing rules for your specialty in the current Guide to Surgical Selection).
- Registration for selection (fee) late in the prior year, then a formal application early in the selection year, strict documentation and verification rules; late or unverifiable CV items are struck out.
- Limits on attempts: most specialty boards cap the number of times you can apply (commonly 3–4 valid applications); check the specialty regulations before you 'burn' an early application.
- Substantial plastics experience expected, competitive applicants have multiple unaccredited plastic surgery registrar terms.
- Application caps apply (check the current ABPRS selection regulations).
Selection and points
How selection works
| Component | What it involves |
|---|---|
| Structured CV | Scored against a published specialty matrix, research, higher degrees, presentations, courses, rural service and specialty experience. Every item must be verifiable. |
| Structured referee reports | Usually the heaviest single component. Referees are commonly drawn from ALL recent terms or from specialty consultants you nominate; scores are averaged and standardised. |
| Semi-structured interview | Scenario-based stations (judgement, communication, conflict, ethics), not primarily a knowledge test. Only shortlisted applicants are interviewed in most specialties. |
Points & scoring
- CV matrix: publications, higher degrees, presentations, courses (incl. microsurgery courses), teaching, rural service.
- Referee reports from plastic surgeons weigh heavily; the interview is scenario-based and heavily preparation-sensitive.
The unofficial view
- The typical successful applicant has 2+ unaccredited plastics years, multiple publications, a microsurgery course, and consultants actively championing them.
- Hand surgery exposure (plastics or ortho hand units) is a respected differentiator and a useful hedge.
- Because intakes are tiny, a single strong unit's support can carry you, and a single lukewarm referee can end a cycle. Manage relationships accordingly.
Competition & demographics
Competitiveness
- 19 appointed nationally for 2026 (ASPS/RACS, verified) against far larger applicant pools, success rates in the ~15–20% range are typical (indicative).
- Multiple application cycles are the norm; median entry PGY5+.
Who's in the program
- Among the more gender-balanced surgical intakes in recent years (~40–50% women).
- Training posts concentrated in metro tertiary centres with burns/microsurgery services.
Exams
| Exam | When | Format | Cost | Pass rate |
|---|---|---|---|---|
| GSSE (Generic Surgical Sciences Examination) Score matters in some specialties' shortlisting, not just the pass; check your specialty's rules. | Before applying to SET (sit PGY2–4 for most people) | MCQ papers covering anatomy, physiology and pathology, a large basic-sciences exam similar in scale to a college primary | ≈ $5,500 | Roughly 50–70% per sitting depending on cohort (indicative) |
| Fellowship Examination FRACS (Plast) | Final training years | Written + vivas + clinicals | ≈ $10,500 | ≈ 70–85% (indicative) |
Fees and pass rates are indicative; check the college's current fee schedule and exam reports.
What training costs
- Selection registration + application fees ≈ $800–1,000 per attempt.
- GSSE ≈ $5,500 per sitting.
- Annual SET training fee ≈ $10,000–11,500 per year once on the program (the single most expensive training program in Australia).
- Mandatory RACS skills courses before/early in SET: ASSET, EMST (≈ $3,000–3,800 each), CCrISP and others per specialty.
- Fellowship examination ≈ $10,500, plus courses; most trainees also spend $5,000–20,000 on exam prep and interstate travel across training.
How to improve your chances at each stage
StageMedical student
- Get into a skin cancer, burns or microsurgery research group; plastics units publish prolifically and take students.
- Learn suturing to a high standard, plastics interns/residents are judged on wound closure from day one.
StageIntern (PGY1)
- Chase plastics, hand and burns terms; do a suturing/flap course.
- Start GSSE prep and get a first publication moving.
StageResident (PGY2–3)
- Unaccredited plastics reg jobs (including regional skin-cancer-heavy posts) build logbook and referees.
- Do a recognised microsurgery course; present at ASPS/state meetings so the small community knows your face.
StageRegistrar years & applications
- Diversify referees across 2+ plastics units; keep verification-grade records of everything.
- Interview coaching matters at this level of competition; treat it like a fellowship exam.
StageIf you don't get on (or change your mind)
- Adjacent paths: general surgery → breast/melanoma; ENT (facial plastics overlap); dermatology (procedural/Mohs, different selection but same territory); GP with skin cancer surgery focus.
See also the general strategy guide: universal CV, referee and interview advice that applies across specialties.
Job market & workforce outlook
Outlook: Public reconstructive posts limited and fractional; private demand (skin cancer, hand, cosmetic) strong, regulation of the cosmetic sector is tightening in plastics' favour
- Public reconstructive appointments are limited, fractional and metro-clustered; burns and hand call rosters need staffing, which sustains some public demand.
- Private practice demand is strong across skin cancer, hand and aesthetic work; recent cosmetic-industry regulation (endorsement rules) has strengthened the position of FRACS plastic surgeons.
Income
- Within the ATO top 'surgeons' category; private plastic practices span an enormous range. $500,000 to well over $1,500,000 for high-volume aesthetic practices (indicative).
- Reconstruction-weighted public careers earn standard staff-specialist packages; the cosmetic tail drives the headline numbers.
Pre-tax, indicative, and highly variable with hours, setting and billing model. ATO figures are averages of taxable income by reported occupation.
Subspecialties & special interests
| Area | Notes |
|---|---|
| Microsurgical reconstruction | Free flaps, breast recon, head & neck |
| Hand & peripheral nerve | Shared with orthopaedics |
| Burns | Statewide services, employed model |
| Craniofacial / paediatric | Children's hospital based |
| Aesthetic surgery | Private; fellowship training recommended |
International medical graduates
- Specialist IMGs apply through the RACS SIMG pathway for an assessment of comparability (substantially / partially / not comparable), then complete a period of oversight ± the Fellowship exam.
- Surgery is not yet on the expedited specialist pathway (as of early 2026), general surgery and ENT are flagged as priority candidates to be added next; check the Medical Board list for the current position.
Official links
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